| dc.contributor.author | MAC LACHLAN, MALCOLM | en |
| dc.date.accessioned | 2014-12-11T10:41:46Z | |
| dc.date.available | 2014-12-11T10:41:46Z | |
| dc.date.issued | 2013 | en |
| dc.date.submitted | 2013 | en |
| dc.identifier.citation | Mannan, H., El Tayeb, S., MacLachlan, M., Amin, M., McVeigh, J., Munthali, A. & Van Rooy, G., Core concepts of human rights and inclusion of vulnerable groups in the mental health policies of Malawi, Namibia, and Sudan, International Journal of Mental Health Systems, 7, 7, 2013, 1-13 | en |
| dc.identifier.other | Y | en |
| dc.description | PUBLISHED | en |
| dc.description | Corresponding author | en |
| dc.description.abstract | Abstract
Background:
One of the most crucial steps towards delivering judicious and comprehensive mental health care is
the formulation of a policy and plan that will navigate mental health systems. For policy-makers, the challenges of a
high-quality mental health system are considerable: the provision of mental health services to all who need them,
in an equitable way, in a mode that promotes human rights and health outcomes.
Method:
EquiFrame
, a novel policy analysis framework, was used to evaluate the mental health policies of Malawi,
Namibia, and Sudan. The health policies were assessed in terms of their coverage of 21 predefined Core Concepts
of human rights (Core Concept Coverage), their stated quality of commitment to said Core Concepts (Core
Concept Quality), and their inclusion of 12 Vulnerable Groups (Vulnerable Group Coverage). In relation to these
summary indices, each policy was also assigned an Overall Summary Ranking, in terms of it being of
High
,
Moderate
,or
Low
quality.
Results:
Substantial variability was identified across
EquiFrame
’
s
summary indices for the mental health policies of
Malawi, Namibia, and Sudan. However, all three mental health policies scored high on Core Concept Coverage.
Particularly noteworthy was the Sudanese policy, which scored 86% on Core Concept Coverage, and 92% on
Vulnerable Group Coverage. Particular deficits were evident in the Malawian mental health policy, which scored
33% on Vulnerable Group Coverage and 47% on Core Concept Quality, and was assigned an Overall Summary
Ranking of
Low
accordingly. The Overall Summary Ranking for the Namibian Mental Health Policy was
High
; for the
Sudanese Mental Health Policy was
Moderate
; and for the Malawian Mental Health Policy was
Low
.
Conclusions:
If human rights and equity underpin policy formation, it is more likely that they will be inculcated in
health service delivery.
EquiFrame
may provide a novel and valuable tool for mental health policy analysis in
relation to core concepts of human rights and inclusion of vulnerable groups, a key practical step in the successful
realization of the Millennium Development Goals. | en |
| dc.description.sponsorship | how this affects their understanding of a policy
–
is
therefore of critical importance. Interpretations do not
arise in isolation from who the analysis is performed by,
for whom, and in what context. Although these complex
issues are very important, it is equally important to
recognize that in many instances the pragmatic reality of
lived exclusion is hurtful, frequently resulting in needless
mortality, and often all too easy to recognize by the fail-
ure to address it in health policies.
In order to realize the hope that better policies will be
associated with better healthcare, empowerment and in-
clusion of vulnerable and marginalized groups must occur
in the process of policy development and efforts to imple-
ment such policies, as well as in policy documents. The
practice of power, privilege, and dominance, in local and
national policy contexts, and also in the context of pro-
grams supported through international aid, will continue
to undermine aspirations for equity [11,63]. Without in-
clusive and effective means of policy development and im-
plementation, policy
‘
on the books
’
will be inert. Perfectly
equitable heath policies will only contribute to inclusion if
cognate policies in other sectors embrace similar princi-
ples, and if they are translated in measurable actions.
While this has not been the focus of this paper, it is neces-
sary for the potential benefits of better written policy to
become a reality.
Conclusions
One of the most crucial steps towards delivering judi-
cious and comprehensive mental health care is the for-
mulation of a policy and plan that will navigate mental
health systems and services development [1]. While im-
perative to improving conditions for people with mental
disabilities, mental health policies are absent or deficient
in the majority of countries of the world however [2],
with forty percent of countries as yet without a dedicated
mental health policy [3]. Cent
ral to a mental health policy
that translates into truly effective and justly distributed
health service provision is a health policy fortified by
human rights and underpinned by equitable access to
health services requiring that priority is afforded to vulner-
able groups. Addressing mental health problems in vulner-
able groups can support development outcomes more
generally, including improved participation in economic,
civic, and social activities [9]. Restoration of mental health
is not only crucial for individual well-being therefore, but is
also critical for economic growth and reduction of poverty
in countries [64]. By providing a policy analysis framework
of core concepts of human rights and vulnerability,
Equi-
Frame
may operate as a novel and valuable tool in the
evaluation and revision of existing mental health policies,
and in the development of the copious mental health pol-
icies that as now evident are yet to be formulated. Evaluat-
ing, revising, and developing me
ntal health policies through
an equity lens that aims to extend health services to the
most vulnerable and marginalized and using a broader
human rights framework is an important practical and
moral initiative in the successf
ul realization of the Millen-
nium Development Goals, and so too the Movement for
Global Mental Health, perhaps all-important.
Competing interests
The authors declare that they have no competing interests.
Authors
’
contributions
HM
: conception and design, analysis and interpretation of data; drafting the
article, revising it critically for important intellectual content.
SET
: conception
and design, analysis and interpretation of data; drafting the article, revising it
critically for important intellectual content.
MML
: conception and design,
analysis and interpretation of data; drafting the article, revising it critically for
important intellectual content.
MA
: conception and design, analysis and
interpretation of data.
JMV
: drafting the article, revising it critically for
important intellectual content.
AM
: conception and design, analysis and
interpretation of data.
GVR
: conception and design, analysis and
interpretation of data. All authors read and approved the final manuscript.
Acknowledgements
This research was funded by the European Commission Framework
Programme 7 [Project Title: Enabling universal and equitable access to
healthcare for vulnerable people in resource poor settings in Africa; Grant
Agreement no.: 223501] | en |
| dc.format.extent | 1-13 | en |
| dc.language.iso | en | en |
| dc.relation.ispartofseries | International Journal of Mental Health Systems | en |
| dc.relation.ispartofseries | 7 | en |
| dc.relation.ispartofseries | 7 | en |
| dc.rights | Y | en |
| dc.subject | Mental health policy, Core concepts of human rights, Vulnerable groups, Malawi, Namibia, Sudan | en |
| dc.subject.lcsh | Mental health policy, Core concepts of human rights, Vulnerable groups, Malawi, Namibia, Sudan | en |
| dc.title | Core concepts of human rights and inclusion of vulnerable groups in the mental health policies of Malawi, Namibia, and Sudan | en |
| dc.type | Journal Article | en |
| dc.type.supercollection | scholarly_publications | en |
| dc.type.supercollection | refereed_publications | en |
| dc.identifier.peoplefinderurl | http://people.tcd.ie/mlachlan | en |
| dc.identifier.rssinternalid | 91933 | en |
| dc.identifier.doi | http://dx.doi.org/10.1186/1752-4458-7-7 | en |
| dc.rights.ecaccessrights | openAccess | |
| dc.identifier.uri | http://hdl.handle.net/2262/72414 | |
