Open Letter endorsing the Report of the United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
To whom it may concern,
Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
We, a wide variety of organisations and individuals representing people with personal experience of mental health services, professionals and academics, welcome and endorse in the strongest possible terms the report of the United Nations Special Rapporteur, Mr. Dainius Pūras, on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
See the report here.
This ground-breaking report is the second important commentary on mental health that has come out of the UN human rights system this year. This challenging report highlights that mental health has been a forgotten issue for far too long, leaving far too many people to suffer human rights abuses within mental health services. This most recent report goes further than the earlier report of the Office of the High Commissioner for Human Rights by calling out the ‘global burden of obstacles’ which are preventing our mental health systems from adopting a human rights-based approach which would guarantee the right to mental health for all.
We agree with the Special Rapporteur that these obstacles include power asymmetries, the prevalence of the biomedical model and biased use of evidence within the mental health system. We therefore also welcome the Special Rapporteur’s call for a shift in paradigm away from isolating mental health services which are coercive and medicalised, in line with the UN Convention on the Rights of Persons with Disabilities, to one that is recovery and community-based, promotes social inclusion and offers a range of rights-based treatments and psychosocial support at primary and specialized care levels. He also recognises the human rights imperative to invest in prevention and promotion. We endorse the Special Rapporteur’s further comments that: “…a reductive neurobiological paradigm causes more harm than good, undermines the right to health, and must be abandoned…. There is a need of a shift in investments in mental health, from focusing on “chemical imbalances” to focusing on “power imbalances and inequalities.”
We are living in a world of astounding – and very welcome – scientific and professional developments, which give great hope in our joint struggles to improve the health and wellbeing of all citizens. But it is also important to recognise that health is also a matter of social justice. Inequalities, poverty and abuse all impact on our physical and mental health, and the solutions are political and social as well as technical. The report rightly identifies a variety of effective practices and alternatives which situate mental health within a human rights and recovery-based paradigm and we agree that these must be scaled up and invested in.
Therefore we particularly welcome the Special Rapporteur’s recognition of the fact that mental health problems are; “… strongly linked to early childhood adversities, including toxic stress and sexual, physical and emotional child abuse, as well as to inequalities and violence, including gender based inequalities and gender based violence, and many other adverse conditions which people, especially those in vulnerable situations such as poverty or social exclusion, face when their basic needs are not met and their rights are not protected.”
We welcome these positive messages for a global approach to health and psychological wellbeing which ensures the participation of diversity of rights-holders and relevant stakeholders including users and survivors, civil society and communities and empowers them. We agree with the Special Rapporteur that we need to focus on the primary prevention of suffering and ill-health, as well as the care and recovery of people who experience ill-health or distress. We therefore look forward to a future where we work together to provide a coherent, scientific, but humane and psychological vision; where we offer care rather than coercion, fight for social justice, equity and fundamental human rights, and to establish the social prerequisites for genuine mental health and wellbeing.