regimes based on another person making decisions for someone, such as guardianship, wardship, or laws on mental health that allow forced treatment, should be abolished. 253 128. The CRPD Committee has held emphatically that regimes based on substitute decision-making and denial of legal capacity have had a detrimental impact and continue to have a disproportionate detrimental impact on persons with disabilities, especially those with a cognitive or psychosocial disability. 254 At the same time, many states maintain a medical conception of persons with disabilities, on considering them as objects of rights and as unable to make decisions for themselves. The then-U.N. High Commissioner for Human Rights indicated that under that conception guardians, wards, or representatives of persons with mental disabilities are appointed who on many occasions abuse their position of authority. 255 129. The CPRD Committee has held that the model of support for adopting decisions of the person with disabilities should take into account the following elements: States parties have an obligation to provide persons with disabilities with access to support in the exercise of their legal capacity. States parties must refrain from denying persons with disabilities their legal capacity and must, rather, provide persons with disabilities access to the support necessary to enable them to make decisions that have legal effect. Support in the exercise of legal capacity must respect the rights, will and preferences of persons with disabilities and should never amount to substitute decision-making.… [S]afeguards must be present in a system of support in the exercise of legal capacity…. The primary purpose of these safeguards must be to ensure the respect of the person’s rights, will and preferences. In order to accomplish this, the safeguards must provide protection from abuse on an equal basis with others. 256 130. Based on what is indicated, the states should examine the laws that regulate wardships and guardianships and take measures to draw up laws and policies to replace the basic regimes of substitution decision-making by providing support for decision-making that respects the autonomy, will, and preferences of the person. 257 131. The European Court has noted that the states should provide persons with disabilities resources that make it possible to challenge any limitation on their right to legal capacity. 258 132. Among the violations that may arise, the IACHR highlights institutionalization in psychiatric institutions of persons who have a mental health disorder or condition without their consent, forced medical treatment, and the impossibility of living a life in community. In these situations, institutionalization may itself end up being the conditioning factor for a mental health disorder or condition to become a disability, precisely because of building a barrier in the terms of the social approach already referred to. 2.2 General considerations on institutionalization and the right to personal liberty United Nations, Committee on the Rights of Persons with Disabilities, General Comment No. 1. Article 12: Equal recognition before the law, May 19, 2014, para. 7. 254 United Nations, Committee on the Rights of Persons with Disabilities, General Comment No. 1. Article 12: Equal recognition before the law, May 19, 2014, para. 9. 255 United Nations, High Commissioner for Human Rights. From Exclusion to Equality: Realizing the rights of persons with disabilities. Geneva: United Nations. 2007, p. 97. 256 United Nations, Committee on the Rights of Persons with Disabilities, General Comment No. 1. Article 12: Equal recognition before the law, May 19, 2014, paras. 16, 17, and 20. 257 United Nations, Committee on the Rights of Persons with Disabilities, General Comment No. 1. Article 12: Equal recognition before the law, May 19, 2014, para. 26. 258 ECHR (European Court of Human Rights), A.N. v. Lithuania. Judgment of August 31, 2016, para. 90. 253 22