UN rapporteur seeks change to mental health care

The UN Special Rapporteur on the right to health, Dainius Puras, has called for a “sea change” in mental health care around the world.

He made the call while presenting his latest report to the UN Human Rights Council in Geneva.

Puras said that where mental health systems existed, they were segregated from other forms of health care and based on outdated practices that violated human rights.

He added that “we need little short of a revolution in mental health care to end decades of neglect, abuse and violence.”

He urged states to move away from traditional practices and thinking and move toward a long overdue shift to rights-based approach.

According to him, the current mental health policies and services are in crisis of power imbalance.

Puras said that progress was being hindered by huge imbalance in the systems currently used in policy making, service provision, medical education and research.

He explained that there was unequivocal evidence of failure of system that relied heavily on biomedical model of mental health services.

The expert said “this include the front-line and excessive use of psychotropic medicines, and yet these models persist.”

“This pattern occurs in countries across the national income spectrum. It represents failure to integrate evidence and voices of those most affected into policy, and a failure to respect, protect and fulfil the right to health,” he added.

He warned that power and decision-making in mental health were concentrated in the hands of “biomedical gatekeepers,” particularly those representing biological psychiatry.

He explained further that gatekeepers adhere to “two outdated concepts: that people experiencing mental distress and diagnosed with mental disorders are dangerous, and that biomedical interventions are medically necessary in many cases.”

“These concepts perpetuate stigma and discrimination, as well as the practices of coercion that remain widely accepted in mental health systems today”, he maintained.

He said that paternalistic and excessively medicalised concepts must give way to participatory, psychosocial care and support in the community.