Mental health and human rights are complementary approaches to the betterment of human beings
While talking about our conditions on mental health status, Article 35 of the Constitution of Nepal prescribes only about the physical health of citizens, not about the conditions of mental health issues. As mental health-related policy, plans and strategy were incorporated in the 2019 National Health Policy, the 1996 Mental Health Policy was automatically cancelled.
Mental health is a major concern worldwide and Nepal is not an exception. If we evaluate the developments in the field of mental health, the pace appears to be slow in Nepal. Dr. Brock Chisholm, the first director-general of the World Health Organization (WHO), in 1954, had presciently declared that “without mental health there can be no true physical health.”
In recent years, there has been increasing acknowledgement of the important role mental health plays in achieving global development goals, as illustrated by the inclusion of mental health in the Sustainable Development Goals. Depression is one of the leading causes of disability. Suicide is the fourth leading cause of death among 15-29-year-olds. People with severe mental health conditions die prematurely – as much as two decades early – due to preventable physical conditions. Despite progress in some countries, people with mental health conditions often experience severe human rights violations, discrimination, and stigma. Many mental health conditions can be effectively treated at relatively low cost, yet the gap between people needing care and those with access to care remains substantial. Effective treatment coverage remains extremely low.
International human rights instruments are important in the context of mental health because they are the only source of law that legitimizes international scrutiny of mental health policies and practices within a sovereign country and also because they provide fundamental protections that cannot be taken away by the ordinary political process. Mental health and human rights are inextricably linked. They are complementary approaches to the betterment of human beings. Some measure of mental health is indispensable for human rights because only those who possess some reasonable level of functioning can engage in political and social life. On the other hand, human rights are indispensable for mental health as they provide security from harm or restraint and the freedom to form and express beliefs that are essential for mental well-being.
There are also agreed international standards of good practice which are not legally binding. These include the UN Declaration on the Rights of Mentally Retarded Persons (1971) 15; the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care (1991) ; the Standard Rules for Equalization of Opportunities for Persons with Disabilities (1993); the Declaration of Madrid (1996) and other standards such as WHO’s Mental Health Care Law: ten basic principles and WHO Guidelines for the Promotion of Human Rights of Persons with Mental Disorders (1996).These standards may serve to countries as interpretative guides to international treaty obligations. International human rights instruments create a number of broad protections that provide important rights to people with mental illnesses, such as: the right to the highest attainable standard of physical and mental health; protections against discrimination; protections against torture, inhuman, or degrading treatment; and protection against arbitrary detention.
So, there is always a need for awareness and health literacy, both of these are two sides of the same coin. Stigma and discrimination are negative consequences of ignorance and misinformation. Mental health awareness campaigns have yielded positive outcomes. Some of the strategies undertaken to target awareness and address stigma around mental illness include participation by family members, sensitization to treatment and social inclusion. Lack of knowledge about mental illnesses poses a challenge to the mental health care delivery system. Research has highlighted the role of community-based systems in low-income countries and has also yielded positive results in creating awareness, thereby impacting participation. Considering that most of the earlier strategies to enhance mental health have not succeeded over the past six decades or more in less-developed countries, the time has come to take on a new approach with renewed vigor. Mental health awareness can become both the means and the way of ending this apathy. Progressive government policies based on evidence-based approaches, an engaged media, a vibrant educational system, a responsive industry, aggressive utilization of newer technologies and creative crowd-sourcing might together help dispel the blight of mental illnesses.
While talking about our conditions on mental health status, Article 35 of the Constitution of Nepal prescribes only about the physical health of citizens, not about the conditions of mental health issues. As mental health-related policy, plans and strategy were incorporated in the 2019 National Health Policy, the 1996 Mental Health Policy was automatically cancelled. There was therefore a need for a detailed strategy and action plan to address the challenges and problems in the mental health sector, so the 2020 National Mental Health Strategy and Action Plan was prepared. Its vision is to improve the mental and psychosocial health of Nepalese, enabling them to live productive and quality lives. The guiding principles of the plan are to ensure easy and equal access to high-quality mental health services; integrate mental health services into primary healthcare; maintain participation, cooperation and partnership between government, non-government and private sectors; and provide an evidence-based and comprehensive mental health service that is rights-based, participatory and inclusive. Its strategies include managing the necessary resources, workforce and delivery of mental and psychosocial services; conducting awareness campaigns to remove superstitions and myths related to mental illness and promote mental health; protecting human rights of people with mental illness and psychosocial disability; and promoting research by integration of mental health service-related information into the current information system. It also mentions monitoring and evaluation of programme implementation at all three government tiers – central, provincial and local.
In conclusion, if the right to mental health is to become tangible, rather than aspirational, international institutions, governments and civil society must articulate achievable methods of implementing and enforcing it. The development of a remarkable, but still incomplete, human rights structure acts as an important means to achieve these goals and persons with mental illnesses will certainly benefit from the continual development of human rights systems at the international, regional and national levels.