HQ Team
October 9, 2023: The WHO has released new guidelines to aid nations in reforming legislation to end human rights abuses and increase access to quality mental care.
Human rights abuses and coercive practices in mental health care, supported by existing legislation and policies, are still far too common, according to the “Mental health, human rights and legislation: guidance and practice” report.
Involuntary hospitalisation and treatment, unsanitary living conditions and physical, psychological, and emotional abuse characterise many mental health services across the world.
Since the adoption of the United Nations Convention on the Rights of Persons with Disabilities in 2006 many countries have sought to reform their laws, policies and services.
Too few have adopted or amended the relevant laws and policies on the scale needed to end abuses and promote human rights in mental health care, according to the report.
Psychiatric hospitals
“Mental health is an integral and essential component of the right to health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“This new guidance will support countries to make the changes needed to provide quality mental health care that assists a person’s recovery and respects their dignity, empowering people with mental health conditions and psychosocial disabilities to lead full and healthy lives in their communities.”
A majority of government expenditure on mental health is allocated to psychiatric hospitals — 43% in high-income countries.
Community-based care services are more accessible, cost-efficient and effective in contrast to institutional models of mental health care.
The guidance outlines what needs to be done to accelerate deinstitutionalisation and embed a rights-based community approach to mental health care.
Community support
This includes adopting legislation to gradually replace psychiatric institutions with inclusive community support systems and mainstream services, such as income support, housing assistance and peer support networks.
Ending coercive practices in mental health — such as involuntary detention, forced treatment, seclusion and restraints — is essential in order to respect the right to make decisions about one’s own health care and treatment choices, according to the report.
The new guidance aims to rope in all legislators and policy-makers involved in drafting, amending and implementing legislation impacting mental health, such as laws addressing poverty, inequality and discrimination.
The guidance proposes legislative provisions to end coercion in mental health services and enshrine free and informed consent as the basis of all mental health-related interventions.
Dignity
It provides a checklist to be used by countries to assess and evaluate whether mental health-related legislation is compliant with international human rights obligations.
“Our ambition must be to transform mental health services, not just in their reach, but in their underlying values, so that they are truly responsive to the needs and dignity of the individual,” said Volker Türk, UN High Commissioner for Human Rights.
“This publication offers guidance on how a rights-based approach can support the transformation needed in mental health systems.”
