New WHO guidelines seek to stop human rights violations in mental health

Globally, most mental health is still provided in psychiatric hospitals, and violations of human rights and coercive practices are still too common. But providing mental health care in a human rights-oriented and recovery-oriented community is proving successful and cost-effective, according to new guidelines released today by the World Health Organization.

The mental health care recommended in the new guidelines should be community-based and should include not only mental health care but also support for daily life, such as facilitating access to housing and liaising with education and employment services.

WHO’s new “Guidelines on Community Mental Health Services: Promoting People-Based and Rights-Based Approaches” further reaffirm that mental health care must be based on a human rights-based approach, as recommended by the WHO Comprehensive Mental Health Action Plan 2020 -2030. approved by the World Health Assembly in May 2021.

A much faster transition to redesigned mental health services is needed

“These comprehensive new guidelines are a strong argument for a much faster transition from coercive mental health services and focus almost exclusively on the use of drugs to manage mental health symptoms, a more holistic approach that takes into account individual circumstances and desires and offers a variety of approaches. treatment and support, ”said Dr. Michelle Funk of the Department of Mental Health and Substance Use, who led the development of the guidelines.

Since the adoption Convention on the Rights of Persons with Disabilities (CRPD) in 2006, an increasing number of countries attempted to reform their mental health-related laws, policies, and services. To date, however, few countries have established the frameworks needed to meet the far-reaching changes required by international human rights standards. Reports from around the world point out that serious violations of human rights and coercive practices are still too common in countries of all income levels. Examples include forced admission and involuntary treatment; manual, physical and chemical restriction; unhygienic living conditions; and physical and verbal abuse.

Most state budgets for mental health still go to psychiatric hospitals

According to the latest WHO estimates, governments spend less than 2% of their health budgets on mental health. Furthermore, most of the reported mental health expenditure is allocated to psychiatric hospitals, except in high-income countries where this amount is about 43%.

The new guidelines, which are primarily aimed at those responsible for organizing and managing mental health care, provide details of what is needed in areas such as mental health law, policy and strategy, service delivery, funding, workforce development and civil society participation. in order for mental health services to comply with the Convention on the Rights of Persons with Disabilities.

Includes examples from countries including Brazil, India, Kenya, Myanmar, New Zealand, Norway and the United Kingdom of community mental health services that have demonstrated good practice in terms of non-coercive practices, community involvement and compliance with people’s legal capacity (i.e. decision about their treatment and life).

Services include crisis support, mental health services provided in general hospitals, field services, supported life approaches, and peer support. Data on financing and evaluation results of the presented services are included. The above cost comparisons show that the services presented in the community give good outcomes, that service users are preferred and can be provided at comparable costs with conventional mental health services.

“However, the transformation of the provision of mental health services must be accompanied by significant changes in the social sector,” said Gerard Quinn, the UN Special Rapporteur on the Rights of Persons with Disabilities. “Until that happens, discrimination will continue that prevents people with mental health from leading full and productive lives.”