A/HRC/41/34 and scientific evidence. These developments include the recognition that an individual’s autonomy and self-determination, including that person’s right to be involved in medical decision-making, is essential for good health (see A/64/272 and A/HRC/32/44). 9 Conversely, relative powerlessness is a fundamental cause of social inequality and poorer mental and physical health. The psychosocial environment is increasingly recognized as just as important for health as the physical environment (see para. 53).10 17. The right to health is also enshrined in several international treaties. Treaty bodies have indeed progressively adopted interpretations to include not only material preconditions for individual health, but also psychosocial and structural determinants that promote the well-being of both individuals and society. These determinants include community inclusion, 11 an environment for children that is free from violence, 12 ending violence against women,13 participation in cultural diversity14 and eradicating xenophobia.15 Likewise, the Special Rapporteur has previously discussed the normative importance of psychosocial determinants of health in relation to people on the move (see A/73/216), persons deprived of liberty (see A/HRC/38/36), persons with psychosocial disabilities (see A/HRC/35/21); and children and adolescents (see A/70/213 and A/HRC/32/32). B. Obligations 18. States have a tripartite obligation to respect, protect and fulfil the right to mental health, including the underlying determinants to promote mental health. Respecting the right to mental health requires States to ensure policies, laws and practices that do not hinder the promotion of mental health or well-being, particularly for those in the most disadvantaged situations. Cuts to social welfare, laws and policies that restrict access to sexual and reproductive health information and services, the criminalization of drug possession or cultivation for personal use, laws that restrict civil society space and corporal punishment of children and adults illustrate how Governments can directly undermine the promotion of health. 19. Protecting mental health requires taking the measures necessary to prevent third party interference. Harmful practices such as “conversion therapy” for lesbian, gay, bisexual, transgender and intersex persons, private centres or “camps” using religion instead of science to treat drug dependence or mental health struggles, and the outsized influence of pharmaceutical companies in the dissemination of biased information about mental health issues (see A/72/137) all require positive, protective action from the State. In many parts of the world, these practices are the result of a complex set of factors, including power imbalances that lead to biased use of evidence, a lack of investment in rights-based policies and services, and overreliance on coercive, punitive and overmedicalized measures. These practices also reflect a failure to fulfil right to health obligations: they demonstrate a lack of political will to support, replicate and sustain evidence-based social interventions that foster well-being, prevent discrimination and promote community inclusion. 9 10 11 12 13 14 15 See Whitehead, M. and others, “How could ‘control over destiny’ lead to socioeconomic inequalities in health? A synthesis of theories and pathways in the living environment” in Health & Place, vol. 39 (2016), pp. 51–61. See Richard Wilkinson and Kate Pickett, The Inner Level: How More Equal Societies Reduce Stress, Restore Security and Improve Everybody’s Well-being (Allen Lane, 2018). See Committee on the Rights of Persons with Disabilities, general comment No. 5 (2017) on living independently and being included in the community. See Committee on the Rights of the Child, general comment No. 13 (2011) on the right of the child to freedom from all forms of violence. See Committee on Economic, Social and Cultural Rights, general comment No. 22 (2016) on the right to sexual and reproductive health, paras. 7–8. See Committee on Economic, Social and Cultural Rights, general comment No. 21 (2009) on the right of everyone to take part in cultural life, para. 16. See joint general comment No. 3 (2017) of the Committee on the Protection of the Rights of All Migrant Workers and Members of Their Families / No. 22 (2017) of the Committee on the Rights of the Child on the general principles regarding the human rights of children in the context of international migration, paras. 20 and 40. 5