June 8, 2017
At the Thirty-fifth session of the Human Rights Council (June 6-23, 2017), the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health presented his latest report, focusing on mental health as a global health priority.
In this report, the Special Rapporteur calls for a paradigm shift in mental health policies, moving away from a strict biomedical approach to an approach in which the social and underlying determinants of mental health are also addressed, among others by the prioritization of mental health promotion and prevention in public policy.
Conclusions (excerpt from the report)
“Mental health has often been neglected and when it does receive resources, it becomes dominated by ineffective and harmful models, attitudes and imbalances. That has led to the current situation of the grossly unmet need for rights-based mental health promotion and care. People of all ages, when they have mental health needs, too often suffer from either an absence of care and support or from services that are ineffective and harmful.
The failure of the status quo to address human rights violations in mental health-care systems is unacceptable. As mental health emerges as a policy priority, it is crucial now to assess the failure to chart a better way forward, reaching consensus on how to invest and how not to invest.
An assessment of the global burden of obstacles alarmingly suggests their burden may be heavier than any burden of “mental disorders”. The crisis in mental health should be managed not as a crisis of individual conditions, but as a crisis of social obstacles which hinders individual rights. Mental health policies should address the “power imbalance” rather than “chemical imbalance”.
The urgent need for a shift in approach should prioritize policy innovation at the population level, targeting social determinants and abandon the predominant medical model that seeks to cure individuals by targeting “disorders”.
Today, there are unique opportunities for mental health. The international recognition of mental health as a global health imperative, including within the 2030 Sustainable Development Agenda, is welcome progress. The right to health framework offers guidance to States on how rights-based policies and investments must be directed to secure dignity and well-being for all. To reach parity between physical and mental health, mental health must be integrated in primary and general health care through the participation of all stakeholders in the development of public policies that address the underlying determinants. Effective psychosocial interventions in the community should be scaled up and the culture of coercion, isolation and excessive medicalization abandoned.
There are already promising initiatives in place throughout the world, including in low- and middle-income countries, which challenge the status quo. Creating the space, through strong political leadership and resources, to enable those practices to take shape in communities is a powerful means to promote and advance the changes needed.
The Special Rapporteur seeks to develop, through an inclusive and participatory process and open dialogue, guidelines on human rights and mental health to support all stakeholders in the implementation of rights-based mental health policies in their respective areas of work. He welcomes contributions and suggestions in this respect.”