A/HRC/41/34
when legal barriers, such as the criminalization of poverty, homelessness or drug use, are
removed.
26.
Determinants of mental health and measures taken to promote mental health must be
accessible without discrimination, particularly for those in vulnerable situations. This
includes physical and economic accessibility to determinants, such as non-violent school
and home environments, healthy workplaces that respect the full spectrum of labour rights,
and a robust and active civil society supporting the struggles of those furthest behind.
27.
Determinants of mental health and measures taken to promote mental health must
also be acceptable to the individuals and communities involved. Such a context requires the
active participation of communities and the fostering of civic space. Acceptable action will
be determined by the unique needs of society throughout its life cycle, as well as genderspecific requirements and respect for diversity, including cultural and neurodiversity.
28.
Actions taken to realize the right to mental health must be of good quality, and they
require evidence-based data and information that is multidisciplinary. Responses to mental
health conditions that are based on the use of coercion, as an exception allowed in
legislation, are becoming the rule. Continued investment in policies and services, with
prevailing patterns of coercion, excessive medicalization and institutionalization, are a
serious obstacle to the effective realization of the right to mental health. Such systems
reinforce vicious cycles of stigmatization, discrimination and social exclusion, and may be
more detrimental than the mental health conditions they are supposed to treat.
E.
International assistance and cooperation
29.
The obligation of international cooperation for the realization of the right to mental
health is recognized in international treaties and reinforced by the commitment to a global
partnership for sustainable development made in Sustainable Development Goal 17. States
in a position to assist must provide lower-income States with international assistance to
help them realize the right to mental health. There is an immediate obligation to refrain (or
withdraw) from the provision of development assistance that is discriminatory, or where
violence or other human rights violations are committed. International cooperation to
promote well-being must not be viewed as an economic or moral benefit for the
Governments involved, but as a legal obligation.
30.
The Special Rapporteur reiterates previous calls for the allocation of adequate
resources to international assistance, which requires a more balanced, rights-based response
that emphasizes the promotion of mental health (see A/HRC/35/21). While development
assistance towards the global promotion of mental health is on the rise, overseas
development assistance budgets fail to exceed 1 per cent of investment in mental health. 17
Global aid indicators and trends continue to have a focus on biased knowledge from
biomedical research and programmes, which, alone, cannot be considered compliant with
right to health obligations. The Special Rapporteur is concerned that a human rights-based
approach is not fully integrated into international projects that assist developing countries in
improving their mental health policies and services. Without clear efforts to promote
research and action on the political and social epidemiology of distress, including poverty,
inequality, discrimination, State repression and corporate capture, these vital issues will
remain on the margins of global mental health action.
31.
Rebalancing development assistance for mental health promotion requires diverse
leadership and civil society engagement. There is a human rights imperative for mental
health promotion to be scaled across the various development sectors: from rural farming,
gender-based violence programming, migration and humanitarian assistance, private sector
development and international trade to health-care sector reforms, including
deinstitutionalization. All development stakeholders have an important role to play in
supporting and enabling this work.
17
See Patel, V. and others, “Sustainable development and global mental health – a Lancet commission”
in The Lancet, vol. 387 (2016), pp. 1143–1145.
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