A/HRC/44/48 Contents Page I. Introduction ................................................................................................................................... 3 II. Global health: progress, challenges, common ground, and a fractured consensus ........................ 3 A. Contextual entry points and priorities ................................................................................... 3 B. Participation and power: a global perspective ...................................................................... 5 C. Standardization and practice-based evidence ....................................................................... 6 D. Determinants of health and measurement ............................................................................. 7 Over-medicalization and threats to human rights .......................................................................... 8 A. Context: from “bad” to “mad”. Medical power and social control ....................................... 8 B. World Health Organization essential medicines list and mental health ................................ 10 C. Across the life course: specific groups vulnerable to excessive medicalization ................... 11 Rights-based approaches to alternatives: defining features, foundational principles and application of normative framework ............................................................................................. 13 A. Scaling up alternatives as a core obligation under the right to health ................................... 13 B. Alternatives models of mental health services as human rights in practice: key concepts and principles of rights-based support ................................................................... 13 C. Key principles ....................................................................................................................... 14 D. Accountability for systems transformation ........................................................................... 16 Global threats and future trends .................................................................................................... 16 A. Mainstreaming the right to mental health in all global contexts ........................................... 16 B. Climate change ..................................................................................................................... 16 C. Digital surveillance ............................................................................................................... 17 D. Coronavirus disease (COVID-19) and its effects on mental health ...................................... 18 Conclusions and recommendations ............................................................................................... 18 III. IV. V. VI. 2

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