A global perspective on Human Rights and Mental Health

Human rights

This article is authored by:

Dakshta Kapoor 

Human rights are the basic rights and freedoms that belong to everyone. They cannot be taken away, although some can sometimes be restricted for a legitimate rationale.

History of Human Rights

The modern concept of human rights emerged from Western politics and philosophy. The English legal document of Magna Carta of 1215 and The English Bill of Rights of 1689 are some of the earliest examples of the human rights laws. 

a. The Magna Carta of 1215 was an agreement between the English King John and the barons who were unhappy about the taxation policies of the Monarch. It included clauses in the forms of rights language it granted the barons the right to legal trial and prevented their arrest or imprisonment or outlawing or abuse or denial of ownership of property without the legal trial. 

b. The English Bill of Rights of 1689 was an agreement between the parliament and the King that prevented the latter from abusing the Protestants. It included clauses that prohibited levying of money by the crown and provided the right to petition the King, right to the fair trial, right against cruel and unusual punishments or excessive fines, and right to parliamentary privileges’ (speech, votes, etc) to the members of parliament. 

Present Scenario 

India is a party to the International Covenant on civil and political rights including economic, social and cultural rights. It was adopted by the General Assembly of the United Nations on 16 December 1966. Reviewing the report of UN India is a signatory to the aforesaid conventions and the human rights development which is embodied in the Constitution of India. 

The National Human Rights Commission in India was constituted under the Protection of Human Rights Ordinance of 28 September 1993 and it is also mentioned as an autonomous body.

The Act is legislated to establish the National and State Human Rights Commission. This act gives immense powers to the Commission in furtherance of the prevention of violation of human rights. 

The Universal Declaration of Human Rights (UDHR) in its Article 21 mentions that, the right to a standard of living which is adequate for the health and well-being of himself/herself and of his/her family which includes food, clothing, housing, and medical care and necessary social services extended to the right to security in the scenario of unemployment or other lack of livelihood in such circumstances which are beyond his/her control are available to everyone irrespective of his caste, creed, sex or gender. 

Mental Health is a Human Right 

According to UNHRC; the right to health contains; both freedom and entitlements:

  • Freedoms include the right to control one’s health, including the right to be free from non-consensual medical treatment and experimentation. 
  • Entitlements include the right to a system of health protection (i.e., health care and the underlying determinants of health) that provides equality of opportunity for people to enjoy the highest attainable standard of health.

There are three most significant determinants of mental health which are;

a. Social inclusion

b. Freedom from discrimination and violence

c. Access to economic resources

The key difference between Mental Health & Mental Illness

  • Mental health is a state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can make a contribution to his or her community. Having poor mental health is associated with emotional distress and psychosocial impairment; the effects of poor mental health are both severe and prevalent, with poor mental health being more common than depression. 
  • Mental illness is a recognized, medically diagnosable illness that results in the significant impairment of an individual’s cognitive, affective, relational abilities. These disorders result from biological or psychosocial factors and can be managed using approaches comparable to those applied to physical disease.

Canada is one of the examples of high rate of mental illness

Reasons for focusing mental health on the global platform

  • The first and foremost reason to focus on the aspect of mental health globally is due to the High Prevalence i.e. 1 in 4 people globally experience a mental health problem in their lives which results into a huge global burden of disease affecting not only the individual present but also communities and entire societies and the effects can be seen in the present as well as future.
  • The second reason is due to the low investment; health care budgets spent on the mental health are negligible in comparison with what other areas within health (diseases like cardio-vascular, Cancer, pharmaceutical intervention, etc.) 

It is also noted that almost 1/3 countries have no specifically allocated budget, for mental health as they have not settled a proper mental health strategy. All of this leads to the negative predictions on the society; WHO and nation-state estimate that mental health problems will soon overtake any other problems in terms of the overall disease analysis if urgent action is not taken. In 2010 the economic burden of the disease grows more than 50% annually. 

Focusing on tackling stigma, discrimination, and human rights abuses in Mental Health:-

  • Globally, socio-economic issues, and inequalities contribute towards increased mental health problems (Common problems associated with psychic). One of the major obstacles reported is to address the serious issues of stigma about mental health issues caused by other people’s lack of knowledge, attitude, and behavior. 

It can be also stated as Mental Health illiteracy. It can further lead to;

1. Impoverishment, low quality of life 

2. Social marginalization or social exclusion 

3. Hampers help-seeking treatment adherence and recovery 

Resulting in the loss of opportunity for individual and society 

  • Comorbidity of physical and mental ill-health crisis; In terms for comorbidity, for instance, people report; 

– Mental ill-health stigma is often perceived and experienced as worse than the physical health condition and in its association hampers both physical and mental health recovery.

– It is also noticed that people with comorbid physical and mental health problems are often not received by the physical health care they need which results in their shorter life span. 

– When we focus on the crisis for instance Covid-19, Ebola, or forced migration mental health is too often overlooked. 

Mental health illiteracy can lead to stigma discrimination and in turn, lead to severe human rights abuses. 

The right to health is a broad concept which can be broken down into for instance the rights to maternity, portable water, right to food including shelter rights and so on. It is also responsible for the protection of determinants of health care. 

Review of Article 21 concerning Human Rights and Mental Health

Article 21 of the constitution of India is available to citizens and non-citizens of the country. The article is mainly inspired by the American Constitution. 

According to the constitution of America, no one shall be deprived of life and personal liberties except according to due process of law. The due process of law means that courts have the power to control the actions of legislative and executive. It was noted that the courts can question either the substantive and procedural laws or can question both. 

During the implementation of the Indian Constitution Dr. B.R Ambedkar suggested the due process of law into the constitution of India. But Sir Alladi Krishnaswamy Aiyar said that there will be a time when we have to get the social legislations then this due process of law will create an ambiguous situation to implement laws, thus the term Procedural established by the law came into effect which will only focus on the Procedural aspect of law. 

 The Right to life under article 21 covers the ambit of rights where one of them is the Right to Die. According to the Right to Die,  if one person has a right to live then he/she must have a right to not live. Due to the right several unexpected Suicides’ were attempted which was further discussed in the case,

P Rathinam vs. Union of India AIR 1994 SC 394

According to the case, the petitioners were about to get punished under section 309 of the Indian Penal Code (IPC) because they attempted to commit suicide, they further challenged the section 309 of the IPC and stated that article 21 gives the Right to Die and so section 309 should stand invalid. 

But if we focus on today’s scenario according to the case; 

Gian Kaur vs. State of Punjab AIR 1996 SC 946

Supreme Court held that in the constitution of India the waiver of fundamental rights is not allowed. Hence if a person has been provided with the right to life he/she cannot give away the right so easily. 

And thus, the right to die is not protected under article 21 of the constitution of India. Further provided section 309 of the Indian Penal Code which states that if any person tries to commit suicide shall be punished with simple imprisonment for which the term may exceed to 1 year or with fine or both stand valid.  

Focusing on this the constitution further provides the Right to health care as one of the fundamental rights. 

Right to Health India

The constitution of India provides that every person has access to a proper living standard of physical and mental health. India is a signatory of the International covenant of human rights. Supreme Court of India held in article 21 of the Indian Constitution that the issues related to human health will be interpreted with international law.

The declaration of WHO (World Health Organization)

The World Health Organization is an agency of the United Nations that aims and regulates the international public health securities and is the part of the Nations Development Group. It was established on 7th April 1948. The headquarters of WHO is in Geneva, Switzerland.

 WHO promotes the mental well being of a person further includes the prevention of mental disorders, and efforts to increase access to quality mental health care that respects people’s human rights. 

  • Focusing on the present scenario WHO has declared a global human rights emergency in mental health. 
  • According to the organization all over the world, people with mental disabilities experience a whole range of human rights violations.

They experience this both within and outside the health care context. 

Within the Health care context; 

In many countries, people who require basic health care treatment do not have proper access to it. In other countries, the only care available in the psychiatric institution is associated with gross human rights violation including degrading treatment and living conditions and this is because of the absence of community based mental health care. 

Outside the health care context (society); 

People are denied the right to vote accompanied with marriage, and have children. Mental health not only destroys the person internally but leaves its grassroots with outside the health care context. 

As a result, many people with mental disabilities live in extreme poverty or are criminalized and end up in Prison all of which effects the late recovery of the concerned person suffering from a disability. Further, it downgrades the negative spiral of disempowerment, hopelessness, and long term consequences like Suicide. 

FAILURE OF HUMANITY by a well-known jurist PROFESSOR KLEINMAN also stated that people often attach unnecessary stigma that can future lead to the chronic ailment for the person having such a disability. 

The Relationship between Human Rights and Mental Health

Human rights violations can negatively impact mental health. Conversely, respecting human rights can improve mental health.  The relationship between mental health and human rights are divided into three parts; 

  • Torture and displacement negatively affect mental health. 
  • Mental health practices, programs, and laws, such as coercive treatment practices, can impact human rights.
  • Finally, the advancement of human rights benefits mental health synergistically.

These results beyond mental health scenario and creates a close connection between the physical and mental ailment in the society.

The World Health Organization in its Constitution says that health is a state of complete physical, mental and social well-being. It is not merely because of the absence of disease or anything but because of the mental level attained as human to protect the fundamental rights of every human being without any discrimination on the basis of caste, creed or any political or economic biasness. This is included in the preamble of UN charrer.

For Instance, the right of physical and mental health well being is essential for exercising the right to work; and at the same time, exercising the right to work contributes positively to the physical and mental health f a human. Similarly promoting and protecting health requires explicit and concrete efforts to promote and protect human rights and dignity. Besides, greater fulfillment of human rights requires sound attention to health and societal determinants. In other words, the right of health is necessary for exercising human rights; and at the same time, exercising human rights positively contributes to the right of health.

The Office of the United Nations High Commissioner for Human Rights as a key agent for human rights and mental health scenario

According to OHCHR the relationship between mental health and human rights is an integral and interdependent one. For instance, there are economic and clinical reasons attach to moral and legal obligations, to advance mental health care as the basic fundamental human right.

In 2014, WHO estimated that less than 5% of the government budget is allocated to meet the mental health scenario which is almost less in terms of physical health.

It is observed that around 20% of the world’s children and adolescents have a mental health condition, with suicide the second leading cause of death among 15-29-year-olds. About 1/5th of people living in urban areas suffer from mental health issues and lack of resources is also one of the most prominent challenges in today’s era covered with the lack of unprofessional skills in the field of mental health recovery. 

Contribution by WHO;

110 countries came forward to contribute in WHO which includes;

  • Integration in general health care and disease or topic-specific programmers such as those for HIV, tuberculosis and gender-based violence; 
  • Suicide prevention; 
  • Workforce development for mental health; 
  • Promotion of the quality of care and the rights of people receiving care; 
  • Mental health policy and legislation; 
  • Mental health and psychosocial support in humanitarian emergencies; 
  • Development and testing of innovative psychological interventions including digital interventions; 
  • Mental health in the workplace; 
  • Mental health economics; 
  • The mental health of children and adolescents; 
  • Mental health promotion.

WHO’s mental health activities cover normative activities and country support activities, it is in the eyes of people to bring it in an application.

UN understands the Right to health framework; 

  • The right to health framework suggests a human rights-based approach to ensure that health facilities, goods, and services for mental health care available in sufficient quantity and are an affordable basis on non-discrimination. 
  • The services provided need to be gender-sensitive, and medically appropriate, and respectful of medical ethics. 

An integral feature of the right to health is the expectation for meaningful participation of all humans in decisions and policies on the health care department. 

It is not surprising, that attention has most recently turned to develop ways in which stigma and discrimination can be reduced. The fact that such negative attitudes appear to be such harassing in the mind of orthodoxy which makes it more difficult to implement the laws such created. 

In the UK, the “Time to Change” campaign is one of the biggest programs attempting to address mental health stigma and is supported by both charities and mental health service providers. This provides blogs, videos, TV advertisements, and promotional events to help raise awareness of mental health stigma and the detrimental effect this has on mental health sufferers. 

The world is a changing place to live in. Variations in the mindsets of humans create an ambiguous situation to strive with the current scenario altogether. 

Laws and regulations thus bind the nation and somehow implement the new arenas of the world. However such laws are yet to be picturized. 

“The views of the authors are personal

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