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Bachelet calls for mental health care to be based on human rights

Human rights Council Intersessional consultation on Mental Health and Human Rights
Statement by Michelle Bachelet, UN High Commissioner for Human Rights

15 November 2021

Excellencies,

Distinguished panellists,

I am honoured to open today’s panel.  

As we continue to navigate through COVID-19, mental health is finally emerging as a global priority.

As it should always have been.

The pandemic has had a major impact on mental health and wellbeing across societies. And, as it was the case with other groups in vulnerable situations, COVID-19 has had a disproportionate impact on people with mental health conditions or psychosocial disabilities.

Those residing in institutional settings have faced a worsening of existing conditions, higher risk of contagion, confinement, overmedication, isolation and even death.

The few mental health community services that existed in countries were often disrupted and suffered from budgets cuts.  

The pandemic has widened the gaps that already existed in psychosocial support. They have become more evident. And so has the urgency for us, as a global community, “to promote a paradigm shift in mental health and to adopt, implement, update, strengthen or monitor, as appropriate, all existing laws, policies and practices”.

That is what this Council’s Resolution 43/13 call on us to do.

Existing mental health systems often continue to fail those seeking support.

Either because many people with psychosocial disabilities and with mental health conditions are still either lacking access to recovery-based support services, or because they are caught in a vicious cycle of violence in their interaction with them.

For example, estimates indicate that more than 10% live with a mental health condition at any one time. Treatment coverage is unacceptably poor, especially in low- and middle-income countries.

Historically, people with psychosocial disabilities and with mental conditions have been  wrongly deemed dangerous to themselves and others. They are still commonly institutionalised, sometimes for life; criminalized and incarcerated because of their conditions.

Would you seek mental health support from a system that denies you choice and control over decisions that affect you, lock you up and prevent you from having contact with friends and family? If you managed to overcome these challenges, could you go back to this system?

Let us consider two scenarios.

If a person in emotional distress is met with violence when searching for health care, it is fair to say they may never want to re-engage with such a service. Reoccurring lack of support increases the risk of exclusion, homelessness and further violence.

On the other hand, what if a person’s encounter with the mental health system is one where their dignity and rights are respected? Where relevant professionals understand that how their intersecting identities impact how they access and navigate the system? A system that will not only empower an individual as an agent of their own recovery, but it will support their journey of health and well-being?

This system is based on human rights.

It is an approach that promotes trust, enables recovery and provides both users and professionals with a framework in which their dignity and rights are valued and respected.  

In line with the Convention on the Rights of Persons with Disabilities, there needs to be an urgent shift away from institutionalization and towards inclusion and the right to independent living in the community.

That requires greater investment in community-based support services that are responsive to people’s needs

Governments must also increase investments in narrowing human rights gaps that can lead to poor mental health – such as violence, discrimination and inadequate access to food, water and sanitation, social protection and education.  

Excellencies,

Today’s consultation is a space to share positive experiences in promoting and protecting the rights of people with mental health conditions or psychosocial disabilities through law and public policies. 

Human rights and the general principles enshrined in the Convention on the Rights of Persons with Disabilities will guide us through this journey.

I am heartened by the commitment expressed by governments during the last World Health Assembly to scale up quality mental health services at all levels. And it is encouraging to hear that some countries have found new ways of providing mental health care, including by reforming their legislation and policies to improve rights-based responses.

I am particularly pleased to see the WHO QualityRights initiative, a rights-based and recovery- oriented approach to mental health care, being increasingly implemented, as well the agency’s guidance on community mental health services.

My Office looks forward to further strengthening our collaboration with the World Health Organization and other partners to promote this human rights-based approach.

Dear friends,

Within our grasp is the opportunity of our lifetimes: to recover better from the pandemic.

For that, it is clear that countries need to give mental health higher priority.

That means higher investments to transform support and care systems and make them fully embrace human rights.  

Fulfilment of the right to health, including mental health, can empower and restore individual dignity and contribute to more tolerant, peaceful and just societies.

In that spirit, I wish you a fruitful and constructive discussion.