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The recovery- and rights-based care model represents an evolution in the way we understand and address mental health, with the primary aim of continuing to improve care.
This approach reinforces the centrality of the individual, their dignity and their life plan, and is made possible by close public-private collaboration and cooperation between institutions.
In this context, the Mental Health and Addictions Master Plan (PDSMiA) of the Department of Health of the Government of Catalonia is, as part of a pilot project, the task of rolling out the World Health Organisation’s (WHO) ‘Quality Rights’ model to the Order of St John of God and the Fundació Hospitalàries. This partnership will enable new needs to be identified and will drive a genuine and far-reaching transformation of the mental health care system. This joint effort facilitates the sharing of knowledge, resources and experience to move towards a more humane, respectful and effective model.
What is the ‘QualityRights’ model?
‘QualityRights’ is a set of tools provided by the WHO that encourage and support governments and organisations worldwide to assess and improve the quality of services and human rights, based on the United Nations Convention on the Rights of Persons with Disabilities (CRPD).
This initiative provides training, raises awareness and offers guidance to:
- Break down stigma and discrimination.
- Achieve a real transformation of mental health services worldwide towards a holistic care model that respects diversity, human rights and the social inclusion of those receiving care.
- One of the key programmes is the ‘QualityRights’ online training course, which is also available in Spanish and through which 60,000 people worldwide have already been accredited.
The project in Catalonia
The aim of the project is to begin implementing the recovery- and rights-based care model across various mental health, addiction and disability services and facilities in Catalonia, including both inpatient and community-based services. The hospitals and centres participating in the project are:
- Sant Joan de Déu Hospital, Barcelona
- Sant Joan de Déu Healthcare Network
- Sant Joan de Déu Terres de Lleida
- Fundació Hospitalàries Barcelona
- Sant Boi Hospital Foundation
- Martorell Hospitals Foundation
- Barcelona North Hospitals Foundation
identifying strengths and areas for improvement, collecting data and analysing barriers and opportunities for implementing the model. To date, 42 facilities have been visited and assessed.
At the same time, all centres are implementing a common training strategy on the care model based on recovery and human rights. At present, the institutions are encouraging all staff and volunteers at each organisation to undertake the initial training, which includes modules on human rights, legal capacity and the right to make decisions, tools for the complete reduction of coercive measures, and strategies for restoring wellbeing and life plans, and more comprehensive training programmes for trainers are being rolled out in collaboration with Obertament.
Putting the recovery- and rights-based care model into practice: good practices in mental health
Some examples of good practice that illustrate how the recovery- and rights-based care model translates into improved quality of care and a better quality of life for people include:
Respect for people’s autonomy is promoted by providing support for decision-making rather than overriding their wishes. This approach ensures that everyone can exercise their rights on an equal footing.
Bringing in people with personal experience of mental health as support workers provides support based on empathy and lived experience. This role promotes recovery and strengthens the sense of belonging and hope.
It enables people to express their preferences regarding their future care at times when they may not be in a position to make decisions. It is a key tool for respecting individual wishes and values.
Alternatives are being promoted to avoid practices such as physical restraints, prioritising safe, respectful and person-centred environments. This change improves the care experience and protects human rights.
Activities are promoted that foster social inclusion and holistic wellbeing. These initiatives help to build relationships, develop skills and give meaning to the recovery process. Care is approached as a holistic and integrated service, based not only on pharmacological treatment and psychological support, but also on viewing the individual from different perspectives and taking their needs into account.
Initiatives are being carried out to change society’s perception of mental health, tackling prejudice and discrimination. These campaigns promote a more inclusive and respectful society.
Both volunteering and activism are tools for social change and the development of societies through people’s active participation in the community. When volunteers and campaigners are people who have experienced or are currently experiencing mental health issues, this enables them to find meaning in their lives and play a part in the community, whilst at the same time helping to combat the discrimination and stigma (and self-stigma) surrounding mental health and to defend their rights.
Useful resources
The WHO has developed a comprehensive package of training and guidance materials that can be used to build capacity in line with the UN Convention on the Rights of Persons with Disabilities and other international human rights standards.
A thematic portal by SOM Mental Health 360 which aims to discuss mental health rights, seeking answers to questions such as: what are the main rights that are often violated in relation to people with mental health problems? And what model of recovery should we be moving towards in order to promote the rights and autonomy of these individuals?