A/HRC/44/48 violations of economic and social rights, such as neoliberal policies and austerity measures. Harms to mental health can equally arise from systemic violations of civil and political rights that lead to structural discrimination and violence against different communities, as well as restricting the space of civil society. 7. In many high-income countries, there has been a mainstream focus on the improvement of existing mental health systems, alongside campaigns to resist and reduce over-medicalization. In many low- and middle-income countries, there has been a policy shift towards developing or increasing access to mental health services similar to those in high-income countries, alongside simultaneous grassroots activism focused on developing community-owned and peer-led support systems.2 Globally, almost all contexts share the need for a paradigm shift in mental health, although what that shift looks like in practice is a matter of much debate. 8. Contextual entry points are important to ensure that advocacy strategies are not uncritically exported from global North to South. Some experts view less established mental health infrastructures, especially in low-income countries, as a hindrance to the realization of the right to mental health and the rights enshrined in the Convention on the Rights of Persons with Disabilities. They argue that what is required under the Convention is unrealistic and even counterproductive to the promotion and protection of human rights settings with such scarce resources. Others see less-established mental health infrastructures as an opportunity for transformation and creative innovation. Recognition of these contextual nuances and the wider sociopolitical factors that shape them means that while a dominant global status quo in mental health exists, it is fracturing under the pressure of these divergent and powerful movements and experiences. 9. Mental health systems worldwide are dominated by a reductionist biomedical model that uses medicalization to justify coercion as a systemic practice and qualifies the diverse human responses to harmful underlying and social determinants (such as inequalities, discrimination and violence) as “disorders” that need treatment. In such a context, the main principles of the Convention on the Rights of Persons with Disabilities are actively undermined and neglected. This approach ignores evidence that effective investments should target populations, relationships and other determinants, rather than individuals and their brains. 10. How that dominance is overcome requires transformative human rights action. However, action that focuses only on strengthening failing mental health-care systems and institutions is not compliant with the right to health. The locus of the action must be recalibrated to strengthen communities and expand evidence-based practice that reflects a diversity of experiences. Such community-led recalibration enables the necessary social integration and connection required to more effectively and humanely promote mental health and well-being.3 11. Globally, there is insufficient allocation of adequate resources for mental health, including for advocacy, support and research led by persons with disabilities. There is a lack of investment in capacity-building for civil society, including organizations of persons with disabilities, human rights advocates and academia, on the Convention on the Rights of Persons with Disabilities and its conceptual connections with other human rights treaties, specifically those that enshrine the right to health. As such, very little literature and scholarship has been developed on what a rights-based approach to mental health might look like in a range of practices and contexts. Rights-based frameworks are starting to emerge and can serve as essential building blocks for future communities of practices to expand and develop within and beyond existing mental health systems. 4 2 3 4 4 See TCI Asia, “Turning the tables: the imperative to reframe the debate towards full and effective participation and inclusion of persons with psycho-social disabilities. Excerpts from ‘Galway-Trieste’ conversations – part IV”, 28 October 2019. See Bhargavi V. Davar, “Globalizing psychiatry and the case of ‘vanishing’ alternatives in a neo‐ colonial state”, Disability and the Global South, vol. 1, No. 2 (2014). See Peter Stastny and others, “Critical elements of rights-based community supports for individuals experiencing significant emotional distress: foundations and practices”, Health and Human Rights Journal (forthcoming, June 2020); Faraaz Mahomed, “Establishing good practice in rights-based