New Resources from the WHO’s QualityRights Initiative

QualityRights was launched in 2012 as the World Health Organization global initiative to promote the rights of people with psychosocial, intellectual and cognitive disabilities and to transform the way mental health services are provided in line with a recovery based approach.

The five main objectives of the QualityRights initiative are to:

• Build capacity to understand and promote human rights and recovery.
• Improve the quality of care and human rights conditions in mental health and related services.
• Create community-based and recovery-oriented services that respect and promote human rights.
• Develop a civil society movement to conduct advocacy and influence policy-making.
• Reform national policies and legislations in line with the Convention on the Rights of Persons with Disabilities (CRPD) and other international human rights standards.

These international human rights standards, and in particular the CRPD, have guided the vision of this initiative. Freedom from coercion and violence, respect for legal capacity, autonomy and liberty, community inclusion and other fundamental rights so often denied to people with psychosocial, intellectual and cognitive disabilities are central to all aspects of the QualityRights initiative.

The current focus is on capacity building for all stakeholders on these issues and the empowerment of people with psychosocial, intellectual and cognitive disabilities. In this respect we have recently published a set of training modules covering the following topics: Understanding human rights, Promoting human rights in mental health, Improving the mental health and related service environments and promoting community inclusion, Realising recovery and the right to health in mental health and related services, Protecting the right to legal capacity in mental health and related services and Creating mental health and related services free from violence, coercion and abuse. These core modules provide stakeholders with the knowledge and tools to enable them to apply the CRPD and other human rights principles in the community and in the context of mental health services.

In addition, a number of specialised training modules have been created to provide people with more in depth knowledge and skills around specific topics. The specialised training modules cover Supported decision making and advance planning, Promoting recovery in mental health and related services and Strategies to end the use of seclusion and restraint.

Both the core and the specialised training modules have been developed with a wide audience in mind, including practitioners, people with lived experience, families, care partners, Organizations of Persons with Disabilities (DPOs) and others.

Initial experiences and results of the QualityRights training with diverse stakeholders from various regions of the world are promising, with important impacts on attitudes and practices following training.

Separately we have also developed material providing guidance on Setting-up and operating a civil society organisation in mental health and related areas and putting in place effective Advocacy actions to promote human rights in mental health and related areas to support the important role that civil society has in promoting rights in services and in the community more broadly. These materials have drawn substantially upon the vast knowledge and expertise of NGOs, DPOs and people with lived experience.

To further address the knowledge and practice gap, we are at the early stages of developing guidance that will identify and describe innovative services and best practices compliant with a human rights based approach. This guidance will ultimately assist decision-makers and service providers to put in place services that are community-based and recovery-oriented, and to operate without coercion and with respect for the right to legal capacity. To date we have developed guidance for establishing individual and group peer support. There are many more innovative services and supports such as the Hearing Voices Network, Personal Ombudsperson (Sweden), Soteria houses (US and UK), Circles of support (UK), and home support services, but they remain at the margins and most policy-makers, health professionals, people using services and others are not aware of them. If implemented, these services and supports have the potential to transform the mental health system in a positive human rights and evidenced based way.

Ongoing assessment and monitoring is also key to ensuring that all services are fully compliant with human rights standards. As part of the QualityRights initiative, we have developed the QualityRights assessment toolkit which measures the degree to which services are compliant with a number of key standards linked to the CRPD. The toolkit outlines the standards which should be achieved in mental health and related services to respect human rights and promote recovery. A dedicated module which we have developed on Implementing improvement plans for service change can be used in conjunction with the other training and guidance tools to address the gaps identified as part of the assessment process.

Finally, the WHO QualityRights initiative also encompasses the WHO MindBank, an online platform which provides quick and easy access to national and international resources, strategies, policies, legislation and service standards relating to human rights, mental health, disability, development and other topics. Since its creation in 2014, MindBank has become an essential tool for supporting the work of policymakers, advocacy groups, academics and researchers. As a tool for advocacy, it allows people to identify the current situation, potential gaps in laws and policies as well as examples of innovative policies and strategies to develop effective advocacy actions and messages at the national and international level. It currently contains more than 6000 documents from 192 countries across the world.

The challenge to promote the rights of persons with psychosocial, intellectual and cognitive disabilities and to transform mental health services across the world is colossal. The QualityRights initiative seeks to provide actors everywhere with the tools that they need to become active agents for change.