Globally, mental health care continues to be provided primarily in psychiatric hospitals, and rights violations and coercive practices remain all too common, according to the UN agency.
“A more holistic approach”
You guide recommends that mental health services be localized in the community and include support for daily life, for example by facilitating access to housing, as well as to education and employment services.
“This comprehensive new guide provides a strong argument for a much faster transition from mental health services that use coercion and focus almost exclusively on using medications to manage symptoms of mental health conditions, to a more holistic approach that takes into account the specific circumstances and wishes of the individual and offers a variety of approaches for treatment and support, ” She said Dr. Michelle Funk of the Department of Mental Health and Substance Use, who led the development of the guide.
The serious abuses continue
WHO estimated that governments currently spend less than two percent of their overall health budgets on mental health. This spending is mainly intended for psychiatric hospitals, except in high-income countries where the percentage is around 43 percent.
The guide promotes person-centered services based on a human rights-based approach, as recommended by the WHO Mental Health Action Plan 2020-2030, approved last month.
WHO pointed out that although countries have increasingly sought to reform their mental health care laws, policies and services following the adoption of the United Nations Convention on the Rights of Persons with Disabilities in 2006, few have made progress in meeting the changes required by international human rights standards.
Serious human rights violations and coercive practices are still too common in all countries, the agency said. Examples include forced admission and forced treatment, as well as manual, physical and chemical restraint, unsanitary living conditions, and physical and verbal abuse.
Good practices on display
The new guide outlines what is required in areas such as mental health law, service delivery, financing and workforce development so that mental health services comply with the Disability Rights Treaty.
Contains examples of community-based mental health services from countries such as Brazil, India, Kenya, Myanmar, New Zealand, Norway and the UK that have demonstrated good practices, such as in non-coercion, community inclusion and respect for people’s rights to make decisions about their treatment and their life.
Highlighted services include crisis support, mental health services provided within general hospitals, outreach services, supported living approaches and support provided by peer groups. Cost comparisons indicate that they provide good results and are preferred by users. They can also be provided at comparable cost to traditional health services.
“The transformation of the provision of mental health services must, however, be accompanied by significant changes in the social sector,” said Gerard Quinn, UN Special Rapporteur on the Rights of Persons with Disabilities.
“Until that happens, the discrimination that prevents people with mental health problems from leading full and productive lives will continue.”