World Mental Health Day: WHO urges legislative reforms to end coercion

There is a need for the government to adopt legislative reforms to end coercion in mental health services and enshrine free and informed consent as the basis of all mental health-related interventions, the World Health Organisation has said.

World Mental Health Day is celebrated every year on October 10 (today) to raise awareness about mental health around the world and to mobilise efforts to support those experiencing mental health issues.

The WHO said legislative provisions should provide guidance on how more complex and challenging cases can be handled in legislation and policies without recourse to coercive practices.

In order to respect individual rights to health decisions, the global body said ending coercive practices in mental health such as involuntary detention, forced treatment, seclusion, and restraints is essential.

“Mental health is an integral and essential component of the right to health,” said Tedros Ghebreyesus, WHO director-general. “This new guidance will support countries to make the changes needed to provide quality mental health care that assists a person’s recovery and respects their dignity, empowering people with mental health conditions and psychosocial disabilities to lead full and healthy lives in their communities.”

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According to WHO, there is a growing body of evidence that indicates how coercive practices negatively impact physical and mental health, often compounding a person’s existing condition while separating them from their support systems.

Human rights abuses and coercive practices in mental healthcare, supported by existing legislation and policies, are still common. Involuntary hospitalisation and treatment, unsanitary living conditions, and physical, psychological, and emotional abuse characterize many mental health services across the world.

About three out of 10,000 in Nigeria suffer mental disorders without adequate provision for their care, according to the WHO Mental Health Atlas 2020.

Nigeria’s total mental health expenditure per person stood at N89 as of 2020, marking one of the lowest in the world.

The new guidance aims for all legislators and policymakers involved in drafting, amending, and implementing legislation impacting mental health, such as laws addressing poverty, inequality, and discrimination.

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It also provides a checklist to be used by countries to assess and evaluate whether mental health-related legislation is compliant with international human rights obligations.

In addition, the guidance also sets out the importance of consulting persons with lived experience and their representative organisations as a critical part of this process, as well as the importance of public education and awareness on rights-based issues.

While the guidance proposes a set of principles and provisions that can be mirrored in national legislation, countries may also adapt and tailor these to their specific circumstances without compromising human rights standards.

While many countries have sought to reform their laws, policies, and services since the adoption of the United Nations Convention on the Rights of Persons with Disabilities in 2006, too few have adopted or amended the relevant laws and policies on the scale needed to end abuses and promote human rights in mental health care.

“Our ambition must be to transform mental health services, not just in their reach, but in their underlying values, so that they are truly responsive to the needs and dignity of the individual. This publication offers guidance on how a rights-based approach can support the transformation needed in mental health systems,” said Volker Türk, UN High Commissioner for Human Rights.