A/HRC/39/36 evidence about the benefits of force in psychiatry, and the fact that, on the contrary, several findings documented negative experiences and lasting anger by those subjected to forced treatment. It was concluded that human rights violations still took place in mental health settings, which caused inequalities to proliferate, and that that was compounded by intersecting identities. Any successful reform would require a change of heart within psychiatric and clinical practice to move beyond the biomedical model of psychiatry. D. Improving practices to combat discrimination, stigma, violence, coercion and abuse 32. The panel was composed of representatives of the United Nations Population Fund (UNFPA), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the International Committee of the Red Cross (ICRC), Human Rights Watch, and Akershus University Hospital, Norway. The panellists highlighted the centrality of mental health to general health, human rights and dignity. All panellists agreed that in order to promote inclusion and mental health, multiple forms of discrimination and inequality must be addressed — relating to youth, women, persons living with HIV/AIDS, persons living in poverty, persons living in rural regions, persons with disabilities including persons with psychosocial disabilities, and other intersecting identities. The panellists promoted a people-centred approach to empower communities as agents of change, by including rights holders in the design and implementation of programmes and services and in the training for them. 33. Monica Ferro, of UNFPA, emphasized that mental health was a component of sexual and reproductive health and rights, and that mental health issues could develop due to lack of choice in reproductive decisions and could arise in connection with the psychological dimensions of conception, pregnancy, childbirth, post-partum care, and events relating to abortion, miscarriage, HIV/AIDS and female genital mutilation. She suggested that mental health should be integrated into all sexual and reproductive health and rights policies, strategies, programmes and statistics. She referred to the determinants of mental health, and emphasized that gender discrimination often led to detrimental impacts on women’s rights; for example, the increased likelihood of women being subjected to sexual violence linked to the prevalence of post-traumatic stress disorder suffered by women; women’s higher rates of diagnosis with depression, compared to men with identical symptoms; and the greater challenges for women in accessing reproductive health services due to a lack of economic resources. 34. Tim Martineau, of UNAIDS, emphasized that people living with HIV, like other marginalized and stigmatized groups, faced significant levels of depression linked to the fear of having their status disclosed, and to accessing treatment. Often, discrimination and exclusion were exacerbated by other layers of identity, such as race, sexual orientation and age, leading to further isolation and poorer health outcomes and the added risk of violence and oppression due to widespread stigma. UNAIDS placed human rights and health at the heart of its response to AIDS, by concentrating on prevention, treatment and human rights to fight stigma and discrimination and promote accountability, through a global monitoring system to which approximately 170 countries reported with indicators on discrimination, stigma, and community empowerment. UNAIDS also engaged in global advocacy with other agencies, and supported countries in eliminating stigma and discrimination, improving monitoring, laws, legal literacy and access to justice, raising the awareness of lawmakers, and building the capacity of health-care workers to improve quality of care. Mr. Martineau emphasized the importance of empowering communities as agents of change. 35. Milena Osorio, of ICRC, shared information about the ICRC Mental Health and Psychosocial Support Unit, designed to assist victims of armed conflict, violence and disasters. ICRC interventions were implemented in 105 multidisciplinary programmes in 50 countries and provided a comprehensive package of services in a continuum of care to eliminate stigmatization and discrimination. She specified that her unit supported victims of torture, families with missing relatives, victims of violence and injured persons. It applied inclusive and multidisciplinary approaches to its work with the communities and individuals themselves in designing programmes and providing training to professionals, 11

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