WHO/ OHCHR Guidance on Mental Health, Human Rights, and Legislation
On the 9th October 2023, The World Health Organisation and United Nations collaboratively published their new practical guidelines, calling for a significant shift away from the biomedical model of mental health.
“The WHO/ OHCHR Guidance on Mental Health, Human Rights, and Legislation provides key information on how to adopt a human rights-based approach when reviewing, adopting, implementing and evaluating mental health related laws, and includes a practical checklist enabling countries to assess whether their laws align with current human rights standards.” The guidance covers many subjects in the realm of psychotropic medication and psychiatric care. Here are some passages from the publication.
THESE PASSAGES ENCOURAGE MOBILISING PUBLIC OPINION
Mobilizing public opinion is critical for encouraging legislators to debate and pass proposed legislation.
Obtaining the support of public opinion should be initiated as early as possible through public consultations, media strategies and other activities that could provide an opportunity to raise public awareness about the proposed legislation.
Persons with lived experience should play an active role in these activities. The development of a new law is a valuable opportunity to empower organisations of persons with mental health conditions and psychosocial disabilities, and the legislative process can also serve as a vehicle to educate, influence social attitudes and facilitate social change.
SO LET YOUR OPINION BE HEARD!
Two of the most influential organisations in the world are calling you to voice your opinion, so now is the time to do so.
Sign our petition, or if our petition is not to your liking and you would prefer to make another statement, start your own petition. Whatever you do, make sure that your voice does not go unheard.
Here are some other interesting passages from the publication
While the biomedical model frames mental health conditions as “brain diseases” that need to be treated with drugs, a human rights-based perspective embraces human differences and recognizes individuals experiencing distress or unusual perceptions as having a full set of diverse experiences and contexts and not as having a problem that needs to be “cured” or “fixed”.
Prescription of psychotropic drugs
Countries should adopt a higher standard for the free and informed consent to psychotropic drugs given their potential risks of harm in the short and long term (217, 218).
Countries, for example, can require written or documented informed consent (e.g. expressed by a recording in video or audio formats) after providing detailed information on potential negative and positive effects, and the availability of alternative treatment and non-medical options.
Legislation can require medical staff to inform service users about their right to discontinue treatment and to receive support in this. Support should be provided to help people safely withdraw from treatment with drugs.
The prescription of psychotropic drugs and follow-up requires careful physical health assessment and monitoring.
Medical professionals have the obligation to inform persons using mental healthservices of the possible risks, harms and side effects in the short, medium and long term associated with use of the proposed psychotropic drugs, and of the right to initiate a process of discontinuation and to be supported to do this safely.
◉ A medical practitioner shall not administer psychotropic drugs in a dosage that, having regard to professional standards, is excessive or inappropriate.
◉ The health authority shall report, on regular basis, the availability of discontinuation programmes for psychotropic drugs.
Legislation can also help to improve the availability of specific mental health goods and services at the primary care level. For example, it can ensure that psychotropic drugs are as available and accessible as other medications, while securing higher standards for free and informed consent and safe prescribing, communication regarding all available alternative treatment, care and support options, and support for discontinuing psychotropic drugs (see section 2.3.1)
Legislation can also help correct distortions created by health insurances. For example, health insurances may not include coverage for psychosocial interventions, community-based services, inpatient services, drug dependence services, or care related to suicide attempts or self-inflicted injuries. If an insurance policy covers medication but not therapies (the former being less costly than the latter), a perverse incentive is created to choose pharmacological treatment over therapy. Likewise, if health insurance finances inpatient services only, there is little chance of community-based services being developed. Other perverse incentives include case-based payments or reimbursements for inpatient stays, but per capita funding for community mental health services.