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The right to mental health 2017, para. 88
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- 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
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- 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
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- 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. 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
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- 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. 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
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- 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
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- 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
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- 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
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- 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
Corruption and the right to health 2017, para. 87h
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- [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. 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
The right to mental health 2017, para. 95c
- Paragraph text
- [To ensure that health-care services guarantee the right to mental health for all, States should:] Invest in psychosocial services, that are integrated into primary care and community services to empower users and respect their autonomy;
- 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. 30
- Paragraph text
- The Constitution of WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Like all aspects of health, a range of biological, social and psychological factors affect mental health. It is from this understanding that duty bearers can more accurately understand their corresponding obligations to respect, protect and fulfil the right to mental health for all. Most of the current discussions around mental health and human rights have focused on informed consent in the context of psychiatric treatment. While that discourse is deeply meaningful, it has emerged as a result of systemic failures to protect the right to mental health and to provide non-coercive treatment alternatives.
- 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. 20
- Paragraph text
- The psychosocial model has emerged as an evidence-based response to the biomedical paradigm.It looks beyond (without excluding) biological factors, understanding psychological and social experiences as risk factors contributing to poor mental health and as positive contributors to well-being. That can include short-term and low-cost interventions that can be integrated into regular care. When used appropriately, such interventions can empower the disadvantaged, improve parenting and other competencies, target individuals in their context, improve the quality of relationships and promote self-esteem and dignity. For any mental health system to be compliant with the right to health, the biomedical and psychosocial models and interventions must be appropriately balanced, avoiding the arbitrary assumption that biomedical interventions are more effective.
- 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. 31
- Paragraph text
- The evolving normative context around mental health involves the intimate connection between the right to health, with the entitlement to underlying determinants, and the freedom to control one’s own health and body. That is also linked to the right to liberty, freedom from non-consensual interference and respect for legal capacity. While informed consent is needed to receive treatment that is compliant with the right to health, legal capacity is needed to provide consent and must be distinguished from mental capacity. The right to health also includes a right to integration and treatment in the community with appropriate support to both live independently and to exercise legal capacity (see, for example, E/CN.4/2005/51, paras. 83-86, and A/64/272, para. 10). The denial of legal capacity frequently leads to deprivation of liberty and forced medical interventions, which raises questions not only about the prohibition of arbitrary detention and cruel, inhuman or degrading treatment, but also 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
- All
- Año
- 2017
Párrafo
The right to mental health 2017, para. 77
- Paragraph text
- Reductive biomedical approaches to treatment that do not adequately address contexts and relationships can no longer be considered compliant with the right to health. While a biomedical component remains important, its dominance has become counter-productive, disempowering rights holders and reinforcing stigma and exclusion. In many parts of the world, community care is not available, accessible, acceptable and/or of sufficient quality (often limited to psychotropic medications). The largest concentration of mental hospitals and beds separated from regular health care is in higher-income countries, a cautionary note for lower and middle-income countries to forge a different path and shift to rights-based mental health care.
- 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. 22
- Paragraph text
- In the context of universal health coverage, as one of the important global commitments under the 2030 Agenda, it is critical to strengthen health-care systems so that all segments of population trust primary care and primarily use this level of services for most health conditions. This would be an effective anti-corruption measure to help decrease the prevailing tendency whereby users of health services prefer to bypass primary care and use specialized health-care services. The Special Rapporteur welcomes recent initiatives developed and replicated in some countries through which medical doctors educate the general population against wasteful or unnecessary use of medical tests, treatments and procedures in health care. Such initiatives, inter alia, “choosing wisely”, “realistic medicines” or “preventing over-diagnosis”, should be supported by States as effective measures to develop rational health-care services and thus prevent unnecessary and costly use of specialized interventions.
- 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. 20
- Paragraph text
- Although many everyday practices in health-related services may not be considered as corruption, legally speaking, their accumulation and their acceptance by various stakeholders have a detrimental cumulative effect on the performance of health-care systems and, indirectly, on individual and societal health. It is for that reason that the present report is focused not only on those forms of corruption that are legally defined as breaking the law and should be brought to justice, but also on those practices which undermine principles of medical ethics, social justice, as well as effective and transparent health-care provision. When such practices are not properly addressed, they pave the way to non-transparent decisions at all levels of policymaking, policy implementation and services provision and thus lead to corrupt environments and foster institutional 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
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personas afectadas
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 45
- Paragraph text
- Participation in health decision-making leads to improved health outcomes and is essential for ensuring the distribution of policies and programmes to broader segments of the population, thus making governance more accountable. Participation goes beyond merely being educated, informed or consulted. It implies a human right to actively engage individuals and groups in the development, implementation and review of policies, standards, indicators, benchmarks or legislation, particularly aimed at including the voices and needs of more vulnerable or otherwise underrepresented and especially affected populations.
- 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
- All
- Año
- 2017
Párrafo
Corruption and the right to health 2017, para. 50
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- There is a significant demand from civil society for accountability of Governments and other institutions. Sustainable Development Goal 16 includes a commitment to create effective, transparent and accountable institutions at all levels. Accountability is at the heart of human rights and central to the fight against corruption. Human rights-based accountability for corruption helps reveal where corruption has taken place and resulted in human rights abuses. Effective accountability processes are also important for the reason that they can have a deterrent effect in relation to corruption. It is therefore troubling that research suggests that accountability for corruption is rare, indicating a need for governments to take concerted steps to strengthen accountability mechanisms and processes.
- 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. 4
- Paragraph text
- The right to health provides a valuable normative framework and constitutes a legally binding imperative to analyse and address corruption affecting health and occurring in and beyond the health sector. The framework reflects notions of good governance, transparency, accountability and participation, which are key when it comes to combating corruption. It places legal obligations on States to guarantee access to health-related goods and services for all, including individuals and groups in situations of vulnerability, and this requires them to take actions to curb corruption where it occurs.
- 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. 44
- Paragraph text
- Meaningful participation of people in decisions that affect their health and socioeconomic well-being is a key component of the right to health and crucial when it comes to combating corruption in health care and in society at large. States’ obligations under article 12 of the International Covenant on Economic, Social and Cultural Rights require that the right to participate in decision-making processes affecting their health and development must be an integral component of any relevant policy, programme or strategy. Sustainable Development Goal target 16.7 stipulates the duty to ensure responsive, inclusive, participatory and representative decision-making at all levels.
- 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. 68
- Paragraph text
- Thus, the framework of institutional corruption highlights both the harm done and what is lost, namely, harm to patients; loss of public trust and confidence in the integrity of academic medicine; and distortion of the scientific evidence base. It exposes the economies of influence that contribute to those harms and losses and it is a call for action to neutralize those influences. Below, the Special Rapporteur reviews three main areas in the mental health field using this framework, namely, the process of development and promotion of diagnostic categories for mental health conditions, psychotropic drug research and clinical practice guidelines.
- 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. 54
- Paragraph text
- Governments must take action where monitoring and review have revealed corrupt practices. Not only should sanctions be applied, but remedies must also be awarded and implemented. Accountability should not be exclusively equated with a blame and punishment model that puts front-line workers in the firing line. Rather it is better understood as reinforcing the rule of law, including the promotion and protection of the right to health in the health system. Court judgments, as well as recommendations from other review bodies, can lead to actions by governments and other duty bearers producing transformative changes in the health sector.
- 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. 36
- Paragraph text
- The right to health requires that States take action, including policy, legislative and budgetary action, to prevent corruption from impeding the available, accessible, acceptable and good-quality health care.
- 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. 86
- Paragraph text
- Applying a human rights-based approach to health and related policies and avoiding selective approaches to human rights and the production and use of evidence in the realization of the right to health are the most effective measures for combating 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
- Año
- 2017
Párrafo
The right to mental health 2017, para. 37
- Paragraph text
- Some obligations are not subject to progressive realization and must be implemented immediately, including certain freedoms and core obligations. Core obligations include the elaboration of a national public health strategy and non-discriminatory access to services. In terms of the right to mental health, that translates into the development of a national mental health strategy with a road map leading away from coercive treatment and towards equal access to rights-based mental health services, including the equitable distribution of services in the 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
- Governance & Rule of Law
- Health
- Personas afectadas
- All
- N.A.
- Año
- 2017
Párrafo