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OHCHR and WHO launched guidelines to end mistreatment in mental health services

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In anticipation of World Mental Health Day, the World Health Organization (WHO) and the Office of the High Commissioner on Human Rights (OHCHR) have jointly introduced today a guidance titled “Guidance and Practice for Mental Health, Human Rights and Legislation.” The objective is to support countries in reforming their laws to eliminate human rights violations and improve access to quality mental health care.

Human rights abuses and coercive practices in Psychiatry

Instances of human rights abuses and coercive practices in the field of health care persist across the globe often supported by existing laws and policies. These include hospitalization and treatment of substandard living conditions, as well as physical, psychological and emotional mistreatment prevalent in numerous mental health services.

Although several countries have made efforts to revise their laws, policies and services since the adoption of the United Nations Convention on the Rights of Persons with Disabilities in 2006 only a limited number have taken measures to amend relevant legislation on a significant scale. This is required to put an end to these abuses and promote rights within mental health care.

Dr. Tedros Adhanom Ghebreyesus, Director General of WHO emphasizes that “Mental health is a component inseparable from the right to health.”

He also argues that this updated guidance will enable countries to make the changes in order to provide high-quality mental health care that promotes individuals’ recovery and respects their dignity. This empowers people with health conditions and psychosocial disabilities to lead fulfilling and healthy lives within their communities.

Volker Türk, the UN High Commissioner for Human Rights emphasizes the importance of transforming mental health services not only in terms of their reach but also in their core values ensuring that they truly align with the needs and dignity of each person. He states that this publication offers guidance on how a rights-based approach can facilitate the needed transformation within health systems.

Encouraging Effective Mental Health Care Based in Communities

The majority of government spending on mental health is allocated to psychiatric hospitals, particularly in high-income countries accounting for 43% of the budget. However, evidence shows that community-based care services are not only more accessible but also more cost-effective and efficient compared to institutional models of mental health care.

The guidance outlines the steps to accelerate the process of deinstitutionalization and establish a community-oriented approach to mental health care based on human rights principles. This includes implementing legislation that gradually replaces institutions with inclusive community support systems and mainstream services, like income support, housing assistance and peer support networks.

Putting an End to Abusive Practices

According to the participants of the launching event and all those who participated in the guidelines, it is crucial to put an end to coercive practices in mental health. These practices, like detention and forced treatment, seclusion and restraints, violate the right of individuals to make informed decisions about their own healthcare and treatment options.

Moreover, there is mounting evidence that shows the effects of these coercive practices on both physical and mental well-being. They worsen existing conditions and isolate individuals from their support networks.

The guidance suggests incorporating provisions that eliminate coercion in mental health services. It emphasizes the importance of establishing informed consent as the cornerstone of all mental health interventions. Additionally, it provides recommendations on how to handle cases within legal frameworks and policies without resorting to coercive measures.

Adopting a Rights-Based Approach to Mental Health

Recognizing that promoting health extends beyond just the healthcare sector this new guidance is targeted at legislators and policymakers involved in drafting, amending and implementing laws related to mental health. This includes legislation addressing issues such as poverty, inequality and discrimination.

The guidance also includes a checklist for countries to assess whether their health-related legislation aligns, with international human rights obligations. Furthermore, it highlights the significance of seeking advice from individuals who have experiences and the organizations that represent them as an essential part of this process. It also emphasizes the importance of education and raising awareness about rights-related matters.

While the guidance suggests a set of principles and provisions that can serve as a framework for legislation it recognizes that countries have the flexibility to adapt and tailor them according to their particular circumstances. This includes considering factors such as context, languages, cultural sensitivities, legal systems and more—all while upholding human rights standards.

On October 10th the World Health Organization (WHO) joined communities in observing World Mental Health Day 2023 under the theme “Mental health is a fundamental right, for all.”

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