A/HRC/44/48 undermines the ethical obligation to “do no harm”. The main obstacle for the realization of the right to mental health does not rest with individuals and their global burden of mental disorders, but rather in the structural, political and global burden of obstacles being produced by archaic, broken mental health systems. 84. Those obstacles, power asymmetries in mental health care, the dominance of the biomedical model and the biased use of knowledge, need to be addressed by changes in laws, policies and practices. In particular, the dominance of medicalization in both existing and even in some “progressive” policy reforms continues to mask broader social injustices that must be confronted and addressed by the global community. Movements of service users, of persons with psychosocial disabilities, of mad people, of people who hear voices, who are rights holders in all their diversity, must be at the forefront of efforts for rights-based change. Scaling up rights-based support within and outside existing mental health systems holds much promise for the changes that are needed. 85. There is a common cause in this rapidly changing world. Significant global changes are afoot and the crisis in global mental health has common connections in other areas of human rights activism. Authoritarianism, late-stage neoliberalism, climate change, paternalism and the rise of big data all present risks to the enjoyment of human rights and an opportunity for coming together in solidarity to rethink and reshape social, economic and political structures to ensure a sustainable, peaceful, just and inclusive future. 86. The Special Rapporteur recommends that States: (a) Undertake the legislative, policy and other measures required to fully implement a human rights-based approach to mental health with the inclusive participation of those with lived experience; (b) Invest in rights-based research in this area to support those measures and better conceptually integrate implementation and efforts on the ground for reform; (c) Integrate public health evidence, lived experience and rights-based research to guide decision-making on global and national public policy strategies. That should include prioritizing a shift away from medicalization in the development of mental health, criminal justice and public welfare-related reforms; (d) Take immediate steps to implement the recommendations in Human Rights Council resolutions 32/18 and 36/13 on mental health and human rights; (e) Promote mental health by increasing financial support to sustainable, cross-cutting programmes that reduce poverty, inequalities, discrimination on all grounds and violence in all settings, so that the main determinants of mental health are effectively addressed; (f) Invest in child- and adolescent-friendly mental health services that are family-focused and community-based, and prevent financial and other incentives that fuel institutionalization, social exclusion and the overuse of psychotropic medication; (g) Promote the principles of healthy ageing and respect for the rights of older persons to live in the community, and put in place measures, including workforce strengthening, to end the overdiagnosis and overuse of psychotropic medication. 87. The Special Rapporteur recommends that organizations representing the psychiatric profession, including academic medicine and psychiatry: (a) Firmly establish human rights and social justice as core values when promoting mental health interventions; (b) Modernize medical education and integrate mental health and human rights into medical education and research, with a special focus on the need to radically reduce coercion, over-medicalization, institutionalization, all forms of discrimination against persons with mental health conditions and other human rights violations; 19