A/HRC/41/34 interventions. This model has led not only to the overuse of coercion in case of psychosocial, intellectual and cognitive disabilities, but also to the medicalization of normal reactions to life’s many pressures, including moderate forms of social anxiety, sadness, shyness, truancy and antisocial behaviour. The most vocal message that can reach stakeholders with the resources and power to support meaningful transformation in global mental health is the need to close the “treatment gap”. The Special Rapporteur is concerned that this message may further the excessive use of diagnostic categories and expand the medical model to diagnose pathologies and provide individual treatment modalities that lead to excessive medicalization. The message diverts policies and practices from embracing two powerful modern approaches: a public health approach and a human rightsbased approach. 50. Any effective engagement with violence as a determinant of mental health therefore needs to address the role of mental health services in perpetuating violent and paternalistic practices, which have reinforced the myth that individuals with certain diagnoses are at high risk of perpetuating violence and posing a threat to the public. There is no scientific evidence to support this myth, which is instrumentalized by discriminatory mental health laws that deprive people of liberty and their autonomy. 51. Regrettably, many parts of mental health-care systems, such as residential institutions and psychiatric hospitals, too often themselves breed cultures of violence, stigmatization and helplessness. The models that have reinforced the legacy of discrimination, coercion and overmedicalization in mental health care should be abandoned. Efforts should be refocused towards non-coercive alternatives that respect the rights of persons with a lived experience of mental health conditions and mental health-care services. Such alternatives should address holistic well-being, and place individuals and their definition of their experiences, and their decisions, at the centre. III. Issues in focus A. Relationships across the life cycle 52. The quality of social relationships – the complex social tapestry of affiliation and connections between individuals, families and communities – over the course of life, across generations, between government and people, between different nations, and between mankind and nature, is a crucial determinant of health, and mental health in particular. Respectful, non-violent relationships, and opportunities for solidarity, mutual support and trust are the foundation of well-being and resilience and offer strong protection in times of adversity. 53. Relationships at all levels and throughout the life cycle are shaped dynamically by wider social, economic, political and cultural factors; broadening the scope of determinants to include the emotional and psychosocial environment is therefore crucial. The quality of relationships and community identity between individuals in society is an increasingly important factor in the realization of the right to health and the prevention of violence. 54. When basic needs are not met, support or care responsibilities not addressed, and rights (particularly maternal and reproductive rights) are not protected, positive family and community relationships are undermined, as is the care of those who are in a vulnerable situation. Respectful human relationships lie at the heart of policies that support inclusion, diversity, dignity and human rights. 55. Abusive relationships, gender-based violence, sexual abuse, violence against children and other forms of violence are closely associated with imbalances of power and restricted rights and freedoms, and with political, economic and cultural structures that determine conditions throughout a person’s lifetime at home, in schools, at work, in healthcare settings and in the community. Socioeconomic conditions that generate insecurity and fear for the future increase the risk of conflict between communities. These conditions are felt individually and collectively, and these experiences have intersectional implications, particularly for persons belonging to ethnic and racial minorities, indigenous communities, 11