A/HRC/41/34 20. States must facilitate, provide and promote conditions in which mental health and well-being can be realized. Fulfilling the right to mental health requires the provision of not just equitable health care (and alternatives to the biomedical model), but also of public mental health interventions that can protect populations from key risk factors for poor mental health. It requires action outside of the health sector in homes, schools, workplaces and communities. It also includes facilitating the best possible start to life for children through evidence-based family support, such as parental leave and conditions for safe motherhood, supportive parenting interventions and early childhood education. States should provide an adequate workforce to support these efforts, and rethink how to build resources for social healing, community strengthening and the promotion of a healthy society. States should also formulate national policies aimed at reducing or eliminating the toxicity of the physical and psychosocial environment. C. Resource allocation 21. Dedicating resources for the promotion of mental health is not an easy task, and resource constraints vary from one country to another. States have an obligation to commit a maximum of available resources to the progressive realization of the right to health. In its general comment No. 14, the Committee on Economic, Social and Cultural Rights acknowledged that resource constraints are impediments; the Covenant therefore provides for progressive realization of the right to health. While the Special Rapporteur is concerned that States do not invest enough resources in mental health in general, he is even more concerned that a larger proportion of available resources are directed to ineffective systems, reliant on excessive medicalization, coercion and institutionalization, breeding stigmatization, discrimination, disempowerment and helplessness. 22. The right to mental health also includes obligations of immediate effect, such as the non-discriminatory provision of services to promote mental health and equitable access to interventions and core determinants for those in the most marginalized situations. Core obligations include the formulation and implementation of national public mental health strategies across public policy sectors, and not just within the health-care framework. The core obligations articulated by the Committee on Economic, Social and Cultural Rights in its general comment No. 14 should be considered in conjunction with developments in research and evidence on the promotion of mental health. 23. In order to achieve progressive realization of the right to health, States should take deliberate, concrete and targeted action towards fulfilling the right to mental health in all its forms, including the promotion of mental health. By emphasizing the conditions necessary to thrive and flourish, benchmarks can not only close the “treatment gap” but can also support the development of indicators that focus on upstream protective factors, such as an adequate standard of living and social inclusion.16 D. Availability, accessibility, acceptability and quality 24. To be compliant with the right to health, determinants of mental health must always be available, accessible, acceptable and of good quality. 25. Determinants of mental health and action to promote mental health must be available in sufficient and adequate quantity. Availability means the presence of core social and underlying determinants that are essential to the promotion of well-being for individuals and society, including access to health-related information and education, and healthy and positive relationships between individuals based on trust, respect and tolerance. Importantly, community relationships and kinship can have benefits when factors such as access to housing, food, social security and community integration are strengthened and 16 6 For a national example of the development of equity-based indicators for mental health, see National Health Service Health Scotland, Scotland’s mental health: Adults 2012 (Edinburgh, 2012).

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