As the world prepares to observe World Mental Health Day, the World Health Organization (WHO) and the Office of the High Commissioner on Human Rights (OHCHR) are collaborating to launch groundbreaking guidance titled “Mental health, human rights and legislation: guidance and practice.” This collaborative effort aims to assist nations in reforming their legislation to put an end to human rights violations within mental health care while enhancing access to high-quality services.
Sadly, human rights abuses and coercive practices continue to be pervasive in mental health care, often sanctioned by existing laws and policies. Involuntary hospitalizations, deplorable living conditions, and various forms of maltreatment persist within mental health services worldwide.
While many nations have made efforts to reform their legal frameworks, policies, and services since the adoption of the United Nations Convention on the Rights of Persons with Disabilities in 2006, progress has been slow, and far too few have made the necessary legal and policy amendments to eradicate abuses and promote human rights within mental health care.
A Fundamental Right: Mental Health as Integral to Health
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized, “Mental health is an integral and essential component of the right to health.” He further underscored that the new guidance will empower countries to institute the requisite changes to deliver quality mental health care that supports individuals’ recovery while upholding their dignity. This approach aims to empower individuals with mental health conditions and psychosocial disabilities to lead fulfilling lives within their communities.
Transforming Mental Health Services with a Rights-Based Approach
Volker Türk, UN High Commissioner for Human Rights, emphasized the need to overhaul mental health services, not only in terms of their reach but also in terms of their core values, making them genuinely responsive to individual needs and dignity. He stated, “This publication offers guidance on how a rights-based approach can support the transformation needed in mental health systems.”
Promoting Community-Based Mental Health Care
One critical aspect of the guidance is the promotion of community-based mental health care. While a significant portion of government expenditure on mental health goes to psychiatric hospitals (43% in high-income countries), evidence suggests that community-based care services are more accessible, cost-efficient, and effective compared to institutional models of mental health care.
The guidance outlines the necessary steps to accelerate deinstitutionalization and adopt a rights-based community approach to mental health care. This includes replacing psychiatric institutions with inclusive community support systems and integrating essential services like income support, housing assistance, and peer support networks.
Ending Coercive Practices
The guidance also addresses the pressing need to end coercive practices in mental health, such as involuntary detention, forced treatment, seclusion, and restraints. These practices infringe on individuals’ rights to make decisions about their healthcare and treatment choices.
Research has shown that coercive practices have detrimental effects on both physical and mental health, exacerbating existing conditions and isolating individuals from their support systems. The guidance proposes legislative provisions to end coercion in mental health services, placing free and informed consent at the core of all mental health-related interventions.
A Rights-Based Approach for All
Recognizing that mental health is not solely the responsibility of the healthcare sector, the guidance is intended for all legislators and policymakers involved in drafting, amending, and implementing legislation related to mental health. This includes laws addressing poverty, inequality, and discrimination.
Moreover, the guidance provides a checklist for countries to assess whether their mental health-related legislation aligns with international human rights obligations. It emphasizes the importance of consulting individuals with lived experience and their representative organizations as a crucial part of this process, as well as the significance of public education and awareness on rights-based issues.
While the guidance offers a set of principles and provisions that can be incorporated into national legislation, countries have the flexibility to adapt and tailor these to their unique circumstances without compromising human rights standards.
This joint effort by WHO and OHCHR signifies a significant step forward in the global pursuit of mental health rights, aiming to create a world where every individual, regardless of their mental health condition, can access quality care and live a life of dignity and empowerment within their communities.
