Human rights principles in developing and updating policies and laws on mental health

The World Health Organization's Mental Health Action Plan 2013–2020 stipulates human rights as a cross-cutting principle (WHO, 2013) and foresees global targets to update policies as well as mental health laws in line with international and regional human rights instruments. The international human rights agreements repeatedly refer to health, including mental health. The most pertinent provisions related to mental health are enshrined in the 2006 Convention on the Rights of Persons with Disabilities (CRPD), which sets out human rights in an accessible and inclusive fashion to ensure the equal participation of persons with disabilities. The inconclusive description of disability in the treaty overtly refers to ‘mental impairment’ as part of an explicitly evolving understanding of disability. This text sketches some of the underlying concepts as they apply to the realm of mental health: non-discrimination of persons with disabilities and measures that should be taken to ensure accessibility in a holistic understanding; removal of social and attitudinal barriers as much as communication and intellectual barriers but also institutional hurdles. The CRPD's paradigm shift away from framing disability mainly through deficits towards a social understanding of disability as the result of interaction and focusing on capacity is the core on which the provision of mental health services at community level to enable participation in society shall be ensured. Questions of capacity, also to make decisions and the possible need for support in so doing, are sketched out.