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A plenary session in the Costa Rican Legislative Assembly in San José, September 28, 2021.
© 2021 Asamblea Legislativa de la Republica de Costa Rica via Wikimedia Commons
Last week, Costa Rica’s Legislative Assembly passed a troublesome bill to create a National Act on Mental Health. The bill follows an outdated biomedical model to treat people who might be experiencing a mental health crisis or have mental health conditions, also known as psychosocial disabilities.
The bill is modeled on an old mental health treatment paradigm based on medication and inpatient nonconsensual treatment that has been called into question by different stakeholders, including the World Health Organization (WHO) and United Nations treaty bodies like the Committee on the Rights of Persons with Disabilities. The former UN Special Rapporteur on the Right to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health has stated that informed consent is a core element of the right to health, both as a freedom and an integral safeguard for its enjoyment.
Indeed, mental health policies around the world are moving away from this model. Instead, the correct approach should be person-centered, by providing community-based services and focusing on the person’s recovery plan. Recovery is something that cannot be addressed through a one-size-fits-all lens; it requires a program that builds trust, fosters self-control, and creates opportunities for well-being.
Last April, the WHO launched a training program for mental health providers rooted in the principles and contents of the Convention on the Rights of Persons with Disabilities, which Costa Rica ratified in October 2018. Known as Quality Rights, the program gives core importance to a person’s right to make decisions and direct one’s own life, including when dealing with mental health issues, and especially when experiencing crises.
Costa Rica’s Legislative Assembly should harmonize domestic legislation with core human rights principles in the realm of mental health. In 2014, the Committee on the Rights of Persons with Disabilities recommended Costa Rica review its mental health policies and criticized the fact that they were still based on the outdated biomedical model. Far from honoring this recommendation, the assembly has continued to provide the same old medicine that has proved ineffective around the globe. There needs to be a shift toward a human rights-based model instead; the first step is to revise this worrisome legislation.
