A/HRC/41/34 stress.35Healthy, non-violent relationships contribute effectively to sustainable development and include not only human relationships but also the relationship between humankind and nature. B. A public mental health approach to violence 82. Interpersonal and collective violence are matters of global concern, and have a profound and lasting impact on mental health, particularly on the mental health of children. Many of the Sustainable Development Goals are directly aimed at preventing violence or addressing many of its underlying causes. Preventing violence in the home, in health-care and educational settings and in society at large is a prerequisite to the realization of the right to mental health. Although a full review of violent practices is outside the scope of the present report, the Special Rapporteur emphasizes the effects of suicide, structural violence, and interpersonal and collective violence on mental well-being to illustrate the relevance of violence throughout a person’s lifetime. Bullying is also of importance, as discussed above. 83. A public health approach to preventing violence addresses the underlying structural, community and close relationship factors that exert a long-term influence on risks of violence. Interventions include the implementation of early-year and school programmes, strengthening communities, changing cultural norms, reducing income inequality and improving social welfare. Efforts should be made to balance the focus on violence against women and girls with an equally strong focus on violence against males of all ages. Understanding the human need for social recognition, respect, dignity and status will make an important contribution to understanding the connection between unequal power relations, unequal life chances, social exclusion, male unemployment and the increased risk of violence. 84. Suicide is a form of self-directed violence that is often a response to adversity. It is a public health issue that requires population-based interventions that tackle determinants, strengthen life skills and resilience, and promote social connection and support, particularly in the case of groups who feel excluded or who are in a vulnerable situation. Such interventions empower individuals in a vulnerable situation, and may be more effective than individually targeted interventions that tend to medicalize emotional pain. If too much is expected from and invested in high-risk interventions, this can reinforce ineffective and coercive practices, such as involuntary hospitalization and treatment, excessive use of psychotropic medications and social exclusion. When these common responses are overused, they disempower individuals, reinforce their lack of control and autonomy, instil a sense of helplessness and stigmatization, and may negatively affect their long-term outcomes. Many experiences of distress are shaped by poverty, inequality, discrimination and violence, which thus emphasizes the need for interventions that address health determinants, improving human living conditions rather than pathologizing diverse responses and different ways of being. 85. The Special Rapporteur welcomes the debate on addressing depression as a risk factor for suicidal behaviour, but is concerned by the remaining global tendency to medicalize depression and suicidal behaviour, and by the further promotion of the disproven theory of “chemical imbalances”. All major national and international stakeholders should do more to address the determinants of depression and suicide. While severe forms of depression may require treatment with biomedical interventions, persons with a milder form of depression and related conditions may benefit from other forms of care and support that avoid overmedicalization and are evidence-based and culturally appropriate. 86. Structural violence stems from unequal power relationships in social structures, notably exemplified by racism, sexism, heterosexism and ableism, where groups in a vulnerable situation are systematically prevented from meeting basic needs and suffer from 35 16 See Baxter, D.E., and Pelletier, L.G., “Is nature relatedness a basic human psychological need? A critical examination of the extant literature” in Canadian Psychology/Psychologie canadienne, vol. 60, No. 1 (2019), pp. 21–34.