Dainius Puras
Professor and the Head of the Centre for Child psychiatry social pediatrics at Vilnius University. He is also visiting Professor at the University of Essex (United Kingdom).
Lithuania
Investing in mental health in 21st century – challenges and opportunities
There is an increasing global understanding that mental health is a new priority in the 21st century within and beyond health-related policies and services. Many recommendations, coming from WHO and other UN bodies, as well as other international organizations and independent experts, urge governments to invest more and with better quality in all components while addressing mental health (promotion, prevention, treatment and rehabilitation).
However, there is no full agreement between experts about some other important issues. One group of experts suggests scaling up existing interventions, based on existing bio-psycho-social model, so that treatment gap is covered and more people in need in all regions of the world could have access to mental health services. On the other hand, there is another group of experts and organizations that are critically addressing the status quo in global mental health and suggesting that paradigm shift is needed. Critical assessment of the status quo is based on high prevalence of coercion, institutionalization, overuse of biomedical interventions in mental health services worldwide, and on the fact that existing power asymmetries and bias in knowledge and evidence pave the way to epidemics of human rights abuses.
The roles and views of main stakeholders, including professional groups, such as psychiatry, psychology, social work, nursing, and also civil society organizations, such as organizations of users and ex-users of services, are of utmost importance, when future of mental health policies and services is discussed globally, regionally and nationally. Among central issues of global discourse are the following themes: human rights in mental healthcare and the need to implement the UN Convention of the rights of persons with disabilities (CRPD), informed consent, optimal balance between biomedical and psychosocial interventions, power asymmetries, impact of violence, discrimination, inequalities and other risk factors in the development of mental health conditions. These issues will be discussed in the presentation, based on the resolutions of the UN Human right council on mental health and human rights (2016, 2017) and on the report of the UN Special rapporteur on the right to health to UN Human rights council (2017).
The presentation will highlight the need to learn lessons from the history of psychiatry, psychology and mental healthcare. Too often in the past good intentions of researchers and clinicians have resulted in interventions that later appeared to do more harm than good. This is why addressing and promoting the professional ethics and universal human rights principles are of crucial importance for further development of mental health policies and services.
Professor and the Head of the Centre for Child psychiatry social pediatrics at Vilnius University, and teaches at the Faculty of Medicine, Institute of International relations and political science and Faculty of Philosophy of Vilnius University, Lithuania. He is also visiting Professor at the University of Essex (United Kingdom) and a Distinguished Visitor with the O'Neill Institute for National and Global Health Law, Georgetown university (USA). As a medical doctor, he serves as a consultant at the Child Development Center, at Vilnius University Hospital.
UN Special Rapporteur on the right to physical and mental health.
