WHO and OHCHR launch new guidance to improve laws addressing human rights violations in mental health care

Ahead of World Mental Health Day, the World Health Organization (WHO) and the Office of the High Commissioner for Human Rights (OHCHR) are jointly launching new guidance titled “Mental Health, Human Rights “man and legislation: guidelines and practices”, to support countries in reforming their legislation in order to end human rights violations and improve access to quality mental health care.

Human rights violations and coercive practices in mental health care, supported by existing legislation and policies, are still far too common. Involuntary hospitalization and treatment, unsanitary living conditions, and physical, psychological, and emotional abuse characterize many mental health services around the world.

While many countries have sought to reform their laws, policies and services since the adoption of the UN Convention on the Rights of Persons with Disabilities in 2006, too few have adopted or amended relevant laws and policies on the scale necessary to end abuse and promote human rights in mental health care.

“Mental health is an integral and essential part of the right to health,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “This new guidance will help countries make the changes needed to provide quality mental health care that promotes a person’s recovery and respects their dignity, enabling people with mental health problems and psychosocial disabilities to lead a full and healthy life in their communities.

“Our ambition must be to transform mental health services, not just in their scope, but in their underlying values, so that they truly meet the needs and dignity of the individual. This publication offers guidance on how a rights-based approach can support the necessary transformation of mental health systems,” said Volker Türk, United Nations High Commissioner for Human Rights.

Promoting more effective community mental health care

The majority of reported public spending on mental health is allocated to psychiatric hospitals (43% in high-income countries). However, data shows that community care services are more accessible, more cost-effective and more effective in contrast to institutional models of mental health care.

The guidance sets out what needs to be done to accelerate deinstitutionalization and integrate a community-based, rights-based approach to mental health care. This involves passing legislation to gradually replace psychiatric institutions with inclusive community support systems and mainstream services, such as income support, housing assistance and peer support networks.

End coercive practices

Ending coercive mental health practices – such as involuntary detention, forced treatment, seclusion and restraints – is essential to respecting everyone’s right to make decisions about their own health care and health choices. treatment.

Additionally, a growing body of evidence demonstrates how coercive practices negatively impact physical and mental health, often worsening a person’s current condition while alienating them from their support systems.

The guidance proposes legislative provisions to end coercion in mental health services and enshrine free and informed consent as the basis for all mental health interventions. It also provides advice on how more complex and difficult cases can be handled within legislation and policy without resorting to coercive practices.

Using the guidance to adopt a rights-based approach to mental health

Recognizing that mental health is not solely the responsibility of the healthcare sector, the new guidance is aimed at all legislators and policy makers involved in drafting, amending and implementing laws impacting mental health, such as laws addressing poverty, inequality and discrimination.

The new guidance also provides a checklist for countries to use to assess whether mental health legislation complies with international human rights obligations. Additionally, the guidance also highlights the importance of consulting people with lived experience and their representative organizations as an essential part of this process, as well as the importance of education and public awareness of rights-based issues .

Although the guidance proposes a set of principles and provisions that can be reflected in national legislation, countries can also adapt and adapt them to their specific circumstances (national context, languages, cultural sensitivities, legal systems, etc.), without compromising human rights standards. .

On October 10, WHO will join global communities in celebrating World Mental Health Day 2023, the theme of which is “Mental health is a universal human right.”