A/HRC/41/34 members of the lesbian, gay, bisexual, transgender and intersex community, and persons with disabilities. 56. Relationships are also deeply influenced by scars of the past, such as historical injustices, the legacy of colonialism, racism, slavery and land appropriation, the subjugation of women and violations of sexual and reproductive rights, the historic oppression of the lesbian, gay, bisexual, transgender and intersex community and the denial of the rights of children. Social trauma, such as systemic racism, violent conflict and displacement, can damage communities for generations. Poverty, inequality and power asymmetries make it difficult or even impossible to build and sustain relationships of mutual trust and respect. Reducing inequalities, systemic socioeconomic disadvantages, disempowerment, social exclusion, insecurity and displacement is a precondition for enabling respectful, non-violent relationships that support mental health. 57. The central contexts for human relationships are protected by international human rights law, such as the right to family life, participation in the cultural life of a community, community responsibilities, protection from attacks on honour and reputation, protection from discrimination and equality in dignity. Greater emphasis is needed on the extent to which restrictions or infringements of human rights have a negative impact on human relationships and community cohesion. 1. Early childhood 58. Promoting and protecting human relationships starts with the relationship between infants and primary care givers. Interventions that foster emotional health and social development from early childhood should be given priority as investments in human development and global health. To give every child the best start in life begins with supporting maternal health, including mental health, as the foundation for the emotional health and cognitive development of the child. This includes maternal education, family leave and decent working conditions and nutrition, as well as social and emotional support. 59. When one considers the powerful evidence linking adverse childhood experiences with life-long poor mental and physical health and well-being, there is a strong argument for structural interventions to address these indicators of poor well-being. Early childhood trauma can include exposure to a traumatic event prior to the age of early adolescence, such as child abuse, sexual violence, exposure to verbal or physical fights within the home, armed conflict, refugee status, or the unexpected death of a close relative or friend. Early childhood development can be protected by supporting children, parents and families. Early detection of social and emotional difficulties and screening for different diagnostic categories without family support programmes in place may lead to exclusion, institutionalization and overmedicalization. Approaches of this type cannot be considered compliant with right to health obligations. Instead, early detection should be viewed as complementary to community-based support for parents and children. 60. Barriers to positive family and community relationships, such as economic conditions or laws that separate families, have damaging long-term consequences for children’s emotional and cognitive development. 23 61. States should take immediate measures to progressively replace the institutional care of children, with a view to its full elimination. These measures should include, first of all, progressively investing in a variety of community-based and family-focused services. With regard to children under 5 years of age, with or without disabilities, institutional care should be qualified as a form of violence and harmful practice, and therefore should be banned. States should prioritize the right of children to emotional and social development, tantamount to efforts made globally to reduce mortality rates for children under the age of 5. 62. Overmedicalization is especially harmful to children, 24 and global trends to medicalize complex psychosocial and public health issues in childhood should be addressed with a stronger political will. 23 12 See Emma Sammans and others, Women’s work: mothers, children and the global childcare crisis (London, Overseas Development Institute, 2016).