Statement by the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health at the 73rd session of the General Assembly

New York, 19 October 2018

Mr. Chairperson,
Distinguished Delegates,
Ladies and Gentlemen,
 
It is a pleasure to be here today to discuss my report on the right to mental health of people on the move. 

Mental health is the “state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

My report addresses the realization of the right to mental health of both, people on the move, and the people living in the host communities. To realize everyone’s right to mental health, including people who arrive as migrants or refugees, States must ensure that they can realize their own potential and are able to contribute to their new communities. If this is not done, or even if actions are taken in the opposite direction, then the right to mental health is seriously compromised.

For my report, I was primarily concerned about those who have experienced some form of adversity owing to the nature of their departure, journey and/or reception in a new community. I chose the term “people on the move” to emphasize inclusivity and that beyond legal categories, these people are first and foremost, rights-holders.

Mr. Chairperson,

About 65.6 million people around the world have been forced from their homes by violence and war, by religious, ethnic, cultural and other forms of persecution, and by famine, poverty, environmental disaster, discrimination and other forms of systemic and acute deprivations.

While this unprecedented movement of people is ongoing, another phenomena, the rising of mental health out of the shadows, has reached the global health, human development and human rights agendas.

The most important lesson left by these two major issues of modern times is that policies and practices that are discriminatory and fuelled by hostile attitudes and rhetoric must be addressed and abandoned. The environment of fear and intolerance resulting from negative attitudes and discourse not only harms the mental health and well-being of people on the move, but also threatens the development of enabling environments and have detrimental effects on the mental health and well-being of the general public.

Leaders, politicians and people in position of political power must be aware that their actions and words when xenophobic help to create hostile emotional and psychosocial environments, erode the quality of human relationships and bring mistrust, disrespect and intolerance into societal life.

My ultimate recommendation is that we all must stop these discriminatory and xenophobic trends and develop instead strong communities where good-quality human relations prevail.

Distinguished Delegates,

People on the move contribute to their host communities by adding to their diversity, by helping in the creation of jobs, by counteracting the effects of ageing populations and by improving productivity. The economic contribution they make can sometimes be more than twice the cost of hosting them in a society.

Holistic investment in the right to mental health of people on the move and their host communities can help to reconcile differences and confront the root causes of intolerance and exclusion, which in turn can provide a rich opportunity to promote healthy and cohesive societies.

In my report, I elaborate on two in-focus themes: the right to mental health of children and families on the move, and immigration detention, a practice that many countries have adopted as a default strategy to regulate human mobility.

Undermining family unity in the context of human mobility is detrimental to the mental health and well-being of children and adolescents on the move and generates effects that could last for years or even generations to come. Laws and policies that institutionalize the separation of children on the move from their families or complicate family reunification contribute significantly to adverse mental health and must be eliminated without delay.

On the other hand, immigration detention as a form of deterrence is ineffective and may exacerbate existing mental health challenges which persist after detention, adversely affecting the quality of life of people on the move. Immigration detention should gradually be abolished and the particular detention of children and migrants with psychosocial, cognitive or intellectual disabilities must be immediately prohibited.

Mr. Chairperson,
Distinguished Delegates,

People on the move should be enabled to participate in, or develop, meaningful relationships in their host communities, work, obtain an education and have access to services, including mental health care and support.

In doing so, rights-based mental health care and support services for people on the move should be established and developed in a way that they address their needs for safety, community participation and livelihoods. These services should also provide for their cultural, religious and linguistic needs.

Steps to reverse the reliance on institutionalization, overmedicalization or other forms of rights-violating mental health interventions should be taken, and front-line workers interacting with people on the move, including health-care workers, must receive  human rights training.

In addition, individual screening should be established to identify people on the move who are survivors of sexual and gender-based violence and torture, and those with intellectual, cognitive and psychosocial disabilities or with mental health and well-being needs. Effective referrals to appropriate services are further needed to ensure the sustainability and non-discrimination of mental health care and support for all people.

Mr. Chairperson,

The health status, including the mental health status of a migrant cannot be the basis to decide on entry, stay, naturalization and expulsion of people on the move.

In moving towards more holistic models for inclusive communities, our focus should remain on the key determinants of health, including healthy community relationships and inclusion in social spaces that are free from violence, bulling, intolerance, mistrust and disrespect. In this connection, the understanding of Environment as an underlying determinant of health should necessarily involve the emotional sphere.

Let me conclude by saying that regrettably some of my colleagues will not present their report in person this year. A limited number of changes to the schedule were proposed in July to accommodate mandate holders while respecting the time allotted to Special Procedures and preserving the thematic coherence of the clusters. We regret that these proposals were rejected as we attach great importance to our engagement with this Committee. We express the hope that a better consultation process would be put in place next year.

Thank you.