Abstract
Throughout the last 20 years, the human rights perspective has increasingly developed into a paradigm against which to appraise and evaluate mental health care. This article investigates to what extent the Finnish open dialogue (OD) approach both aligns with human rights and may be qualified to strengthen compliance with human rights perspectives in global mental health care. Being a conceptual paper, the structural and therapeutic principles of OD are theoretically discussed against the background of human rights, as framed by the Universal Declaration of Human Rights, the UN Convention on the Rights of People with Disabilities, and the two recent annual reports of the Human Rights Council. It is shown that OD aligns well with discourses on human rights, being a largely non-institutional and non-medicalizing approach that both depends on and fosters local and context-bound forms of knowledge and practice. Its fundamental network perspective facilitates a contextual and relational understanding of mental well-being, as postulated by contemporary human rights approaches. OD opens the space for anyone to speak (out), for mutual respect and equality, for autonomy, and to address power differentials, making it well suited to preventing coercion and other forms of human rights violation. It is concluded that OD can be understood as a human rights-aligned approach.
Highlights
The human rights perspective on mental health has a long tradition [1]
In his latest report [5], the UN Special Rapporteur for the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health carries this emphasis on human rights further: Introducing the principle of “human rights first” (p. 1), he eschews the traditional supremacy of scientific evidence over other rationales for the promotion and implementation of health care interventions
According to the structural principle of immediacy, within the first 24 h of a crisis situation, help is offered in situ, i.e., outside of mental health care facilities and within the everyday environment of the person or networks of concern
Summary
The human rights perspective on mental health has a long tradition [1]. It has gained importance largely since the publication of the WHO’s guidelines in 1996 [2], increasingly developing into a central paradigm against which to appraise and evaluate mental health care worldwide. Human rights concerns are at the foreground of international considerations [3], paired with the principle of scientific evidence in guiding global mental health care and promotion [4]. In his latest report [5], the UN Special Rapporteur for the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health carries this emphasis on human rights further: Introducing the principle of “human rights first” According to his argument, justifying an intervention’s significance should require a consideration of the existing evidence but more importantly its potential to align with and strengthen human rights.
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