“Reducing the Treatment Gap” Poses Human Rights Risks

(2024)

Lisa Cosgrove, Cristian Montenegro, Lee Edson Yarcia, Gianna D’Ambrozio and Julie Hannah, Health and Human Rights Journal, June 2024, Vol 26, Number 1

Abstract:
The United Nations (UN) officially acknowledged the “global burden” of mental disorders in September 2015, when mental health was included in the UN Sustainable Development Goals (SDGs). In so doing, the UN identified mental health as a priority for global development. The call to “close the treatment gap” was seen as a way to both uphold the right to treatment and integrate mental health into the SDGs, with many asserting that this is a human rights-based approach to transforming mental health. Although using the SDG framework is a sensible and necessary approach to catalyze action on mental health, the integration of mental health into the SDGs has sparked debates about the relevance and role of human rights frameworks in this area. For example, the latest draft resolution on mental health and sustainable development, presented by Mexico to the UN General Assembly, has been met with renewed calls to avoid the psychiatrization of the SDGs. Psychiatrization, in this context, points to the process by which “psychiatric institutions, knowledge, and practices affect an increasing number of people, shape more and more areas of life, and further psychiatry’s importance in society as a whole.” Concerns about psychiatrization stem from the fact that the focus is predominantly on scaling up the diagnosis and treatment of mental disorders, without paying attention to how a biomedical approach is limited in addressing the environmental, social, economic, and political determinants of mental health. Further, the emphasis on “closing the treatment gap” selectively deploys human rights in order to promote increased access to Western biomedical treatments. In so doing, there is a risk that the foundational principles of interdependence and indivisibility of international human rights will not be brought to fruition. What is needed is a holistic, rights-based approach that focuses not only on the clinical or individual interventions and outcomes but also on the process and contexts of implementation. That is why it is critical to ask “what type of evidence is valued (and devalued).” Thus, any discussions about the meaning and logistics of including global mental health as a priority for global development must include the voices of those most affected. Read more

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