WHO seeks end to human rights abuse in mental health care – Expert Reaction

A new World Health Organization guide seeks to end violations of human rights in mental health care.

Human rights abuses and coercive practices remain common across the globe, yet people-centred, community-based approaches have proven success, it says.

The guidance cites a South Auckland example, Tupu Ake, a peer-led crisis service in Papatoetoe. Research shows higher satisfaction with care – and shorter average lengths of stay – at Tupu Ake than at hospital units.

The SMC asked experts to comment on the report. 

Dr Paul Skirrow, Executive Advisor to the NZ College of Clinical Psychologists; and Senior Lecturer, University of Otago, comments:

“A move to human rights-based approaches to mental health care is long overdue, not least because we know that many people with mental health conditions struggle to assert their basic rights in the current system. There’s a strong moral argument for a move to human-rights approaches, as well as a legal imperative with New Zealand’s commitment to the UN Convention on the Rights of People with Disabilities.

“There’s also growing evidence that human rights-based approaches lead to better clinical outcomes, are much preferred by service users and their families, and are highly cost-effective. We hope that the WHO’s new guidance and evidence-based toolkit will lead to many more mental health services adopting these approaches in the near future.”

No conflict of interest.

Dr Sarah Gordon, Senior Research Fellow / Clinical Lecturer – Service User Academic, Department of Psychological Medicine, University of Otago, comments:

“I welcome the World Health Organization’s release of guidance on community mental health services. It is particularly valuable for showcasing the existence, cost-effectiveness and success of good practice – community-based mental health services that are person-centred, recovery-oriented and adhere to human rights standards. It is great to see Tupu Ake – a peer-led, alternative crisis admission service located in Papatoetoe, offering short stays and a day support programme – included as one of the services showcased.

“However, it needs to be highlighted that this is just one service within a system; whereas the WHO identifies generally, and consistent with the findings of He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction, that services are often ‘facing substantial resource restrictions, operating within outdated legal and regulatory frameworks and an entrenched overreliance on the biomedical model in which the predominant focus of care is on diagnosis, medication and symptom reduction while the full range of social determinants that impact people’s mental health are overlooked, all of which hinder progress toward full realization of a human rights-based approach’.

“The WHO guidance identifies that a much faster transition to redesigned mental health services is required. In New Zealand, what this requires is a more urgent, proactive and comprehensive approach to implementation of the recommendations of He Ara Oranga as agreed by the Government in 2019. The recommendations and concrete action steps in this new WHO guidance are an invaluable resource in support of that.”

No conflict of interest.