Attainable Standard Of Mental Health Research Articles

Human rights and the social determinants of mental health: fostering interdisciplinary research collaboration

There is a developing body of research indicating that individual and population-based mental health is affected by a range of ‘social determinants’. Discrimination, poverty, inadequate access to housing and education as well as exposure to violence, conflict and disaster have all been associated with poor mental health and mental illness. International human rights treaties identify many of the social determinants of mental health as matters of human rights. However, limited attention has been paid to the connection between social determinants and the right to enjoyment of the highest attainable standard of mental health. This paper explores the potential for incorporating elements of both social determinants and human rights approaches to provide a new framework for mental health research, policy and practice. While acknowledging potential challenges, it identifies advantages to collaborating across disciplinary boundaries. The social determinants approach provides a foundation for understanding the interconnectedness of rights and draws attention to individual and collective needs, while a human rights approach can help identify the measures that are required to secure the social determinants of good mental health and wellbeing.

Human rights promotion and the ‘Geneva impasse’ in mental healthcare: scoping review

The World Psychiatric Association recently emphasised that the protection of human rights in mental healthcare was a 'central concern'. This paper examines recent literature on human rights and mental healthcare. To (a) outline how international human rights law distinguishes between the protection and promotion of human rights; and (b) explore the literature on promoting human rights in mental healthcare which avoids what has been termed the 'Geneva impasse' between those who argue that compulsory care and treatment can never comply with human rights law and those who argue that they can if certain conditions are met. The following doctrinal methodology was used: (a) identification and detailed analysis of international human rights conventions and commentaries; (b) identification of key literature on human rights and mental healthcare; and (c) critical analysis of key issues emerging from the literature. Much of the literature on human rights and mental healthcare focuses on whether restrictions on compulsory care are required to meet the requirements of United Nations Conventions. There is an emerging literature identifying measures to promote the right to the enjoyment of the highest attainable standard of mental health. There has been a focus on protecting the rights to liberty and equality before the law for mental health patients. The nascent literature on promoting human rights in mental healthcare could mark a way forward beyond the 'Geneva impasse' that has dominated public debate in recent years.

Revising, reforming, reframing: Report of the Expert Group on the Review of the Mental Health Act 2001 (2015)

Involuntary psychiatric admission and treatment in Ireland is chiefly governed by the Mental Health Act 2001. The Irish government announced a review of the 2001 Act in July 2011, and the Report of the Expert Group on the Review of the Mental Health Act 2001 was published on 5 March 2015. The report, which constitutes advice to the Minister for Primary Care, Social Care (Disabilities & Older People) and Mental Health, presents 165 recommendations relating to virtually all areas of the Act. It recommends that 'insofar as practicable, a rights based approach should be adopted throughout any revised mental health legislation' and that the principle of 'best interests' should be replaced by an alternative set of principles as follows: 'the enjoyment of the highest attainable standard of mental health, with the person's own understanding of his or her mental health being given due respect; autonomy and self-determination; dignity (there should be a presumption that the patient is the person best placed to determine what promotes/compromises his or her own dignity); bodily integrity; and least restrictive care'. The Report presents a series of other recommendations aimed at increasing multi-disciplinary involvement in key decisions, promoting human rights and strengthening inspections of community facilities. Overall, the package of measures outlined in the Report is complex, interesting and worthy of debate.