A/HRC/41/34/Add.2 C. Towards reaching parity between physical and mental health 61. The Special Rapporteur acknowledges efforts to include mental health in primary care, the national framework for mental health care and the many good models and practices in different provinces. He urges federal and provincial/territorial authorities to further advance the realization of the right of everyone to mental health and the realization of all human rights of persons with autism and psychosocial, intellectual and cognitive disabilities. The overall main goal is to achieve parity between mental and physical health in the provision of health services. 62. During his visit to Vancouver General Hospital, the Special Rapporteur observed its high quality specialized physical care for people who need intensive care or other physical care, and its good management of admissions and referrals. That same high level should be reached when issues relate to mental health and “problematic substance use”. 63. Innovative solutions are needed in addition to investment in biomedical interventions if physical and mental health parity is to be achieved. That is why it is crucial to address imbalances in the provision and funding of health care. Policy decisions are needed to prioritize investments in those services that are human rights compliant and that do not feed into the vicious cycle of discrimination, stigma, exclusion and overuse of the biomedical model. 64. There are good opportunities for substantial progress. For example, the “Choosing Wisely” initiative seeks to engage health-care personnel in educating the general population against wasteful, unnecessary or costly use of medical tests, treatments and procedures, including specialized interventions. The goal is to develop rational health care by empowering users to choose health care that is truly necessary, supported by evidence, not duplicative and free from harm. Support from health-care authorities for initiatives such as Choosing Wisely could achieve more effectiveness and transparency in mental health and “problematic substance use” services, as well as in the health-care system at large. 65. Canada has a double responsibility towards reaching parity between physical and mental health. On the one hand, determinants of mental health, such as inequalities, discrimination and violence, need to be addressed at the domestic level with enhanced political will and increased investments, so that the risk factors for poor mental health outcomes can be effectively prevented. In that regard, overcoming early childhood adversities is of key importance, considering their detrimental impact and correlation with a higher prevalence for different patterns of poor physical and mental health, including suicide, numerous causes of death and other harm from “problematic substance use” and poorer outcomes in indigenous peoples’ health. Integrating mental health into primary health care is also important to reduce the stigma and discrimination still linked to mental health and “problematic substance use”, to enhance access to integrated and continuing care and to improve social integration. 66. On the other hand, Canada could and should be a champion in critically assessing the current situation of mental health policies and services at the global level and in modernizing mental health policies and services through international support. Its international cooperation should be directed towards the provision of rights-based mental health services and, in compliance with the Convention on the Rights of Persons with Disabilities, should move away from services based on over-medicalization and coercion. These should be conditions for receiving the support of Canada. 67. In 2016 and 2017, the Federal Government invested Can$ 42 million into 85 projects in 31 countries through the non-profit organization Grand Challenges Canada, which is primarily funded by Global Affairs Canada. To receive funding, projects must show they promote innovative approaches that can improve treatment and increase access to mental health care across priorities that include community-based care, non-specialist treatment, improving children’s access to mental health care and improving the supply of medication. 68. Canadian international assistance and cooperation must include the full range of human rights and prioritize persons and groups in the most vulnerable situations. In the 13

Select target paragraph3

Connect to a paragraph
Connect to an entity
Disable highlights
Add to table of contents