A/HRC/39/36
welcomed the growth of good practices, which confirmed that forced treatment and
institutionalization were damaging and unnecessary. She called for greater political
commitment from States to implement the way forward by addressing the social
determinants of mental health, inclusive of, and in collaboration with, persons with
psychosocial disabilities, including through housing support groups, respite care,
personal assistance services and other means. The Convention on the Rights of
Persons with Disabilities and the 2030 Agenda for Sustainable Development provided
the opportunity to build a new narrative based on human rights that fostered
inclusion and not segregation. There could be no sustainable development without
mental health, and mental health without human rights amounted to oppression. She
called upon the United Nations system to internalize the urgent need for change, and
to foster cooperation across agencies and cooperation actors. She affirmed that the
mental health agenda could not move forward when it continued to ignore the human
rights of persons with psychosocial disabilities.
43.
The Special Rapporteur on the right of everyone to the enjoyment of the
highest attainable standard of physical and mental health noted that the consultation
had demonstrated that there was agreement on the root causes of the failure of the
system, and on the required actions to address those challenges: eliminating force and
biomedical interventions, which led to violations of human rights and bred
hopelessness for service users and for service providers who were “forced to use
force”. To promote mental health, the individual should be in healthy and respectful
relationships, including between service providers and users, and forced measures
impeded that. He stressed the need for all stakeholders to work together and
understand that the best way to promote mental health was to fully integrate the
human rights-based approach and foster relationships in all settings. He concluded by
stating that the future was a win-win situation for everyone — including psychiatrists,
who should let go of the monopoly of power and share responsibility — with stronger
commitment by States, and led by a rising critical mass of empowered users.
44.
In light of the discussions, the following recommendations were proposed.
45.
States should re-examine the biomedical approach to mental health, which
maintains the imbalance of power between practitioners and users of mental health
services, through a collective process that includes all stakeholders. Users of mental
health services, persons with mental health conditions and persons with psychosocial
disabilities should play a leading role in developing the conceptual framework that
determines mental health services, and in their design, delivery and evaluation.
46.
States should ensure that all health care and services, including all mental
health care and services, are based on the free and informed consent of the individual
concerned, and that legal provisions and policies permitting the use of coercion and
forced interventions, including involuntary hospitalization and institutionalization,
the use of restraints, psychosurgery, forced medication, and other forced measures
aimed at correcting or fixing an actual or perceived impairment, including those
allowing for consent or authorization by a third party, are repealed. States should
reframe and recognize these practices as constituting torture or other cruel, inhuman
or degrading treatment or punishment and as amounting to discrimination against
users of mental health services, persons with mental health conditions and persons
with psychosocial disabilities. States should ensure their enjoyment and exercise of
legal capacity on an equal basis with others by repealing laws that provided for
substituted decision-making, and should provide: a range of voluntary supported
decision-making mechanisms, including peer support, respectful of their individual
autonomy, will and preferences; safeguards against abuse and undue influence within
support arrangements; and the allocation of resources to enable and ensure the
availability of support.
47.
States should implement people-centred and human rights-based support and
services, including on mental health, which are community-based, participatory and
contextually and culturally respectful and which enable and facilitate participation in
society. These services should be available in the communities where people live,
ensuring that their family and personal networks are not jeopardized but are
14
Select target paragraph3
Connect to a paragraph
Connect to an entity
Disable highlights
Add to table of contents