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The right to mental health 2017, para. 53
- Paragraph text
- The Convention establishes that all mental health services designed for persons with disabilities are to be effectively monitored by independent authorities (art. 16.3). Human rights must be incorporated into the framework of reference for all monitoring and review procedures in the field of mental health. The Special Rapporteur encourages national human rights institutions to pay attention to the right to mental health in their monitoring and promotion activities. Persons with lived experience, their families and civil society should be engaged in the development and implementation of monitoring and accountability arrangements.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personas afectadas
- Families
- Persons with disabilities
- Año
- 2017
Párrafo
The right to mental health 2017, para. 17
- Paragraph text
- Three major obstacles which reinforce each other are identified in the following sections.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Personas afectadas
- N.A.
- Año
- 2017
Párrafo
The right to mental health 2017, para. 42
- Paragraph text
- The effective realization of the right to health requires the participation of everyone, particularly those living in poverty and in vulnerable situations, in decision-making at the legal, policy, community and health service level. At the population level, empowering everyone to participate meaningfully in decisions about their health and well-being requires multisectoral and inclusive engagement with stakeholders, such as users and former users of mental health services, policymakers, service providers, health workers, social workers, the legal profession, the police, carers, family members and the wider community.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Poverty
- Personas afectadas
- Families
- Año
- 2017
Párrafo
The right to mental health 2017, para. 55
- Paragraph text
- Adequate mental health services must be made available. In many countries, the limited mental health and social care available is based on a narrow biomedical model and institutionalization. The scaling-up of care must not involve the scaling-up of inappropriate care. For care to comply with the right to health, it must embrace a broad package of integrated and coordinated services for promotion, prevention, treatment, rehabilitation, care and recovery and the rhetoric of “scaling up” must be replaced with mental health actions to “scale across”. That includes mental health services integrated into primary and general health care, which support early identification and intervention, with services designed to support a diverse community. Evidence-based psychosocial interventions and trained community health workers to deliver them must be enhanced. Services must support the rights of people with intellectual, cognitive and psychosocial disabilities and with autism to live independently and be included in the community, rather than being segregated in inappropriate care facilities.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- Persons with disabilities
- Año
- 2017
Párrafo
The right to mental health 2017, para. 69
- Paragraph text
- The recognition by WHO of the importance of developing rights-based strategies, which promote and protect the mental health of entire populations, is welcomed. Individual and social factors, cultural values and the social experiences of everyday life in families, schools, the workplace and communities influence the mental health of each person. The fact that children spend a significant amount of time in schools and most adults at the workplace, means that rights-based action must promote healthy, safe and enabling environments that are free from violence, discrimination and other forms of abuse. Likewise, a person’s mental health affects life within those domains and is integral to shaping the health of communities and populations. Population-based approaches to mental health promotion move health systems beyond individualized responses towards action on a range of structural barriers and inequalities (social determinants) that can negatively affect mental health.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- Children
- Families
- Año
- 2017
Párrafo
The right to mental health 2017, para. 66e
- Paragraph text
- [The Special Rapporteur takes note of the concerns of various stakeholders, particularly within the medical communities, regarding the absolute ban on all forms of non-consensual measures. He acknowledges that their radical reduction and eventual elimination is a challenging process that will take time. However, there is shared agreement about the unacceptably high prevalence of human rights violations within mental health settings and that change is necessary. Instead of using legal or ethical arguments to justify the status quo, concerted efforts are needed to abandon it. Failure to take immediate measures towards such a change is no longer acceptable and the Special Rapporteur proposes five deliberate, targeted, and concrete actions as follows:] Scale up research investment and quantitative and qualitative data collection to monitor progress towards these goals.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- N.A.
- Año
- 2017
Párrafo
The right to mental health 2017, para. 66a
- Paragraph text
- [The Special Rapporteur takes note of the concerns of various stakeholders, particularly within the medical communities, regarding the absolute ban on all forms of non-consensual measures. He acknowledges that their radical reduction and eventual elimination is a challenging process that will take time. However, there is shared agreement about the unacceptably high prevalence of human rights violations within mental health settings and that change is necessary. Instead of using legal or ethical arguments to justify the status quo, concerted efforts are needed to abandon it. Failure to take immediate measures towards such a change is no longer acceptable and the Special Rapporteur proposes five deliberate, targeted, and concrete actions as follows:] Mainstream alternatives to coercion in policy with a view to legal reform;
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- N.A.
- Año
- 2017
Párrafo
The right to mental health 2017, para. 88
- Paragraph text
- Today, there are unique opportunities for mental health. The international recognition of mental health as a global health imperative, including within the 2030 Sustainable Development Agenda, is welcome progress. The right to health framework offers guidance to States on how rights-based policies and investments must be directed to secure dignity and well-being for all. To reach parity between physical and mental health, mental health must be integrated in primary and general health care through the participation of all stakeholders in the development of public policies that address the underlying determinants. Effective psychosocial interventions in the community should be scaled up and the culture of coercion, isolation and excessive medicalization abandoned.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 53
- Paragraph text
- Judicial, quasi-judicial, political and administrative mechanisms at the local, national and international levels can all play an important review function. It is essential that rights holders are aware of their entitlements and that complaints procedures are simple and accessible. Independent complaints procedures are often valuable. Rights holders must be able to participate in review procedures carried out by quasi-judicial, political or administrative bodies. Moreover, whistle-blower protection in the public and private sectors for individuals in procurement bodies, health authorities, health service providers and suppliers of medicine and equipment supports review through encouraging the reporting of corruption. Domestic human rights bodies, such as national human rights institutions, as well as international mechanisms such as the United Nations treaty bodies and the universal periodic review, can provide an important contribution to enhancing accountability for the right to health, including in the context of corruption.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- All
- N.A.
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 35
- Paragraph text
- Corruption also infringes medical ethics, which are an essential component of acceptable health care. Lastly, in terms of quality, corruption can affect the quality of medicines, for example, when regulators are bribed to carry out less rigorous checks, or when hospital administrators purchase medicines of unknown quality. Quality can also be compromised where bribes are extorted or accepted in decisions on hiring staff, or accrediting, licensing or certifying facilities, in deciding which medicines to include on essential medicines lists, or to market unregulated medicines, which can increase mortality and morbidity among those affected, as well as hampering disease control efforts. Nepotism, cronyism and other forms of favouritism can also compromise the quality of health and health-related services.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 40
- Paragraph text
- Discrimination encompasses any distinction, exclusion or restriction that has the purpose or effect of nullifying or impairing the recognition, enjoyment or exercise by all persons, on an equal footing, of all rights and freedoms. Non-discrimination and equality are human rights obligations which are fundamental to realizing the right to health. Not only must health and other goods and services be available to all on the basis of non-discrimination, but broader promotion and protection of equality and non-discrimination are vital in guaranteeing the equitable enjoyment of the right to health.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 33
- Paragraph text
- In terms of affordability, health-care providers can make health-care services more expensive by demanding payments (informal or under-the-table payments), which can put treatment out of reach and be a matter of life or death, contribute to morbidity or impoverish patients and their families. The payment of bribes by patients for privileged care is common in many countries and results in discriminatory access to care, with wealthier patients likely to access care more easily than those that are too poor to pay bribes. As a result of bribery in procurement processes, medicines may be more expensive.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Economic Rights
- Equality & Inclusion
- Health
- Personas afectadas
- Families
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 77
- Paragraph text
- Institutional corruption in the mental health system has several consequences. One of them is the medicalization of human diversity and misery, which expands the number of patients labelled with mental illness. According to WHO, more than 300 million people of all ages globally suffer from depression, and depression is the leading cause of disability worldwide. However, some researchers have raised serious questions about the reliability of these disease burden estimates. One study concluded that poor-quality data limit the interpretation and validity of global burden of depression estimates. They warn that uncritical application of these estimates to international health-care policymaking could divert scarce resources from other public health-care priorities. While industry certainly profits from a biological approach that emphasizes these disease burden estimates, the attainment of the right to health globally becomes ever more elusive.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 8
- Paragraph text
- Other definitions distinguish between types of corruption, which among other forms include political and institutional corruption. “Political corruption” means manipulation by political decision makers of, for example, policies and rules of procedure in the allocation of resources, such as a government accepting a bribe in exchange for the construction of a large private hospital in the capital. “Institutional corruption” results from the normalization of behaviours that compromise truth-seeking and lead to the formation of perverse incentive structures, and thus addresses the behaviour of actors who exploit their institutional positions to influence institutional processes and actions.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 42
- Paragraph text
- In the health sector, low-income and other groups in vulnerable situations are affected the most by corruption and a lack of transparency. Lower-income groups have the most difficulty affording the informal payments that are often required to receive the medical treatment they need. In health-care settings that face a high level of corruption, the poorer sections of the population and those who live in rural areas may suffer longer waiting periods at public health clinics and are also more frequently denied vaccines than rich and urban sections of the population. Health sector corruption can also lead to discrimination more directly when health-care providers and professionals treat patients differently according to their income and their contact with the medical profession.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 47
- Paragraph text
- Patients’ organizations and other more empowered interest groups may exert influence on health decision-making by lobbying in favour of the prescription and reimbursement of expensive drugs or particular programmes or treatments in a health service at the expense of other treatments or programmes. Paradoxically, these activities can reinforce imbalances and power asymmetries, as they too often result in undue pressure on policymakers to invest in specialized care and vertical programmes of treatment for certain diseases at the expense of primary care and holistic medicine. Thus participation has to be carefully planned, balanced and accompanied by open and transparent planning mechanisms to ensure representation of a broad range of civil society and other key stakeholders.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 52
- Paragraph text
- Health systems are complex and a wide range of monitoring and review processes have a role to play in enhancing accountability for the right to health in the context of corruption. In terms of monitoring, budget monitoring, effective and accurate accounting, audits and public expenditure tracking surveys are ways of monitoring how funds have been allocated and whether they have been distributed as intended, or whether corruption may have occurred. Yet in many low-income countries, Governments lack financial and technical capacity to operate such systems in an effective way. As well as monitoring of funds, monitoring of health professionals’ practice and supplies is also important. The establishment of well-resourced and independent anti-corruption and fraud agencies to prevent and detect corruption, including in the health sector, can also support the monitoring dimension of accountability.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 60
- Paragraph text
- While medical doctors and other health-care workers are accountable and responsible for ethical conduct and non-corrupt behaviour, it is crucial that corrupt practices and institutional corruption do not affect decisions made at the level of academic medicine. Medical schools that train future medical doctors and carry out medical research and university hospitals that provide a tertiary level of health-care services and use expensive biomedical technologies have a key role in preventing corruption in the rest of the health-care system. It is very important to use the principle of academic autonomy in a responsible way. The academic medical elite has enormous power over decision-making and when they advise policymakers on how to invest resources proper accountability mechanisms need to be in place.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Education
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
The right to mental health 2017, para. 43
- Paragraph text
- Health settings must empower users as rights holders to exercise autonomy and participate meaningfully and actively in all matters concerning them, to make their own choices about their health, including sexual and reproductive health, and their treatment, with appropriate support where needed.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
The right to mental health 2017, para. 51
- Paragraph text
- Accountability for the enjoyment of the right to mental health depends on three elements: (a) monitoring; (b) independent and non-independent review, such as by judicial, quasi-judicial, political and administrative bodies, as well as by social accountability mechanisms; and (c) remedies and redress. Accountability provides an opportunity for rights holders to understand how duty bearers have discharged their duties and claim redress where rights are violated. It also provides an opportunity for duty bearers to explain their actions and make amendments if required.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 72
- Paragraph text
- Studies have revealed that commercially funded trials are up to four times more likely to report industry-friendly results than trials without such financial conflicts of interest. In addition, there is clear evidence of publication bias in psychotropic drug trials; research demonstrating the ineffectiveness of a drug can be suppressed or written in a way that conveys a positive result. Such publication biases result in an inflated perception of efficacy and an underestimation of the harms of psychotropic medications.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
The right to mental health 2017, para. 1
- Paragraph text
- Mental health and emotional well-being are priority areas of focus for the Special Rapporteur (see A/HRC/29/33). In each thematic report, he has attempted to bring mental health into focus as a human rights and development priority in the context of early childhood development (see A/70/213), adolescence (see A/HRC/32/32) and the Sustainable Development Goals (see A/71/304).
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- Adolescents
- Año
- 2017
Párrafo
The right to mental health 2017, para. 3
- Paragraph text
- The present report is the result of extensive consultations among a wide range of stakeholders, including representatives of the disability community, users and former users of mental health services, civil society representatives, mental health practitioners, including representatives of the psychiatric community and the World Health Organization (WHO), academic experts, members of United Nations human rights mechanisms and representatives of Member States.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personas afectadas
- Persons with disabilities
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 87h
- Paragraph text
- [The Special Rapporteur urges States to:] Guarantee the right to participation of the population in all actions aimed at combating corruption in health, such as through the disclosure of important health-related information, as well as in the design and delivery of health programmes;
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 9a
- Paragraph text
- [All in all, corruption is a multidisciplinary phenomenon demanding a response from many fields of study. From a legal perspective, the United Nations Convention against Corruption (General Assembly resolution 58/4, annex) lists five acts of corruption, which can be translated as follows to the health context:] The bribery of national and foreign public officials in exchange for an undue advantage;
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- N.A.
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 12
- Paragraph text
- Corruption is particularly detrimental in that it increases mistrust on the part of all stakeholders, especially users of services, not only in the health-care system but also in the abilities and performance of local and national authorities in general. While little research has been done on the impact of corruption on health outcomes, it is suggested, for example, that countries with higher levels of corruption have higher levels of child mortality.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- Children
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 88b
- Paragraph text
- [The Special Rapporteur also urges other relevant stakeholders to:] Address, through legal, policy and other measures, corrupt practices taking place in all stages of the pharmaceutical value chain, including during research and development, manufacturing, registration, distribution, procurement and marketing of medicines;
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Governance & Rule of Law
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 88f
- Paragraph text
- [The Special Rapporteur also urges other relevant stakeholders to:] Enhance transparency and avoid misusing the principle of academic autonomy when investments in health and health care are addressed, so that the integrity of academic medicine and its commitment to the realization of the right to health is not undermined.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Education
- Equality & Inclusion
- Health
- Personas afectadas
- N.A.
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 21
- Paragraph text
- Mindful that the nature of corruption means that it is often difficult to distinguish intentional malfeasance from inefficiencies, errors, and differences in judgments and in priorities, the Special Rapporteur underlines that enhancing transparency is particularly important not only to address clearly corrupt practices but also to address these harmful phenomena, which obstruct the enjoyment of the right to health.
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personas afectadas
- N.A.
- Año
- 2017
Párrafo
The right to mental health 2017, para. 93a
- Paragraph text
- [To ensure that social and underlying determinants for the promotion of mental health for all are addressed, the Special Rapporteur recommends that States:] Prioritize mental health promotion and prevention in public policy, scaling investments across the relevant ministries;
- Organismo
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Tipo de documento
- Special Procedures' report
- Temas
- Equality & Inclusion
- Health
- Personas afectadas
- N.A.
- Año
- 2017
Párrafo