Open Letter

Open Letter endorsing the Report of the United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

To whom it may concern,

Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health http://ap.ohchr.org/documents/dpage_e.aspx?si=A/HRC/35/21

We, a wide variety of organisations and individuals representing people with personal experience of mental health services, professionals and academics, welcome and endorse in the strongest possible terms the report of the United Nations Special Rapporteur, Mr. Dainius Pūras, on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

This ground-breaking report is the second important commentary on mental health that has come out of the UN human rights system this year. This challenging report highlights that mental health has been a forgotten issue for far too long, leaving far too many people to suffer human rights abuses within mental health services. This most recent report goes further than the earlier report of the Office of the High Commissioner for Human Rights by calling out the ‘global burden of obstacles’ which are preventing our mental health systems from adopting a human rights-based approach which would guarantee the right to mental health for all.

We agree with the Special Rapporteur that these obstacles include power asymmetries, the prevalence of the biomedical model and biased use of evidence within the mental health system. We therefore also welcome the Special Rapporteur’s call for a shift in paradigm away from isolating mental health services which are coercive and medicalised, in line with the UN Convention on the Rights of Persons with Disabilities, to one that is recovery and community-based, promotes social inclusion and offers a range of rights-based treatments and psychosocial support at primary and specialized care levels. He also recognises the human rights imperative to invest in prevention and promotion. We endorse the Special Rapporteur’s further comments that: “…a reductive neurobiological paradigm causes more harm than good, undermines the right to health, and must be

abandoned…. There is a need of a shift in investments in mental health, from focusing on “chemical imbalances”

to focusing on “power imbalances and inequalities.”

We are living in a world of astounding – and very welcome – scientific and professional developments, which give great hope in our joint struggles to improve the health and wellbeing of all citizens. But it is also important to recognise that health is also a matter of social justice. Inequalities, poverty and abuse all impact on our physical and mental health, and the solutions are political and social as well as technical. The report rightly identifies a variety of effective practices and alternatives which situate mental health within a human rights and recovery-based paradigm and we agree that these must be scaled up and invested in.

Therefore we particularly welcome the Special Rapporteur’s recognition of the fact that mental health problems are; “… strongly linked to early childhood adversities, including toxic stress and sexual, physical and emotional child abuse, as well as to inequalities and violence, including gender based inequalities and gender based violence, and many other adverse conditions which people, especially those in vulnerable situations such as poverty or social exclusion, face when their basic needs are not met and their rights are not protected.”

We welcome these positive messages for a global approach to health and psychological wellbeing which ensures the participation of diversity of rights-holders and relevant stakeholders including users and survivors, civil

society and communities and empowers them. We agree with the Special Rapporteur that we need to focus on the primary prevention of suffering and ill-health, as well as the care and recovery of people who experience ill-health or distress. We therefore look forward to a future where we work together to provide a coherent, scientific, but humane and psychological vision; where we offer care rather than coercion, fight for social justice, equity and fundamental human rights, and to establish the social prerequisites for genuine mental health and wellbeing.

Yours sincerely

Mental Health Europe – Sante Mentale Europe

British Psychological Society

Mental Disability Advocacy Centre Horatio (European Psychiatric Nurses) Mental Health Perspectives (Lithuania) Society of Social Psychiatry (Greece)

Critical Mental Health Nurses Network (UK) Asylum Magazine (UK)

Psychosocial Research Organization (Greece) Pro-mente Austria

Ubuntu South Africa Promitheas NPO (Greece) Critical Psychiatry Network (UK)

Association of Families for Mental Health (Greece)

Association of Parent Guardians and Friends of People with Autism Larrisa Prefecture (Greece) Social Care Strategic Network for Mental Health

Mad in America

Association for Regional Development and Mental Health (EPAPSY, Greece) Social Cooperatives Activities for Vulnerable Groups (Greece)

Confedracion Salud Mental Espana

Mental Health Interest Forum (PÉF, Hungary)

The European Network of (ex)Users and Survivors of Psychiatry (ENUSP) European Federation of Psychologists’ Associations

Lithuanian Psychological Association Finnish Association for Mental Health International Council of Nurses

The Friendship Bench (Zimbabwe)

Asociación Española de Neuropsiquiatría Fundación (ESMAEN, España) British Association of Social Workers (BASW, UK)

Law Project for Psychiatric Rights

The Social Work Action Network (SWAN) Ireland. Friendship Bench

Hearing Voices Network Cymru

Scottish Recovery Network

Всеукраинская общественная организация людей с инвалидностью потребителей психиатрической помощи “ЮЗЕР” – Ukrainian public organization of people with disabilities, consumers of mental health care

“users”

Society of Psychosocial Research and Intervention (S.P.R.I; Ioannina, Greece). Finnish Association for Mental Health

Social Cooperative Activities for Vulnerable Groups “EDRA” (Greece)

EPSAMY – OIKOTROFEIO ERATO (Mental Health Center – Athens, Greece) SOPSY Korydallos (Greece)

Ενσωματωμένη εικόνα Promitheas N.P.O. (Greece)

ENUSP – European Network of (ex)users and survivors of psychiatry (ENUSP) Psycho-social Research Organization (E.PSY.ME) Greece

Horatio: The Psychiatric Nurses Association of Ireland

Association des groupes d’intervention en défense des droits en santé mentale du Québec. Society of Georgian Psychiatrists

Bapu Trust for Research on Mind & Discourse

Changes Ahead

Association of Parents Guardians and Friends of People with Autism Larissa Prefecture

National Survivor User Network (NSUN) Psychologist for Social Change

International Society for the Psychosocial Approaches to Psychosis (ISPS) Japan National Group of Mentally Disabled People

Association for Psychosocial Support (Susret) Croatia

Community Housing and Therapy

Advocacy Unlimited (Peer Run Community Organization USA) Intensive Interaction Denmark

Social workers in Adult Mental Health, Republic of Ireland

REV France

Recovery Wirral

Social Work Action Network (SWAN)

Mesa Galega da Psicoloxía Clínica (Galician Bureau of Clinical Psychology)

AGAPIR Asociación Galega de Psicólogos Internos Residentes (Galician Association of Psychological Residents) Psicología Clínica de España – Outsiders (Clinical Psychology of Spain – Outsiders)

ISPS- US (International Society Psychological and Social Approaches to Psychosis, US Chapter) Nederlands Comité voor de Rechten van de Mens (NCRM)

Southern California Against Forced Treatment Advocacy Group for the Mentally Ill (AGMI) (Cyprus) Association of Mental Health Providers

European Community Mental Health Service providers network

Bundesverband Psychiatrie Erfahrener e.V., Federal Organization of (ex-) Users and Survivors of Psychiatry

(Germany) ISPS Israel

The Norwegian Psychological Association

Nordic Psychologists Association

Alva Finn (Policy Manager; Mental Health Europe – Santé Mentale Europe) Maria Nyman (Director; Mental Health Europe – Santé Mentale Europe)

Professor Peter Kinderman (Clinical Psychologist, University of Liverpool, UK, Vice-President, British

Psychological Society)

Akiko Hart (Mind in Camden, UK)

Dr. Lucy Johnstone (Consultant Clinical Psychologist and Independent Trainer, Bristol, UK) Kate Allsopp (University of Liverpool, UK)

Anne Cooke (Salomons Centre for Applied Psychology, Canterbury Christ Church University, UK) Professor Pat Bracken (Consultant Psychiatrist, Ireland)

Dr. John Cromby (Clinical Psychologist, University of Leicester, UK)

Mary Boyle (Professor Emeritus of Clinical Psychology, University of East London, UK) Paul Wilson (Head of Mental Health Services, Bath and North East Somerset, UK)

Dr. Kirshen Rundle, MBACP, (Accred.) (Psychotherapist, Norwich, UK) Dr. Alec Grant

Stuart Guy (Senior Lecturer in Mental Health Nursing, University of Wolverhampton, UK) Judith Haire

Steve Flatt (Liverpool, UK)

Alfonso Serrano Movilla (Espana)

Dr. Joanna Wilde (Clinical Psychologist, Aston, UK)

Dr. Jim Probert (Psychologist, University of Florida Counseling and Wellness Center, USA) Dr. Cian Aherne (Clinical Psychologist, Ireland)

Dr Kate Danvers (Clinical and Community Psychologist) Bobby Baker (Artistic Director Daily Life Ltd, Activist)

Kate Mc Grath (Trainee Clinical Psychologist, University of Liverpool, UK) Wendy Micklewright

Edel Mc Glanaghy (Trainee Clinical Psychologist, University of Edinburgh, UK)

Julia Cheah (Clinical Psychology PhD Candidate, Swinburne University of Technology, Australia) Dr Ché Rosebert (Consultant Clinical Psychologist, London, UK)

Dr Christina Richards (Nottinghamshire Healthcare NHS Foundation Trust, UK) Misbah Gladwyn-Khan (Trainee Clinical Psychologist)

Judy Gayton (Canada)

William Nicholas Gomes (Human Rights Defender and Freelance Journalist, York, UK)

Prof. Martin Milton (Professor of Counselling Psychology, Regents University London, UK) Dr Alison Tierney (social anthropologist and family carer, Bristol, UK)

Nicky Hayward (Independent Commentator, Activist and Blogger, UK)

Dr Steve Mayers (Clinical Psychologist, Greater Manchester Mental Health NHS Foundation Trust, UK) Bernard Kat (Director, Psynapse (Psychological Services) Ltd, Newcastle upon Tyne, UK)

Annie Mitchell (Associate Professor and Clinical Psychologist, University of Plymouth, UK) Dr Ruth Allen, (CEO, BASW)

Helen Williams (Clinical Psychologist, Leeds, UK)

Scott Bartle (Trainee Clinical Psychologist, University of East London, UK) Dr. T. R. Moss (Emeritus Consultant Physician)

Louise King

Berit Bryn-Jensen (Norway)

Dr. Alex Thornton (Clinical Psychologist, London, UK) Dr. Lynne Patience (Clinical Psychologist, UK)

Kim Serjeant

Joan Rapaport (Social Worker (retired), UK)

Margaret Turner (Mental Health Social Worker (retired), UK)

Jim Gottstien (President; Law Project for Psychiatric Rights, Alaska, USA) Mirabai Swingler (NHS Chaplain, UK)

Michelle Colder Carras (Postdoctoral Fellow, Johns Hopkins Bloomberg School of Public Health, USA). Professor Andrew Samuels, (University of Essex, UK. Former chair UK Council for Psychotherapy) Kerry Cuskelly, Mental Health Social Worker, Ireland.

Rowland Urey

Debra Joy Williams (Dawlish, Devon, UK)

Alison M Clark (Trainee Counselling Psychologist, City, University of London) Joachim Schnackenberg

Alice Fiorica

Avril Bellinger

Cath Roper (The University of Melbourne, Australia)

Abdelkhalig E.A.Mohammed (psychiatry specialist, Alamal complex for mental health, Madina, Saudia Arabia). S. Randolph Kretchmar

Katie Mottram (Co- Founder, The International Spiritual Emergence Network and #EmergingProud campaign) Sue Irwin

Nicholas Morgan (Director: Euro Youth Mental Health Ltd)

Hanne Conn (mental health professional and user of mental health services) Yasmin Miller

Dr. Kirshen Rundle, ( Psychotherapist) Hannah Dornin

Professor John Read (University of East London, UK)

Eka Chkonia (Associate Professor of Psychiatry, Tbilisi State Medical University, Ukraine) Dr. Piers Gooding (University of Melbourne, Australia)

Peter Coleman (family carer)

Billy Alan Palmer Jr.,(University of Florida, USA) Valentina Alexa (Psychologist, Romania)

Simon Porter

Robert Theoret

Dr. Piers Gooding (University of Melbourne, Australia) David Pilgrim

Dr. Noel Hunter (Clinical Psychologist, New York, USA) Jens N. Roved

Yasmin Ishaq, service Lead Kent Open Dialogue Service

Satu Beverley (Carer, Open Dialogue advocate, Retired Psychologist, Australia) Judi Burstyner (Australia)

Dr. Gillian Proctor (Clinical Psychologist, University of Leeds, UK) Dr. Jan Olav Johannessen (M.D., Ph.D. Chair, ISPS)

Dr Anne Felton (Associate Professor, Mental Health Nursing, University of Nottingham, UK) Dr Nick Hartley, Clinical Psychologist, Newcastle upon Tyne

Dr Lucinda Brabbins

Agnes Higgins (Professor in Mental Health, Trinity College Dublin) Dr. Emma Evans (Clinical Psychologist, Liverpool, UK)

Dr Alison Summers

Dr Andre Bolster (Clinical Psychologist, Norfolk and Suffolk Foundation Trust, NHS, UK) Beverley Satu

Linda Steen (Consultant Clinical Psychologist, University of Manchester, UK) Dr. Rochelle Burgess (Fellow, Firoz Lalji Centre for Africa, LSE, UK)

Kenneth Blatt (Psychiatrist, USA)

Camilla Staunsbrink (Psychologist, Copenhagen, Denmark) Ditte Rose Andersen (Licensed Psychologist, Denmark)

Dr Poul Rohleder (Clinical psychologist and psychotherapist, University of East London, UK) Annette de la Cour (Independent Mental Health Social Worker)

Isabel Clarke (Consultant Clinical Psychologist, Southampton UK)

Dr Helena F Laughton, (Principal Counselling Psychologist, Bucks Early Intervention Service) Dr Sally Zlotowitz (Clinical and Community Psychologist)

Christopher Jones (Trainee Clinical Psychologist, University of East London, UK) Anna Carroll (Hon Sec, Social workers in Adult Mental Health, Republic of Ireland) Magali Molinié (REV France)

Dr Sam Roberts

Dr Lorna Hobbs (Trainee Clinical Psychologist, University of East London, UK)

Martha Griffin (Expert by Experience – Lecturer in Mental Health, Dublin City University) Derry Hunter

Alissa De Luca-Ruane (deputy national convenor – SWAN) Jill Domoney

Jijian Voronka (University of Windsor, Canada) Dan Warrender

Jessica Arenella (PhD)

Dr Tamar Lavy (MD, ABIHM, Psychiatrist, New York City, NY) Rodrigo Llanillo Melgosa, Psicólogo Clínico (Spain)

Junior (Jay) Campbell Deborah Liversage Janice Gurney

Ray Gurney

Dr Karen Newbigging, Senior Lecturer, School of Social Policy,University of Birmingham

Dr. Kathryn Gibb

Aguila Bono del Trigo, Sociologist, Andalusian School of Public Health, Spain

Fatma Zengin, Counsellor and Human Rights Activist Ingvild Myklebust, Psychologist, Trondheim, Norway Juliet Dwek, Integrative Psychotherapist, UKCP reg Lesley Smith

Lozarta Veizaj

Dr Rich Moth (Senior Lecturer in Social Work at Liverpool Hope University, UK)  and Bea Miller (Psychotherapists and Counsellors for Social Responsibility, UK).