Mental Health and disability

Mental health and the rights of persons experiencing psychosocial disabilities has been a neglected area in international development.

Psychosocial disabilities are common within all societies. However persons with psychosocial disabilities often face significant discrimination and stigma and are sometimes not well represented in Disabled Peoples Organisations.

Mental health cannot be considered in isolation from other areas of development, such as education, employment, emergency responses and human rights capacity building.

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) requires that States parties ensure that persons with disabilities have access to adequate health ( Article 25) and rehabilitative services (Article 26), which includes ensuring the right of people with psychosocial disabilities to access mainstream health services, and providing appropriate mental health services.

The UNCRPD also provides the right to personal security and freedom from inhumane treatment (Articles 14 and 15). However persons with psychosocial disabilities can face human rights violations in areas such as decision-making and legal capacity. Many also face violation of their rights to freedom from arbitrary detention and freedom from forced medical treatments.

Trauma from disasters, violence and conflict, can increase the incidence of psychosocial disabilities, necessitating appropriate measures in humanitarian assistance and post disaster responses.

The World Health Organization and partners have a focus on addressing access to quality mental health services for all.

Selected resources in this section include guidance documents, research findings, and network websites regarding inclusion of persons with psychosocial disabilities in development.

See also: Participation of Persons with Disabilities, Humanitarian and Disaster Risk Reduction, Law and Justice

Inter-Agency Standing Committee (IASC) (2017) Reference Group for Mental Health and Psychosocial Support in Emergency Settings, A Common Monitoring and Evaluation Framework for Mental Health and Psychosocial Support in Emergency Settings, IASC, G website

This document provides guidance in the assessment, research, design, implementation and monitoring and evaluation of mental health and psychosocial support (MHPSS) programmes in emergency settings. Although designed specifically for emergency contexts (including protracted crises), the framework may also be applicable for the transition phases from emergency to development (including disaster risk reduction initiatives). The framework assumes familiarity with the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings and an understanding of programming in humanitarian relief and/or development. It will be of use to DFAT officers who are providing support to, reviewing and monitoring projects which aim to provide MHPSS support to people in emergencies.

UN Special Rapporteur on the Right to Health (2017) Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest standard of physical and mental health PDF (312KB)

This report provides an excellent contextual overview, conclusions and recommendations relevant to promoting mental health consistently with the Convention on the Rights of Persons with Disabilities. The report challenges the biomedical approach, and clarifies how power imbalances and biased use of evidence have perpetuated a harmful approach to addressing mental health. The Special Rapporteur calls on all States to adopt a rights-based approach that moves mental health care and support out of institutions and into communities. The report ends with a series of conclusions and recommendations, including for international development cooperation.

WHO (2010) Mental health and development: targeting people with mental health conditions as a vulnerable group (PDF 2 MB, also in HTML version)

This report presents evidence that persons with psychosocial disabilities are particularly vulnerable and neglected and require attention from development stakeholders. It provides guiding principles for the inclusion of persons with psychosocial disabilities across development priority areas, including case study examples. It lists a number of actions to be taken by development actors, including bilateral and multilateral aid agencies, NGOs, civil society, and academic institutions to promote inclusion.

World Network of the Users and Survivors of Psychiatry

The World Network of Users and Survivors of Psychiatry (WNUSP), is a representative organisation of and for persons with psychosocial disabilities. It is a member of the International Disability Alliance (IDA). This website contains links to a number of comments, statements, and position papers regarding issues affecting persons with psychosocial disabilities. This includes definitions and appropriate ways to refer to persons with psychosocial disabilities. The perspectives portrayed on this website are sometimes different to those of other international organisations in regards to psychosocial disability and mental health.

Overseas Development Institute (2013) Background note on old age, disability and mental health: data issues for a post-2015 framework (PDF 546 KB)

This background note provides rationale for the collection of disaggregated data on disability, including persons with mental health issues, and provides a brief overview of gaps and opportunities in the measurement of excluded groups. It is a useful resource for development practitioners who are developing measurement tools that include persons with psychosocial disabilities.

Davar B (2012) Legal frameworks for and against people with psychosocial disability (PDF 200 KB)

This article provides an analysis of legal frameworks affecting persons with psychosocial disabilities in India. The article was a result of advocacy for the UNCRPD in India and contains policy analysis in the context of changing mental health legal frameworks. It provides useful guidance to inform the analysis of legal frameworks, and their influence on the participation of persons with psychosocial disability in daily life/their communities.

Humanity & Inclusion Source: Key list resources on mental health (updated regularly)

Source is a comprehensive and frequently updated online resource centre on disability inclusion. Its key list on mental health provides a range of resources, including research, guidelines, policy briefings, health practitioner information, and links to organisations’ websites. The list of documents contains helpful information for those who wish to better understand mental health and psychosocial disability.

WHO (2010) Promoting the rights of people with mental disabilities (PDF 300 KB)

This information sheet provides governments guidance on protecting and promoting the rights of persons with psychosocial disabilities. It links to supporting WHO documents regarding mental health as a neglected area of development.

WHO (2013) Investing in mental health: Evidence for action (PDF 1010 KB)

This report is targeted at national and international funding agencies. It provides an overview of some of the social and cultural factors contributing to the neglect of mental health within health systems. It provides recent evidence on the benefits of investing in mental health systems and guidance for these investments.

Centre for Human Rights of Users and Survivors of Psychiatry (CHRUSP)

The CHRUSP is a leader in human rights advocacy and the monitoring of issues affecting persons with psychosocial disabilities. Their website contains resources that provide development practitioners with useful information regarding the implementation of the UNCRPD. It also provides links to publications, videos, and human rights advocacy materials.

WHO (2012) The WHO mental health policy and service guidance package

This package of resources contains 14 modules addressing policy, planning and service development. It provides useful guidance for governments and agencies providing technical support to governments regarding the development of mental health systems.

World Health Organisation (WHO) WHO MIND

This website outlines WHO’s approach and role in addressing mental health and development. It contains links to web pages and documents outlining WHO recommendations for the development of mental health services and inclusive general health services, mental health legal reforms, mental health response in emergencies, quality assessments of services, and human rights advocacy regarding persons with psychosocial disabilities. It includes guidance documents, toolkits, case studies, and policy briefings. Some key resources from the website are listed below. (Note that in these documents, the authors definition of persons with mental health conditions includes persons who have mental illness, epilepsy, substance use disorders, child and adolescent mental health problems, intellectual impairments, and persons with psychosocial disability).

Kleintjes A, Lund C and Swartz L (2013) Barriers to the participation of people with psychosocial disability in mental health policy development in South Africa: A qualitative study of perspectives of policy makers, professionals, religious leaders and academics (PDF 200 KB)

This research article examines the barriers to participation of persons with psychosocial disabilities in mental health policy development in South Africa. The findings contribute to the limited research regarding the exclusion of persons with psychosocial disability in policy formation and the authors make useful recommendations to policy makers for better inclusion. Although country-specific, the lessons may be used to inform the analysis of policy formation processes in other contexts.

World Network of Users and Survivors of Psychiatry and International Disability Alliance (2010) The elephant in the room - involuntary psychiatric treatment and the WHO (Word 144 KB)

This resource provides a critical analysis of the above referenced document WHO (2010) Mental health and development: Persons with mental health conditions as a vulnerable group. It provides useful information regarding the various competing perspectives present in certain areas of mental health and development.

World Network of Users and Survivors of Psychiatry (2008) Implementation manual on the United Nations Convention on the Rights of Persons with Disabilities (Word 180 KB)

This manual sets out the actions required of States Parties to protect and promote the rights of persons with psychosocial disabilities.

There are no case studies available

Washington Group on Disability Statistics technical presentation

Jennifer H. Madans Ph.D., Associate Director for Science, National Center for Health Statistics (NCHS) and Mitchell Loeb,
Health Scientist, NCHS from the secretariat of the Washington Group on Disability Statistics delivered a technical session
on how to use the Washington Group questions in monitoring data systems and how to disaggregate data by disability
followed by a question and answer session at the University of Melbourne on Thursday, 30 April 2015. The presentation
was organised by the Australian Government Department of Foreign Affairs and Trade.

Presentation from the Washington Group on Disability Statistics
Picture of a man from India holding a packet of milk that is for sale. His mother is in the background looking on.

Photo: Geoff Oliver Bugbee, 2010

Adi* (30) from India, experienced mental illness. He was able to access appropriate health services, including rehabilitation, for treatment of the illness. He has now established a business selling milk. (*pseudonym used) Copyright: CBM/Bugbee