December is Human Rights month, and because of that, we're going to be focusing on how mental health is a human right (that is often overlooked). The United Nations has a document on human rights-- The Universal Declaration of Human Rights-- that outlines what every person, regardless of gender, sex, religion, race, etc. should have guaranteed to them. It includes that people have a right to education, a right to freedom, to be innocent until proven otherwise, a right to engage in peaceful assembly, a right to work, a right to rest/leisure, rights to housing, food, etc., and much more. This document doesn't outline mental health specifically (it does highlight a right to healthcare and social services in article 25), so in order to build on this for the purpose of today's blog, I want to draw attention to the World Health Organization that outlines that access to mental health services is a human right.
In reality, though, people don't often think of mental health services as a right. Why is this, when access to healthcare is a human right? Maybe it's because of the stigma of mental health services. Maybe it's because for years, people thought of mental health as separate from physical health.
Now, in the United States, we can look at mental health services fairly positively, most of the time. We have the Americans with Disabilities Act for protection. We have the Affordable Care Act. We even have the National Institute of Mental Health. But what we don't have is access to mental health care as a human right-- there are a lot of barriers in the way of that.
Barriers to Mental Health Services as a Right
Access to mental health services is not all that great or even available some of areas. There are places where mental health services just don't exist to the extent that they're needed. Thankfully telehealth is more accessible now than ever, but this doesn't mean everyone has access to services that are needed. Telehealth requires internet access, phone service, etc. that not everyone has.
Getting help for mental health can also be very expensive, especially for those who are uninsured (and even for those who are insured! There are copays, deductibles, etc.). And, for insurance to cover therapy, a diagnosis is required, which people sometimes don't want to have to report to insurance, meaning that they're paying out-of-pocket. Again, a major expense that many people cannot afford.
The stigma of getting help for mental health is also still huge (as mentioned earlier). I like to think about it like this: for physical health, if you break your arm, you go to the hospital, and no one bats an eye. No one says that you're not strong enough, or aren't resilient. People understand. With mental health, this isn't always the case. Because of our society and social stigmas, people will shy away from accessing their right to mental health care out of fear of judgement. People have been told they aren't strong or resilient because they access mental health care, when in reality, reaching out and getting help is one of the strongest things a person can do.
Unfortunately, discrimination also has run rampant in the mental health field (racism, sexism, etc.) that acts as a major barrier to mental health treatment. White individuals are more likely to both seek out and get mental healthcare than Black or Hispanic individuals, and this isn't necessarily because they need or want the help more. There are a variety of reasons this may be, such as high levels of racism, fear of judgment, past discrimination, and more.
The history of mental health care also doesn't always have a great reputation. The Pan American Health Organization outlines some of these, such as history of involuntary admittance to hospitals and coercive practices by providers. This alone can be incredibly intimidating and scary for those seeking mental health treatment, as things like lack of voluntary treatment or partaking in a treatment that wasn't consented to are clear and obvious human rights violations. When mental health care is a human right, and within the care there has, in the past, been a history of violations, it can create a barrier to getting help. I will say that with informed consent and legal and ethical guidelines, though, this has improved GREATLY. Yet the stigma sometimes still remains based on past experiences, thought processes, and stereotypes.
Why is Mental Health Care a Human Right?
As we've talked about, most people know human rights that are basic to us: think food, shelter, and water. Think safety and security. Sometimes, we can easily jump over access to mental health services because we don't see it physically in front of us the way we recognize if a building isn't safe, or if someone does or doesn't have water. But having services for dealing with mental health issues helps people access resources (physical and emotional), helps people gain safety, deal with discrimination, get access to education, be part of a community, and more. Mental health resources help people realize that their mental health deserves to take priority in a variety of situations, and discrimination against those struggling with a mental illness violates human rights at its core.
The UN has this great article on why mental health is a human right that was written in 2018, but is honestly still relevant today. It outlines some things that I think we forget about as a society: that just because mental health is something we don't always see visually, it's crucial to our safety and wellbeing. Without mental health services some people may not continue to live- and at the bare minimum, people have a right to life. Beyond that, people have a right to life in a secure, safe, constant context in which they gain skills so that they can be active members of their society. They have a right to learn healthy ways to cope with life. They have a right to be treated fairly and equitably no matter their condition, and without mental health services, this is less likely to happen.
An example of how mental health is a major factor within human rights involves looking at unhoused peoples. Again, we think of shelter as a human right as a society in general. But what happens when those without shelter don't have a place to live in due to a mental health condition? According to SAMHSA, an estimated 30% of unhoused peoples have a mental health condition. Whether unsheltered people have a mental health condition before or after they don't have a home, the reality is that a mental health service (a right in itself) could therefore also, potentially, help them access another basic human right: shelter.
Mental health incorporates every element of our lives, from our social world, to our jobs, to whether we are fed and clothed. Because of that alone, it is necessary to make sure it is known that mental health care is a human right that everyone deserves access to. The more people who have this ability to get the help they need, the better. And mental health services don't just mean therapy-- they mean in patient hospitals, case and social workers, clinics, private practices, and more.
Mental health care is crucial, as it is a right that incorporates the need for dignity, acceptance, respect, and all other basic human needs.
How To Advocate for Mental Health as Human Right
First of all, do some research! The hyperlinked articles above are great starting points, but there is so much more information out there. For example, this UN article outlines that in 2016, 73 states released a statement together advocating for the fact that mental health is a critical part of health services as a human right. There are more articles, blogs, and more linked below that can provide additional information.
Another thing you can do is to make your voice heard. I'm not saying you need to go into government to do this, because your voice on any scale matters. Talk with your friends about how mental health care is a basic human right. Talk with your family. If they have questions, guide them to resources so that we can all better understand what makes a human right a human right (especially one that some people see as "newer," like mental health). The government's spending (in the US) of mental health care is very low, even if we just look at overall healthcare spending-- this study says that it's only 2.1% of the budget towards all of healthcare. This low budget dramatically needs to change, and to do that, we need to talk about it and understand the barriers in place.
Recognize that seeking mental health services is not just a privilege: it is something everyone has a right to, whether or not our reality yet matches that. Advocate for community based programs that help people towards receiving mental health services. For example, some colleges offer free counseling services to community members (usually done by counseling interns under the guidance of supervisors and professors) that can be hugely beneficial. Or, get involved in community mental health associations in your area, not only to spread the word that mental health care is a human right, but also to continuously learn. Here in Michigan, for example, anyone can join the Mental Health Association in Michigan that provides resources, information, and advocates for quality care.
As we finish this blog post, I want to include a quote from Louise Gaynor-Brooke on behalf of the PLOS Medicine Editors that I think sums what this article is trying to say perfectly:
"The Universal Declaration of Human Rights states that everyone has the right to education, to work, and to a sufficient standard of living to maintain their health and well-being, including access to food, clothing, housing and medical care. Given the interlinked nature of mental health and each of these factors, it is unquestionable that mental wellbeing should be considered a universal human right in itself." (Gaynor-Brook L, on behalf of the PLOS Medicine Editors (2023) Towards mental health as a human right: The key role of lived experience. PLoS Med 20(10): e1004307. https://doi.org/10.1371/journal.pmed.1004307)
So, to conclude, mental health care is health care. Mental health care is, at its very core, a human right.
Resources:
1. The Universal Declaration of Human Rights: https://www.un.org/sites/un2.un.org/files/2021/03/udhr.pdf
2. World Health Organization-- Mental Health: Promoting and Protecting Human Rights: https://www.who.int/news-room/questions-and-answers/item/mental-health-promoting-and-protecting-human-rights#:~:text=Mental%20health%20is%20a%20basic,and%20good%20quality%20care%3B%20and
3. Bonterra-- 5 Barriers to Mental Health Treatment and Access to Care: https://www.bonterratech.com/blog/barriers-to-mental-healthcare-access
4. Pan American Health Organization-- Protection and Promotion of Human Rights in Mental Health: https://www.paho.org/en/topics/protection-and-promotion-human-rights-mental-health
5. United Nations-- Mental Health is a Human Right: https://www.ohchr.org/en/stories/2018/05/mental-health-human-right and The Right to Mental Health https://www.ohchr.org/en/special-procedures/sr-health/right-mental-health
6. PLOS Medicine-- Towards Mental Health as a Human Right: The Key Role of Lived Experience: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004307
7. SAMSHA-- What Is Mental Health?: https://www.samhsa.gov/mental-health
8. Mental Health America-- Mental Health Rights: https://mhanational.org/issues/mental-health-rights
9. National Alliance of Mental Illness-- What Does It Mean to Be a Mental Health Advocate?: https://www.nami.org/Blogs/NAMI-Blog/June-2020/What-Does-It-Mean-to-Be-a-Mental-Health-Advocate
JB
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