All issues publish general papers in addition to Special Sections.
Special Sections Please note these special sections are now closed for submissions
- Abortion in the Middle East and North Africa, Guest Editors Liv Tønnessen, CMI Norway, and Irene Maffi
- Abortion Law Reform, Guest Editors Marge Berer and Lesley Hoggart
- Human Rights for Health across the United Nations, Guest Editors Benjamin Mason Meier and Lawrence Gostin
Mental health and well-being, and human rights
Guest Editors: Dainius Puras, Julie Hannah, and Audrey Chapman
Mental health has in recent years emerged from the shadows to become a global health priority. But despite this elevation, and clear evidence that there can be no health without mental health, nowhere in the world does mental health enjoy parity with physical health in national policies and budgets or in medical education and practice. Globally, it is estimated that less than 7% of health budgets is allocated to address mental health, and much of this goes to long-term institutional care and psychiatric hospitals, resulting in a near total policy failure to promote mental health holistically for all. The arbitrary division of physical and mental health and the subsequent isolation and abandonment of mental health has contributed to an untenable situation of unmet needs and human rights violations (see A/HRC/34/32, paras. 11-21). The human rights community has also tended to neglect the right to mental health and its contribution to the right to the highest attainable standard of health.
Mental health services have been governed by a reductionist biomedical paradigm that has contributed to the exclusion, neglect, coercion and abuse of people with intellectual, cognitive, and psychosocial disabilities, or those who deviate from prevailing cultural, social, and political norms. The status quo, preoccupied with excessive biomedical interventions, including psychotropic medications and non-consensual measures, is no longer defensible.
Civil society, particularly movements led by users and former users of mental health services and organizations of persons with disabilities, have brought attention to the failures of traditional mental health services to meet their needs and secure their rights. They have challenged the drivers of human rights violations, developed alternative treatment approaches and recrafted a new narrative for mental health. This has resulted in a paradigm shift including an evolving human rights framework in the area of mental health. The adoption of the Convention on the Rights of Persons with Disabilities in 2006 laid the foundation for that paradigm shift, with the aim of leaving behind the legacy of human rights violations in mental health services.
The right to the highest attainable standard of health has much to contribute to advancing this shift and provides a framework for the full realization of the right of everyone to mental health. But progress is slow. Effective, acceptable, and scalable treatment alternatives remain on the periphery of health-care systems, deinstitutionalization has stalled, and mental health investment continues to be predominantly focused on a biomedical model.
With the adoption of the 2030 Agenda for Sustainable Development and recent efforts by influential global actors such as WHO, the Movement for Global Mental Health, and the World Bank, mental health is emerging at the international level as a human development imperative. How national efforts harness the momentum of the 2030 Agenda to address mental health has important implications for the effective realization of the right to health.
This special section aims to reflect on this unique moment and calls for papers that address progressive topics and critique the current mental health landscape through the promotion of human rights. Authors who have lived experience of mental distress, people who live or work in middle- and low-income countries, scholars, human rights advocates, and service providers are invited to submit papers on the following issues.
Shifting the paradigm: human rights approaches that address mental health promotion through action on the social and psycho-social determinants of health
A key obstacle to both improving population-wide mental health and well-being as well as transforming existing mental health systems is the lack of attention (and funding) towards the structural causes of poor mental health and distress. Population-based approaches to mental health promotion are those that have moved health systems beyond individualized responses towards action on a range of structural barriers and inequalities (social determinants) that can negatively affect mental health. Papers are invited that:
- critically interrogate how existing policies and practices undermine the human rights imperative to address determinants.
- use human rights to explore ways in which targeting social and psycho-social determinants of mental health can transform global, national, or local mental health policy: including medical education, user/survivor advocacy, policy reform, strategic litigation.
Mental distress and recovery
Community-based alternatives that empower communities to restore dignity and return rights-holders to their families and communities can overcome coercion in mental health treatment. There is an emerging human rights imperative to promote a plurality of contextually appropriate community-based responses, including models that exist outside the biomedical tradition. We welcome papers addressing the normative, public policy, and/or public health dimensions of these community responses.
Rebalancing the evidence base: Mental health research and the production of knowledge
Biased evidence has shaped mental health policies and services. The broadening of disease definitions has medicalized normal human experience, resulting in expanded markets for treatment and diverting attention away from the cultural, socioeconomic and political context of emotional distress. Individualizing, decontextualizing and medicalizing emotional distress reinforces health disparities by reducing the capacity of health systems to serve those with more severe mental health problems—often those from disadvantaged groups who need care the most. As evidence drives policy it is important it is not dominated by the interests of biomedicine and industry. Papers on these topics should develop a strong human rights case to recalibrate mental health research priorities to promote transparent, independent, qualitative, and participatory social science research.
Global mental health: International cooperation and assistance
Global mental health promotion often draws on alarming statistics about the scale and economic burden of “mental disorders”. While acknowledging that millions of people around the world are grossly underserved, the current “burden of disease” approach firmly grounds the global mental health crisis in a biomedical model, too narrow to be proactive or responsive in addressing mental health issues at national and global levels. The focus on treating individual conditions leads to policy arrangements, systems, and services that pave the way for further medicalization of global mental health, rather than addressing the main risk and protective factors affecting mental health for everyone.
Papers on this topic could include:
- Applications of human rights to critique global efforts to “close the treatment gap” and scale up access to mental health services and supports.
- Reflections on how the right to participation can harness contextually relevant responses to the unmet need in mental health services.
- Examination of effective ways to mainstream the right to mental health into health, poverty reduction, and development strategies and interventions.
The editors also welcome papers that explore intersectional issues in relation to human rights and mental health, including inter alia poverty, race, drug use, gender identity or sexual orientation, and ageing.
Health and Human Rights Journal is a peer-reviewed, open access journal under the editorship of Partners in Health co-founder Paul Farmer. It is published twice yearly by Harvard FXB Center, with new issues released in June and December. There are no publication fees unless authors can use open access publication grants.
- Papers must be submitted by 15 January 2020
- Papers have a maximum word length of 7,000 words, including references.
- Author guidelines are available on the website: http://www.hhrjournal.org/submissions/author-guidelines/.
Questions about this special section can be directed to Julie Hannah email@example.com or Carmel Williams, Executive Editor, Health and Human Rights Journal at HHRsubmissions@hsph.harvard.edu
Photo by Angela Duger