1
|
Mion ABZ, Ventura CAA. The WHO QualityRights Initiative and its use worldwide: A literature review. Int J Soc Psychiatry 2024; 70:424-436. [PMID: 38149349 DOI: 10.1177/00207640231207580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
BACKGROUND To subsidize and win the fight against the violation of the human rights of people with mental disorders, an international working group has built a toolkit of quality assurance services and the exercise of human rights by users, both in low-, middle, and high-income countries. The World Health Organization's (WHO) QualityRights Initiative has been discussed and agreed upon by government entities in many countries in its use and implementation. The program includes a service assessment kit and training modules. AIMS In this context, this article aims to synthesize, from database searches, how the QualityRights Initiative is being used worldwide. METHOD This is an integrative literature review, in which 354 articles were initially obtained. After analysis, 25 articles were included in this study. RESULTS The results show different ways of using the initiative: service evaluation; QualityRights Initiative service evaluation and training provision; innovations on how to use the QualityRights Initiative; and QualityRights Initiative trainings. CONCLUSIONS As the first part of the initiative, the service assessment part, was launched before the training materials, most of the articles found (17) were using it. Despite the recent launch of the training part of the initiative, five articles were found to have already conducted the training. In addition, three articles reported on the use of the initiative in other ways, such as translation and cultural adaptation of the modules; updating the document in light of the QualityRights project; and assessing whether its implementation would be effective in reducing coercive practices.
Collapse
Affiliation(s)
- Ana Beatriz Zanardo Mion
- PAHO/WHO Collaborating Center for Nursing Research Development, Department of Psychiatric Nursing and Human Sciences at the University of São Paulo at Ribeirão Preto College of Nursing, Brazil
| | - Carla Aparecida Arena Ventura
- PAHO/WHO Collaborating Center for Nursing Research Development, Department of Psychiatric Nursing and Human Sciences at the University of São Paulo at Ribeirão Preto College of Nursing, Brazil
- Institute of Advanced Studies - Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
2
|
Mahdanian AA, Laporta M, Drew Bold N, Funk M, Puras D. Human rights in mental healthcare; A review of current global situation. Int Rev Psychiatry 2023; 35:150-162. [PMID: 37105153 DOI: 10.1080/09540261.2022.2027348] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/06/2022] [Indexed: 10/18/2022]
Abstract
The relationship between mental health and human rights is complex and bidirectional. Global mental health movements have been emphasizing the promotion of human rights in mental health care in accordance with the UN Convention on the Rights of Persons with Disabilities and the WHO QualityRights Initiative. The main objective of this review is to have an overview of the current global situation of human rights in mental health services by performing a review of scientific literature. The literature search and elimination process yielded a total of 26 articles focussing on human rights-related reports and tools. Further assessment of these articles clearly shows that despite significant improvements in mental health service delivery in the past decade, there is still substantial reporting of the continuing prominence of stigmatizing attitudes, and human rights violations and abuses in mental health settings. The human rights perspective requires society, particularly policymakers, to actively promote necessary conditions for all individuals to fully realize their rights. We suggest developing a more comprehensive model in mental health that integrates human rights into existing services and approaches. A model that recognizes that all people with mental health conditions and psychosocial disabilities are rights holders.
Collapse
Affiliation(s)
- Artin A Mahdanian
- Montreal WHO-PAHO Collaborating Center for Research and Training in Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Suburban Hospital & Bayview Medical Center, Bethesda, Maryland, USA
| | - Marc Laporta
- Montreal WHO-PAHO Collaborating Center for Research and Training in Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Nathalie Drew Bold
- Policy, Law and Human Rights Unit, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Michelle Funk
- Policy, Law and Human Rights Unit, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Dainus Puras
- Clinic of Psychiatry, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| |
Collapse
|
3
|
Saguem BN, Ouanes S, Rhouma A, Nakhli J. Effectiveness of an educational program for reducing mental illness stigma targeting family medicine trainees in Tunisia: A quasi-experimental study. Appl Psychol Health Well Being 2022; 15:686-704. [PMID: 36178042 DOI: 10.1111/aphw.12405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/18/2022] [Indexed: 11/29/2022]
Abstract
Reducing stigma among mental health and health professionals has been an ultimate priority in many countries worldwide. This study aimed to evaluate the effectiveness of a four-session educational intervention for reducing stigma of mental illness targeting family medicine trainees in Tunisia. A quasi-experimental design was adopted with an intervention group (N = 51) and a control group (N = 56). Pre-intervention data were collected using an online survey. A four-session seminar series was implemented and organized. Post-intervention data were collected immediately after the end of the intervention then 2 months thereafter. Instruments included Attribution Questionnaire (AQ-27), Self-Determination Scale (SDS), Empowerment Scale (ES), and Recovery Scale (RS). Repeated measures analysis of covariance and multiple analysis of covariance tests were carried out. Results revealed that the intervention had moderate effects on the AQ-27 score and on six of its stigma factors including factors of the dangerousness model. The intervention improved SDS score, but not ES or RS scores. Positive effects were observed immediately after the intervention and 2 months thereafter. Regular implementation of educational programs in clinical practice would be beneficial. Developing other anti-stigma methods is needed to address the concepts of recovery and responsibility of patients with mental illness.
Collapse
Affiliation(s)
- Bochra Nourhène Saguem
- Research Laboratory LR12ES04, Farhat Hached Hospital, Department of Psychiatry, University of Sousse, Sousse, Tunisia
| | - Sami Ouanes
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - Amal Rhouma
- Research Laboratory LR12ES04, Farhat Hached Hospital, Department of Psychiatry, University of Sousse, Sousse, Tunisia
| | - Jaâfar Nakhli
- Research Laboratory LR12ES04, Farhat Hached Hospital, Department of Psychiatry, University of Sousse, Sousse, Tunisia
| |
Collapse
|
4
|
Lantta T, Anttila M, Välimäki M. Quality of mental health services and rights of people receiving treatment in inpatient services in Finland: a cross-sectional observational survey with the WHO QualityRights Tool Kit. Int J Ment Health Syst 2021; 15:70. [PMID: 34454537 PMCID: PMC8399820 DOI: 10.1186/s13033-021-00495-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This article aims to review the quality of mental health services and the rights of the people receiving treatment in inpatient hospital care in Finland using the World Health Organization's QualityRights Tool Kit as a part of a randomized controlled trial VIOLIN. So far, reports on the QualityRights Tool Kit have mainly been from low- and middle-income countries or countries lacking resources for health services. Reports from countries with well-resourced health care systems, such as the Nordic countries, are still quite few. METHODS A cross-sectional observational survey was conducted on 13 closed inpatient psychiatric wards (acute, rehabilitation, forensic psychiatric) at eight hospitals in Finland. The data for the survey were gathered through a document review, observations, and group interviews among staff members, service users and family members. The STROBE checklist for cross-sectional studies was followed in the reporting. RESULTS Finnish mental health services are partially or fully achieving the standards set by the WHO QualityRights Tool Kit (final scores: 2.5-2.9 out of 3). The highest final score out of the five themes (2.9/3) was achieved under Freedom from torture or cruel, inhuman or degrading treatment or punishment and from exploitation, violence and abuse. The lowest final score out of the five themes (2.5/3) was achieved under the right to exercise legal capacity and the right to personal liberty and the security of person. CONCLUSIONS According to the findings, Finnish mental health services appear to be of high quality. However, we have identified some gaps in quality, which we have addressed in a national randomized controlled trial VIOLIN. Improvements can be realized through shared decision making and relaying information to service users.
Collapse
Affiliation(s)
- Tella Lantta
- Department of Nursing Science, ICT-City, University of Turku, 20014, Turku, Finland
| | - Minna Anttila
- Department of Nursing Science, ICT-City, University of Turku, 20014, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, ICT-City, University of Turku, 20014, Turku, Finland. .,Xiangya Nursing School, Central South University, 172 Tongzipo Road, Changsha, 410013, Hunan, China.
| |
Collapse
|
5
|
Human rights of people with mental illness diagnosis: perceptions among service users, family members and health professionals in Tunisia. JOURNAL OF PUBLIC MENTAL HEALTH 2021. [DOI: 10.1108/jpmh-06-2020-0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to assess the awareness about the rights of people with mental illness in the main psychiatric hospital in Tunisia among the service users, the family members and the staff.
Design/methodology/approach
The Convention of Rights of People with Disabilities mandates that State Parties initiate and maintain campaigns and human rights training to promote understanding of the rights of people with mental illnesses, considered as a main factor for their fulfillment. Service users, family members and staff evaluated, through a survey, the importance of ten rights for persons with mental illness, stated in the convention.
Findings
Disparities were found in the perception of the different rights by and between the three groups. The highest levels of awareness were associated with the freedom from torture or degrading treatment and the right to live with dignity and respect, whereas the lower importance were assigned to the right to participation in recovery plans, to give consent and to exercise legal capacity.
Originality/value
The lack of awareness and the poor perception of rights of people with mental illness is one of the barriers to their achievement. More training and awareness raising is necessary.
Collapse
|
6
|
Carta MG, Ghacem R, Milka M, Moula O, Staali N, Uali U, Bouakhari G, Mannu M, Refrafi R, Yaakoubi S, Moro MF, Baudel M, Vasseur-Bacle S, Drew N, Funk M. Implementing WHO-Quality Rights Project in Tunisia: Results of an Intervention at Razi Hospital. Clin Pract Epidemiol Ment Health 2020; 16:125-133. [PMID: 32874190 PMCID: PMC7431701 DOI: 10.2174/1745017902016010125] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/04/2020] [Accepted: 04/04/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND The aims were: 1) to measure the attitudes of learners (and future trainers) before and after a course on WHO-Quality Rights (QR); 2) to evaluate a psychiatric ward, by previously trained staff on QR, comparing it with a previous evaluation and discussing an improvement plan. METHODS 1) Training sample: 19 subjects (8 males), 41.4±10.6 years, including jurists/lawyers, health professionals, and experts.The QR team developed the 26-item tool to assess the knowledge and attitudes of participants.2) Evaluation of quality of care and respect for human rights in the ward was carried out on 20 staff representatives, 20 family members and 20 users with QRToolkit. RESULTS 1) Learning in QR has partially changed the knowledge and attitudes of trained people.2) The evaluation shows significant delays in the implementation of the rights advocated by the United Nations Convention on the Human Rights of Persons with Disabilities (CRPD). In Themes 1, 3, 4 and 5, the evaluation shows no differences compared to 2014, but in Theme 2, the level was lower than four years before. CONCLUSION The scarcity of resources due to the economic crisis that Tunisia is going through, cannot be considered the only cause of the delays highlighted. However, it is likely that in a context of uncertainty for the future, scarcity of resources and a decrease in staff (i.e., professionals dedicated to psychosocial intervention) may have demotivated the team towards recovery. The improvement in knowledge and attitudes of many staff members after the training may open future positive scenarios.
Collapse
Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | | | | | | | | | | | - Monica Mannu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Rym Refrafi
- Mental Health Departement ,University Hospital Mongi Slim, Tunis, Tunisia
| | - Souha Yaakoubi
- Mental Health Departement ,University Hospital Mongi Slim, Tunis, Tunisia
| | | | - Marie Baudel
- Department of Public Health, WHO, Geneva, Switzerland
| | | | - Natalie Drew
- Department of Public Health, WHO, Geneva, Switzerland
| | - Michelle Funk
- Department of Public Health, WHO, Geneva, Switzerland
| |
Collapse
|