New World Health Organisation and UN Human Rights Guidance
On October 9th, 2023, the World Health Organisation and the UN Human Rights Office jointly published the ‘Mental health, human rights and legislation: guidance and practice’ [1] document.
At Neurodiverse Connection we welcome and celebrate this step away from the medical model of mental health (which posits that mental distress is an illness, resulting from brain abnormality, genetics or biochemical imbalances, to be treated with psychiatric drugs, restraint and detention) and step instead towards social models (which suggest that mental distress is due to socio-economic, cultural and environmental oppression, stigma and social exclusion), human rights and trauma-informed approaches (which move away from pathologizing and asking ‘what’s wrong with you?’ to exploring the question ‘what happened to you that has caused this understandable mental distress you are experiencing?’). This is aligned with the development and training work we are already doing around addressing inequality with CAMHS, Mental Health Services and NHS trusts.
At Neurodiverse Connection we support an improved understanding of neurodiversity in health and social care with the aim of challenging stigma and discrimination and the consideration of intersectionality, continually appraising how we can support the amplification of views and voices that are often unseen and unheard.
Our Neurodivergent Friendly Train the Trainer Wellbeing Approach is trauma-informed, integrative, and comprehensive and we also deliver nervous system focused training sessions focused on regulation and restraint reduction. In addition, we advocate for shifts in culture in NHS Mental Health Services towards a relational, co-regulation and embodiment paradigm, focusing on advocacy for radically rethinking approaches to eating disorders and self-harm by taking an intersectional lens and addressing systemic and sensory oppression, and social exclusion.
The document is over 208 pages long and well worth a read as its purpose if to be ‘resource tool’ which ‘brings together information related to human rights, mental health and legislation in a single comprehensive publication’. Below are some of the key points from the guidance which overlap with our values and priorities.
The WHO and UN are advocating for a significant shift away from the biomedical model of mental health, which relies on diagnoses, medications, forced restraints, and institutionalisation. They propose a trauma-informed, social and community inclusion, human rights, recovery-orientated and person-centred approach. This change is motivated by the recognition of how the current model harms individuals, leading to oppression, control, isolation, stigma, and discrimination. Specific groups, including women, LGBTQ+ individuals, are disproportionately affected, facing forced sterilisations and other human rights violations. The WHO and UN acknowledge the widespread harm caused by the biomedical model, resulting in unjust perceptions of those with psychiatric disorders as dangerous and unstable, leading to discrimination in various aspects of life including healthcare, education, employment, and justice system.
The WHO and UN advocate for fundamental changes in mental health practices, emphasising:
Ending discrimination based on psychiatric diagnoses, ensuring equal access to insurance, housing, and support.
Respecting the legal rights and personhood of individuals seeking mental health services.
Implementing informed consent in all psychiatric treatments, providing accurate information on treatments, side effects, and alternatives.
Eliminating coercive practices, including forced treatments and manipulative conditions for accessing support.
Prohibiting involuntary hospitalisation, forced treatment, seclusion, and restraints.
Developing trauma-informed community support and peer-led services.
Facilitating deinstitutionalisation and ensuring accountability through independent monitoring bodies.
Establishing redress systems for those harmed by psychiatry and biomedical mental health models.
This shift is vital due to ongoing issues such as stigma, discrimination, unequal treatment, limited access to justice, and infringement of human rights in mental health services. The biomedical approach, emphasising medications and risky procedures, neglects social factors contributing to distress, reinforcing discrimination. Additionally, psychiatric diagnoses have been used to deny basic rights, making it crucial to challenge these practices and recognise diverse cultural perspectives. The change aims to dismantle the influence of western medical beliefs rooted in colonial history and establish a more just, inclusive mental health framework. At Neurodiverse Connection we support this.
Reference
World health Organisation and United Nations (2023) Mental health, human rights and legislation, guidance and practice. Available at: https://iris.who.int/bitstream/handle/10665/373126/9789240080737-eng.pdf?sequence=1
