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Mainstreaming the Human Right to Mental Health

Building synergies across mental health policy, care, and research.

Key points

  • Human rights scholar argue that everyone has a right to mental health, which corresponds with the duty of states to provide for its realization.
  • The mainstreaming of the right to mental health has redefined the contours of mental health policy, care, services, and research.
  • Cross-sector interactions are the way forward toward new approaches and narratives on mental health.

Mental health is a global priority, and states and stakeholders are taking steps toward advancing a human right to mental health for all (APA, 2018). This is evidenced by international studies, initiatives, declarations, and domestic policy interventions.

From a right-based perspective, mental health is not the mere absence of a psychiatric condition or psychosocial disability (WHO, 2022). It speaks of an environment in which individuals live a life of dignity.

The application of human rights principles to mental health allows us to incorporate novel ideas about the role of all stakeholders in fostering the security, freedom, justice, and dignity of individuals. With this point of view in mind, many states are revisiting their mental health laws and governance practices.

Policy Interventions: Five Objectives

Broadly, most mental health policy interventions are led by five objectives: protection, promotion, creation, reform, and cooperation.

1. Protection

To protect means to protect persons from harmful activities and ensure that persons with mental illness, mental disability mental health problems are not discriminated against based on their mental health status (WPA, 2016).

2. Promotion

To promote means to bring mental health in parity with physical health in national policies and budgets or medical education and practice (Special Rapporteur, 2017). It includes promoting a humane and dignity-based approach to understanding mental health, reflecting the needs of vulnerable groups based on ethnicity, religion, sexual orientation, gender identity, migration status, age, detention status, and disability.

3. Creation

This objective requires the creation of specific rights and institutional mechanisms to support the right to mental health.

Mental health policies in different states have recognized specific rights. These rights include, among others, the right not to be discriminated against on the ground of mental illness; freedom from arbitrary detention; the right to information about health services; mental health assessment during detention; the right to be protected from mental health risks; the right to justice for violations; the right to legal representation; the right to available, accessible, acceptable, and good quality care; and so on.

4. Reform

To reform means to repeal or amend existing laws, policies, and approaches that currently lead to negative mental health impacts.

5. Cooperation

Cooperation involves supporting and strengthening global partnerships and those between different actors—including civil society groups, the private sector, psychologists, social workers, nurses, users of services, and those living in poverty and the most vulnerable situations. (Special Rapporteur, 2017).

Deepa Kansra/Canva
Source: Deepa Kansra/Canva

Mental Health Care and Services: A New Narrative

In furtherance of the right to mental health for all, approaches to health care and services have undergone a paradigm shift. In 2017, the UN Special Rapporteur on the right of everyone to enjoy the highest attainable standard of physical and mental health emphasized a new narrative for mental health based on non-coercion and the liberation of those using mental health services from isolation,...and discrimination.

The call for a new narrative received widespread attention and has been interpreted by other stakeholders to involve:

  • The advancement of a holistic, coherent, scientific, humane, and psychological vision that offers care rather than coercion, fights for social justice, equity, and fundamental human rights, and establishes the social prerequisites for genuine mental health and wellbeing (British Psychological Association, 2017).
  • Benefitting from the improvements in psychiatric treatment standards and approaches. (ECNP, 2017).

  • The balancing of psychosocial interventions and other treatment alternatives such as self-care techniques or community-led interventions like psychoeducation to provide information, and knowledge to those seeking or receiving mental health services (V. Khedari)

  • The use of narratives for mental health care. These include illness-specific, culture-specific, and marginalized group-specific narratives.

Mental Health Research

Breakthroughs in mental health research are complementary to policy and narratives on mental health. Notable research areas highlighting the multi-faceted and cross-sectoral dimensions of mental health are digital technology and mental health; mental health financing and equity; cross-cultural approaches to mental health; conflict and mental health; digital mental health intervention; mental health in emergencies; mental health of low-income groups; alternatives to mental health services, and so on.

To sum up, the global push to prioritize mental health has shed light on the legal, institutional and cultural practices detrimental to the well-being of individuals. Synergies across mental health policy, services, and research can help spur purposeful reforms and action.

References

APA (2018). Mental Health is a Human Right (apa.org)

Brendan D. Kelly (2014), Dignity, “Human Rights and the Limits of Mental Health Legislation”, Irish Journal of Psychological Medicine, 75–81.

European College of Neuropsychopharmacology (ECNP, 2017), Response to the Report of the UN Special Rapporteur

Larry Gostin (1987). "Human Rights in Mental Health: A Proposal for Five International Standards-Based upon the Japanese Experience" International Journal of Law and Psychiatry, 353–366

UN Convention on Rights of Persons with Disabilities, 2006.

UN Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, 1991.

UN Special Rapporteur (2017) on the Right of everyone to enjoyment of the highest attainable standard of physical and mental health

Vivian Khedari, "An Opportunity to Create a New Narrative on Mental Health", Beyond Conflict.

World Health Organization (2022). World Mental Health Report: Transforming Mental Health for All

Robert Polner (2018). "Mental Health Narratives Matter for Marginalized Young People" Futurity

Felicity Thomas, et.al. (2018). “Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform” Humanities and Social Sciences Communications

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