EUFAMI welcomes UN Special Rapporteur Report on Mental Health and Human Rights
The recently published UN Report of the Special Rapporteur on Mental Health and Human rights expresses several concerns surrounding the rights of persons with mental ill health, such as the chronic underfunding of mental health services around the world, stigmatisation and discrimination of persons with mental ill health, and the need to shift from institutional care settings to community-based care.
Discrimination negatively affects availability of and access to mental health services. Persons experience multiple and intersectoral forms of discrimination, which may deter them from seeking aid or enjoying high-quality services. Discrimination in everyday life, such as in schools, or the workspace, may harm the formation of healthy relationships, which detrimentally impacts mental health. Also, the Report adds, the role of diagnosis and its impact on the person’s life has to be recognised in the context of stigmatisation and labelling.
The UN Special Rapporteur encourages the use of the psychosocial model by service providers, researchers, and in medical education. The psychosocial model builds from the biomedical model and looks beyond biological determinants to also take social determinants of mental ill health into account.
The report highlights that globally, mental health expenditure is dwarfed by physical health expenditure. The funding gap between higher- and lower- to middle-income countries was also highlighted; mental health expenditure is much higher on per-capita terms in the high-income world.
Additionally, institutionalisation and segregated mental health facilities are reported as concerning because they contribute to stigmatisation, and in certain cases violate the human rights of persons in the facilities. Facilities are understaffed in many countries, facing shortages of specialist and non-specialist staff.
The accessibility of mental health services is another factor; in low- and middle-income countries, services are found around cities and urbanised regions, with low availability in urban regions. Segregation of mental health services perpetuate this gap, as it further geographically concentrates the availability of services.
EUFAMI supports the holistic, multifaceted approach to diagnosis, treatment, and research in mental health, looking beyond a purely biomedical model to take social determinants into account as well. Mental health is in the space between persons, and one of the reasons why we continue advocate for inclusion of users, family members, and other social contacts in the care team as active participants. We strongly support the transitioning to community-based care settings, provided that de-institutionalisation is not used as a pure cost-cutting mechanism and investments are made in community support services, including for family carers.
We therefore welcome the report as an additional tool for advocacy towards a wide range of accessible mental health services for users and families, involving them as active participants.