Globally, mental health care continues to be primarily provided in psychiatric hospitals, and human rights violations and coercive practices remain all too common, according to to the World Health Organization.
A more holistic approach
The guidelines recommend that mental health services be provided in the community and include daily life support, such as access to housing, as well as education and employment services.
Dr. said. Michele Fitnik, Division of Mental Health and Substance Abuse, who led the development of the guidelines: “These comprehensive new guidelines make a strong case for a much faster transition from mental health services that use coercion and focus almost exclusively on the use of medications to manage symptoms of mental health conditions, to A more holistic approach takes into account individuals’ circumstances and desires and offers diverse approaches to treatment and support.”
Continuing grave violations
The World Health Organization estimates that governments currently spend less than 2 percent of their total health budgets on mental health. This spending is mainly allocated to psychiatric hospitals, except for high-income countries where the figure is around 43 percent.
The guidelines encourage person-centered services, grounded in a human rights-based approach, as recommended under the WHO Mental Health Action Plan 2020-2030, which was approved last month.
The World Health Organization noted that although countries have increasingly sought to reform their mental health laws, policies and services, following the adoption of the UN Convention on the Rights of Persons with Disabilities in 2006, few countries have made progress in meeting the changes required by international human rights standards.
The organization said that gross human rights violations and coercive practices are still very common in all countries. Some examples include coercive hospitalization and coercive treatment, as well as handcuffing, physical and chemical restraints, unsanitary living conditions, and physical and verbal abuse.
© UNICEF/Sukhum Preechapanic
Show good practice
The new guidelines outline what is required in areas such as mental health law, service delivery, finance and workforce development, that mental health services comply with the Convention on the Rights of Persons with Disabilities.
Examples of community mental health services include in countries such as Brazil, India, Kenya, Myanmar, New Zealand, Norway and the United Kingdom, which have demonstrated good practices, for example: non-coercion, inclusion in the community and respect for people’s right to make decisions about their treatment and lives.
Services highlighted include crisis support, mental health services provided in public hospitals, outreach services, assisted living approaches and support from peer groups.
When comparing costs, the results are good and users like them. It can also be provided at a cost similar to mainstream health services.
Dr. said. Gerard Quinn, Special Rapporteur on the rights of persons with disabilities: “However, the shift in the provision of mental health services must be accompanied by significant changes in the social sector.”
Until that happens, he added, “the discrimination that prevents people with mental health conditions from leading full and productive lives will continue.”