United Nations Report Calls for Revolution in Mental Health Care

United Nations Report Calls for Revolution in Mental Health Care

United Nations Report Calls for Revolution in Mental Health Care

This week, Dainius Pūras, a professor of psychiatry from Lithuania who has been appointed by the United Nations as an independent expert and Special Rapporteur on the right to health, presented a report to the Human Rights Council in Geneva. The report, which can be read in full here, calls for a radical and global “shift in approach” to the treatment of mental health issues.

Dainius Pūras, a medical doctor with notable expertise on mental health and child‘s health serves as Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health for the United Nations

The report by Pūras aims to inform global policy makers and healthcare workers of the current challenges facing mental health care and lay out priorities and opportunities for improving existing systems. The report identifies three major obstacles to mental health reform, including the dominance of the biomedical model, power asymmetries, and the biased use of evidence in mental health research.

While he acknowledges that many other organizations have called for improvements to existing services, he expresses concerns that these calls, based on “alarming statistics to indicate the scale and economic burden of ‘mental disorders,’” are too rooted in the biomedical model to “address the grossly unmet need for rights-based mental health services for all.”

Pūras also lays out an alternative framework for mental health care that is founded on a human rights paradigm. Informed consent makes up a key part of the rights-based approach to mental health care and Pūras argues that forced treatment in ineffective and “perpetuates power imbalances in care relationships, causes mistrust, exacerbates stigma and discrimination and has made many turn away, fearful of seeking help within mainstream mental health services.”

In addition, this paradigm shift means that “rights-based strategies” must also target the social determinants of mental health and seek to improve the environments and communities in which people live. Pūras writes:

When more severe forms of mental distress are present, the reports calls for a rapid shift away from “coercion, medicalization, and exclusion” and towards evidence-based recovery services. “People can and do recover from even the most severe mental health conditions and go on to live full and rich lives,” he adds.

Pūras highlights existing recovery-based services including “peer support, when not compromised,” and “recovery colleges, club houses and peer-led crisis houses.” Open Dialogue and the Soteria House project are both given as long-standing examples of rights-based and effective services for mental health crisis.

Finally, Pūras offers several policy recommendations for confronting global mental health challenges from a rights-based perspective. Among others, his suggestions include:

States take immediate measures to establish inclusive and meaningful participatory frameworks in the design of and decision-making around public policy, to include, inter alia, psychologists, social workers, nurses, users of services, civil society and those living in poverty and in the most vulnerable situations; States and other relevant stakeholders, including academic institutions, recalibrate mental health research priorities to promote independent, qualitative and participatory social science research and research platforms, exploring alternative service models that are non-coercive End all financial support for segregated residential mental health institutions, large psychiatric hospitals and other segregated facilities and service; Ensure that users are involved in the design, implementation, delivery and evaluation of mental health services, systems and policies; Invest in psychosocial services, that are integrated into primary care and community services to empower users and respect their autonomy;

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Read the UN press release here: http://www.ohchr.org/EN/NewsEvents/Pages /DisplayNews.aspx?NewsID=21689&LangID=E

Read the full report here: https://documents-dds-ny.un.org/doc/UNDOC/GEN/G17/076/04 /PDF/G1707604.pdf?OpenElement

MIA-UMB News Editor: Justin Karter is a writer, researcher and community organizer with

graduate degrees in both journalism and community psychology. He is a doctoral candidate in Counseling Psychology at UMass Boston, an active member of the Society for Humanistic Psychology, and is currently working on several scholarly projects at the intersection of psychology, social theory, and political philosophy.

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