Eighty Years of National Mental Health Policy: Exploring the Inclusion of a Human Rights Approach

• Published in: American journal of orthopsychiatry 2024, Vol.94 (4), p.392-402
• Main Authors: Tomaszewski, Evelyn P., Lento, Laura R., Guduru, Surasya, Rangel, Ruta, Yampolskaya, Svetlana, Vashisht, Kriti, Tan, Samantha X. L.
• Format: Article
• Language: English
• Subjects: Discrimination; Equity; Governance; Health care policy; Health disparities; Health Policy; History, 20th Century; History, 21st Century; Human; Human Rights; Humans; Inequality; Mental disorders; Mental Disorders - therapy; Mental Health; Mental health policy; Mental health services; Mental Health Services - legislation & jurisprudence; Mental Health Services - organization & administration; Mental Health Stigma; Policy Making; Social Determinants of Health; Social Discrimination; Social Stigma; Stigma; United States
• ISSN: 0002-9432; 1939-0025; 1939-0025
• DOI: 10.1037/ort0000773

Mental health, historically framed as the mere absence of mental health disorders, has led to unequal treatment, resulting in more persons living with mental health challenges. This limited framing of mental health, often woven into policy and practices across a broad range of governance structures, programs, and services, has led to individual and collective discrimination and structural and systemic inequities, culminating in the infringement of fundamental human rights. Using a broader framework for viewing mental health (e.g., mental health as a continuum), the authors of this article propose that a right to mental health should form the basis of mental health policy. The article also considers the impact of stigma and discrimination and the implications of social determinants of health in forwarding a rights-based approach to mental health policy. The authors conduct a trends analysis of 80 years of United States' mental health policy and reflect on how social determinants and efforts to reduce stigma and discrimination have led to measurable progress toward achieving mental health equity. The Call-to-Action highlights opportunities to further support mental health and wellness through the use of interdisciplinary policy and practice recommendations that include the framing of mental health as a human right. Public Policy Relevance Statement An analysis of over 80 years of policy trends finds national and global policy has had a significant role in the protection and promotion of mental health as a human right. Yet, despite measurable progress, structural barriers, systemic inequities, and stigma and discrimination remain obstacles to mental health equity. The authors contend we are at a critical juncture and must seize the opportunity to define and resource cross-sectorial, interdisciplinary, and community-driven policy and practice initiatives that commit to a rights-based approach to mental health.