From the Council of Europe Commissioner for Human Rights: “While the additional strain generated by the pandemic is new, the mental health situation and lack of services has been a neglected human rights crisis in Europe for a long time. Despite the suffering and economic burden caused by mental health problems, mental health spending in the WHO European region was estimated to amount to only 1% of total health expenditure in 2019, and the majority of that expenditure was channelled towards mental health hospitals. In a very important report in 2017, the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health was already raising the alarm over the fact that ‘the arbitrary division of physical and mental health and the subsequent isolation and abandonment of mental health has contributed to an untenable situation of unmet needs and human rights violations.’

In my Issue Paper on health, I called on governments to pay attention to the essential social determinants of health in order to rebuild more inclusive and resilient health care systems, notably social protection, living conditions, working environment and education. These are all the more relevant for mental health, since mental well-being is determined not only by individual attributes but also by the social environment which can prevent, cause or aggravate mental health problems. In recent decades, a human rights-based, holistic and psychosocial understanding of mental health has been emerging, but this approach still faces a lot of resistance in many of our member states, where a reductionist, biomedical paradigm remains prevalent. Further problems identified in the aforementioned report of the Special Rapporteur are power asymmetries in mental health policies and services, and the biased use of evidence in mental health. In combination, these reinforce a vicious cycle of stigmatisation, disempowerment, social exclusion and coercion.

In order to rise to the challenge posed by the pandemic for mental health services, it is essential to reform them, as well as relevant laws and policies, urgently and from the ground up. As with health policy generally, the imperative to prevent human rights violations must be the guiding principle behind these reforms.”

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