A/HRC/23/41 60. Ensuring non-discriminatory access to health care both in law and practice requires States to decriminalize consensual adult sex work, enact and implement laws extending labour rights, occupational health and safety and access to affordable health care, with particular focus on irregular migrant sex workers. 61. Participation of migrant sex workers in the formulation and implementation of health laws, programmes and collection of disaggregated data is required to ensure that health concerns of sex workers are addressed.133 Measures that provide a confidential and supportive environment for voluntary testing, treatment, referral and counselling, that educate sex workers about sexual and reproductive health rights, including preventing the transmission of HIV, and that tackle the marginalization experienced by sex workers are consistent both with epidemiological evidence and the right to health framework. 134 E. Mental health 62. The provision of timely, affordable and non-discriminatory access to preventative, curative and rehabilitative mental health services and information forms part of the normative content of the right to health. The general stigma and lack of awareness surrounding mental disability,135 together with restricted access to health facilities, goods and services by migrant workers, means that their mental health may often be neglected. 63. Migration is a stressful experience due to dramatic changes to an individual‟s cultural, environmental and social landscape. Its impact on mental health will vary between individuals, due to differences in personal experiences and characteristics, such as age, gender, medical history, cultural background and agency in the migration process. 136 64. Within receiving States, immigration status, social exclusion, living and working conditions, communication with family, integration and access to health services are factors relevant to the mental health of migrant workers. 137 Migration may also induce depressive symptoms in families left behind in sending States. 138 Stigma, marginalization and discrimination are socially embedded and experienced regularly by migrant workers, particularly those who are in an irregular situation.139 Both sending and receiving States 133 134 135 136 137 138 139 H. Yang and others, “Workplace and HIV-related sexual behaviours and perceptions among female migrant workers”, AIDS Care, vol. 17, no. 7 (October 2005), pp. 819-833,; UNAIDS, UNAIDS Guidance Note on HIV and Sex Work (2009); A/HRC/14/20, para. 36. Agnes Binagwaho and others, “Developing human rights-based strategies to improve health among female sex workers in Rwanda”, Health and Human Rights, vol. 12, No. 2 (2010); IOM and UNAIDS, Assessment of Mobility and HIV Vulnerability among Myanmar Migrant Sex Workers and Factory Workers in Mae Sot District, Tak Province, Thailand (2007), pp. 26-27. E/CN.4/2005/51. Nazilla Khanlou, “Migrant mental health in Canada”, Canadian Issues/Thèmes canadiens, (Summer 2010), pp. 9-16; Fang Gong and others, “A life course perspective on migration and mental health among Asian immigrants: The role of human agency”, Social Science & Medicine, vol. 73, Iss. 11 (2011), pp. 1618-1626. H.B.M. Murphy, “Migration, culture and mental health”, Psychological Medicine, vol. 7, no. 4 (1977), pp. 677-684; D. Bhugra, “Cultural identities and cultural congruency: a new model for evaluating mental distress in immigrants”, Acta Psychiatrica Scandinavica, vol. 111, No. 2 (2005), pp. 84-93; Lorena de los Angeles Núñez Carrasco, Living on the Margins: Illness and Healthcare among Peruvian Migrants in Chile (2008), p. 162. Yao Lu, “Household migration, social support, and psychosocial health: The perspective from migrant sending areas”, Social Science & Medicine, vol. 74, Iss. 2 (January 2012), p. 141. Ilan Meyer, “Prejudice as Stress: Conceptual and Measurement Problems”, American Journal of Public Health, vol. 93, No. 2 (February 2003), pp. 262-265. 19