13.10.2015 The WHO increases its focus on dignity in mental health services


All human beings are born free and equal in dignity and rights…. – Article 1 of the Universal Declaration of Human Rights

I am at the WHO annual mhGAP Forum in Geneva, discussing the priorities for mental health at a global level. It is exciting to see a profound shift towards recognising the importance of the experiences that people have in services in their communities. CBM has done a lot of work in promoting the right to access decent mental health services, but we must also ensure that the way that people are treated in those services and wider society is dignified.

The theme of World Mental Health Day this year is ‘dignity’, and we spend time looking at the huge abuse of people in communities, and in mental health services. There was plenty of opportunity to hear from people with psychosocial disabilities about what dignity meant to them, and how they had challenged the system to recognise them as individuals.

One of the examples of resources being developed to promote dignity is QualityRights, which is partly supported by CBM.

The QR toolkit aims to –

  • Provide a framework for assessing and improving the quality of care offered to service users
  • Increase the capacity of persons with psychosocial disabilities to speak confidently about their priorities
  • Promote a civil society movement of people working together to improve care
  • Reform policies and law to better reflect the human rights of persons using services. This includes practical guidelines and standard operating procedures in health facilities

A major evaluation of the project is currently under way in Gujarat, India. The head of mental health for the State, which has a population of 62 million people, spoke about how the project was having an impact on the services in the State. Overall the very transformational aim of the work is to shift the emphasis of mental health services from a paternalistic and controlling environment focused on illness, to one where the priorities and decisions of service users are valued, where the environment promotes dignity, and where the focus is on recovery.

This is a dramatic and fundamental change from the tone of services in many parts of the world at present. The availability of a simple toolkit will help many countries to feel confident about practical measures that they can take to move towards meeting their commitments towards the Convention on the Rights of Persons with Disabilities.

Graham Thornicroft from FundaMentalSDG.org described the work that is being done to ensure that the importance of dignity is recognised in the new Sustainable Development Goals. Mental health and well-being now has a good recognition in the SDGs, and at this stage it is crucial to get the indicators required to hold governments to account. Here is a great film about it, produced by FundaMentalSDG.

This is one way in which we can all contribute to seeing dignity being respected in peoples’ lives.