The use of mechanical restraint is a common practice in psychiatric care, often defended by medical necessity but seldom questioned from a human rights perspective. The purpose of this thesis has been to investigate under which circumstances mechanical restraint by bed through belt fixation could amount to torture and other cruel, inhuman or degrading treatment or punishment. Persons with psychosocial disabilities are in a particularly vulnerable situation and as the International Convention on the Rights of Persons with Disabilities (CRPD) is the most comprehensive rights framework for this group, it has been discussed whether the CRPD sets out additional safeguards in relation to restraint.  A legal doctrinal approach is the basic methodology used in order to outline the current international and European legal framework on torture and other ill-treatment and disability rights. A survivor-controlled research methodology has been applied and to amplify other voices of persons with firsthand experience of being mechanically restrained, interviews have been conducted with persons from Sweden and Spain. Healthcare professionals have also been interviewed. A feminist perspective on the law is applied.  Different international conventions and bodies of the United Nations have diverse interpretations on what acts or omissions that amount to torture and other cruel, inhuman or degrading treatment or punishment, although there is an aim and will to streamline the conventions. It is clear that the use of mechanical restraint can create such intense mental or physical suffering required to reach the common criterion of seriousness. However, some people do not experience the required levels of suffering for it to be considered torture, meaning that it might not amount to torture but rather other ill-treatment. The threshold for being considered torture according to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (UNCAT) seems to be somewhat higher than that of the International Covenant on Civil and Political Rights (ICCPR) and the European Convention of Human Rights (ECHR). In this thesis it was found that the most critical element for this is the requirement of intent. Intent can however be implied under certain circumstances if the practice is of discriminatory nature. If a person has a psychosocial disability, intent might be presumed if States do not provide appropriate health care. In the case of girls and women, intent might also be presumed since they seem to have a higher risk of getting restrained for unlawful reasons.  The main conclusion in this thesis is that mechanical restraint by bed through belt fixation could amount to torture or other cruel, inhuman or degrading treatment or punishment according to the UNCAT, ICCPR and ECHR.

This dissertation is concerned with the under-researched subject of supporting people with learning difficulties to be in control of their own self-advocacy group while undertaking self-directed research. Guided by the social model of disability and emancipatory disability research principles I supported a group of people with learning difficulties within a self-advocacy organisation throughout the course of their own self-directed research project. At the same time, drawing upon various sources of data, I reflexively studied and analysed my own support practice, constructing the critical ethnography that is this dissertation. There were two purposes for working in the above way: (a) to provide the most effective support I could for the researchers to gain and maintain control of their research group and (b) to analyse the processes and challenges involved in providing support for self-directed self-advocacy group members and researchers (in order to develop the literature in this area). Analysis of data revealed the following. Supporting self-directed researchers with learning difficulties requires a broad range of involved, interconnected interpersonal support skills. Working in this way can present supporters with unforeseen time-consuming tasks as well as intellectual and psychological challenges as they respond to the needs and requests of the supported group. Supporting people with learning difficulties to be in control in this way, where the balance of power is actively weighted in their favour, is not only complex it can lead to the supporter facing institutional pressures to assume control over the group, feelings of psychological discomfort or stress and ethical dilemmas. Anaysis of the data led me to conclude that drawing specific boundaries around supporter behaviour and monitoring or developing an actively non-authoritarian practice through a process of critical reflection can be an important aspect of providing consistent and effective support for self-directed researchers with learning difficulties.