We all have rights, we all have mental health: the two are undeniably intertwined, but until 2017 they had rarely been addressed together in the international arena. Earlier last year, the UN Special Rapporteur on the right to health, Dr Dainius Puras (himself a psychiatrist), released his groundbreaking report on the right of everyone to mental health. This was preceded by another excellent report on human rights and mental health by the UN Office of the High Commissioner for Human Rights. Most recently, the Human Rights Council adopted its second Resolution on mental health and human rights. There is something in the air, isn’t there? At Mental Health Europe (MHE), we see 2017 as having been a crossroads for mental health and human rights.
The report by the UN Special Rapporteur is the most comprehensive look at the state of play regarding the right to mental health following the adoption of the United Convention on the Rights of Persons with Disabilities in 2006. MHE believes in the transformative power of human rights as a tool not only for change within mental health services but for changing how we understand mental health. In response to the UN Special Rapporteur’s report, MHE along with its member the British Psychological Society, led an open letter which was signed by over 200+ organisations and individuals, including Mad in America, representing people across the spectrum of the mental health community (users and survivors, people with psychosocial disabilities and lived experience of mental distress, journalists and media outlets, professionals, academics and service providers) in Europe and abroad. Human rights can be a divisive issue among the mental health community, and our aim was to bring together organisations and individuals across the world who believed in the message of the Special Rapporteur — that things need to change.
What the report says
“The history of psychiatry and mental health care is marked by egregious rights violations”
“We have been sold a myth that the best solutions for addressing mental health challenges are medications and other biomedical interventions.”
“Conventional wisdom based on a reductionist biomedical interpretation of complex mental health-related issues dominates mental health policies and services, even when not supported by research.”
“For decades now, an evidence base informed by experiential and scientific research has been accumulating in support of psychosocial, recovery-oriented services and support and non-coercive alternatives to existing services.”
MIA readers will particularly appreciate the shift away from the World Health Organisation’s approach, which speaks to a ‘global burden of disease’, towards overcoming what the UN Special Rapporteur instead calls the Global Burden of Obstacles to achieving the right to mental health for all. These obstacles include the dominance of the biomedical model, power asymmetries and the biased use of evidence within the mental health field.
What the letter says
The letter welcomes and endorses the report which highlights that mental health has been a forgotten issue for far too long, leaving too many people to suffer human rights abuses within mental health services. The signatories also voiced their support for the Rapporteur’s calls for a shift away from isolating mental health services which are coercive and inappropriately medicalised to ones that are recovery and community-based and promote social inclusion. It endorses the positive messages for a global approach to health and psychological wellbeing and ensures the participation of a diversity of rights-holders and relevant stakeholders, including users and survivors of services, civil society and communities, and empowers them.
Action not just words
Of course, letters and reports don’t bring change on their own. MHE is dedicated to having the hard conversations that we need to have within the mental health community and beyond about how we can make change happen. There are promising practices across the world that help to support people with mental health problems in ways that respect their human rights. There are population level interventions which address the social determinants of mental health which would enable us to really start preventing mental ill-health but also improving mental well-being for everyone. However, we won’t advance human rights in mental health simply by having arguments between academics or clinicians or even service users, but by truly enacting this as a civil rights movement. Academics and experts have their role to play, but this isn’t just an academic or professional exercise; it’s about us as citizens and users and survivors of services. The MIA community has contributed vastly to bringing these issues to the fore as a civil rights problem, however we need to think about how we can make this a genuine civil rights movement that engages the world outside this community, including the general public, policymakers and the mainstream media.
Let’s ensure that this crossroads for mental health and human rights yields concrete change in 2018 and the coming years with the support of like-minded communities ready to take the discussion about mental health and human rights to the next level.
We want to reach out to the public, to the media, people with lived experience, survivors of psychiatry, communities, policymakers, psychiatry, all mental health professionals, families and carers to hear their views on human rights and mental health and get them engaged. If you are interested in signing up to the letter or engaging in this conversation, get in touch with us at: [email protected] (for the letter) or tweet @mhesme and one other organisation or influencer that you think needs to hear our message or could help get the message out, like a politician or a journalist, with the hashtag #mentalhealthrights. You can also find some of our tools on human rights (i.e., webinars, positions, toolkits and animated videos) on our website: http://www.mhe-sme.org/.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.