Mental Health as a Human Right

Authors: Lashaine Rakabopa and Nathalie Gullo

July 21, 2026

[Image credit: Juan Eduardo Montalvo/Unsplash]

Introduction

While mental health is being increasingly acknowledged globally, it remains an often overlooked, “lesser” human rights issue and a highly sensitive topic, as many are uncomfortable discussing or acknowledging its reality and impact. According to the World Health Organization, mental health is “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community,” making it a fundamental component of wellbeing.

Over one billion people live with a diagnosed mental disorder, yet few have access to care as, on average, countries dedicate just 2% of their health budget to mental health. In some developing countries, there is little more than one mental health worker per 100,000 people, compared with more than 60 mental health workers per 100,000 people in developed nations. Two-thirds of countries have just one mental health worker per 200,000 or more people. The availability of affordable psychiatric medication and psychotherapy remains limited, especially in low-income countries. Only 9% of people in those countries who are diagnosed with depression receive adequate treatment. Gaps in service coverage are often compounded by limits in quality of care. Fewer than one in ten (9%) people diagnosed with major depressive disorder have been estimated to receive minimally adequate treatment and are prone to receive low-quality mental health care which involves ineffective or unsafe treatment that ignores a patient's dignity, including using outdated methods instead of evidence-based practice. It also includes systemic issues like relying on physical restraints rather than de-escalation, making treatment decisions without patient input and providing little to no follow-up care after a crisis.

This article seeks to discuss the intersection of mental health and human rights, highlighting how social, economic, geopolitical and systematic barriers can be reduced through inclusive and sustainable mental health policies that are rooted in equal human rights. This article will address case studies from Africa, Asia and the Middle East—all being compared to Europe. We will then offer sustainable solutions and policy interventions to address stigma, promote equitable resource allocation and accessibility for global communities as mental health care and awareness are crucial to sustained and holistic development.

Africa

In Africa, nearly 150 million people (10% of Africa’s population) live with a mental disorder, yet mental healthcare is limited—increasingly impacting children and adolescents. As of April 2024, Zimbabwe has only 18 psychiatrists for a population of 17 million; Ethiopia has 113 psychiatrists for a population of 112 million. 

Many cultures in Africa can be considered as having toxic masculinity, in which men are pressured to be strong and emotionally unbreakable. This may contribute to high suicide rates in Africa among men. Despite the significance of this problem, little funding is allocated toward mental healthcare. In Zimbabwe, 0.42% of the healthcare budget is allocated to mental health. Yearly national expenditure on mental health care per capita is projected to be around $0.13 USD. Suicide rates rose in the early 2000s, likely due to economic and social hardships—yet the sociopolitical and economic response to this was limited. To date, there is limited understanding of the needs of the mental health sector and of the nature of mental illness itself in Africa. In Africa, mental health problems are attributed to substance abuse, weakness, and otherworldly control, subsequently leading to shame, mistreatment and intolerance toward people with mental health issues, especially in marginalized communities. A lingering deficit of mental health services and qualified professionals contributes to inadequate access to care, lack of information and overall negative impact on those in need of this specialized care. Simultaneously, there is a growing trend of suicides and referrals to public mental health institutions, particularly during times of economic, social and political instability.

Few functional institutions and a very limited number of qualified professionals in the mental health field in Africa have led to significant treatment gaps. Often, only economically advantaged people are able to access private or overseas care. Mental health crises are exacerbated by misuse of drugs and substances, trauma, genetics, unemployment, poverty, and lack of education. These issues are particularly pronounced in marginalized and rural communities where resources and knowledge are minimal, making mental health a lower priority for many. Food insecurity and unemployment are considered higher priority issues—with substance use getting the most attention as a mental health issue. Strained public resources and inadequate public policy frameworks precipitate implementation obstacles leading to poor service delivery and increased stress elements.  

Asia

In the Southeast Asia Region, about 1 in 7 people (260 million, or 13.2% of the population) live with a mental health disorder. In the Philippines, 3.3 million Filipinos live with depressive disorders, with suicides rates of 2.5 males and 1.7 females per 100,000 persons, according to the Department of Health. Indonesia is the fourth-most populous country in the world—with a population of  270 million people, but it has only around 800 psychiatrists (0.3 psychiatrists per 100,000), 450 psychologists, and 48 mental health facilities. Most psychiatrists work in the capital, further limiting access to care. The pasung practice of confining and restraining people with mental health conditions further undermines care. 

In India,  10% percent of the  population of 1.3 billion currently has one or more mental health problem. A meta-analysis of community surveys in India estimates that the prevalence of depression and anxiety could be up to 33 per 1,000 persons. Nearly one-third of patients who seek care may be at risk for or have symptoms related to depression. Poor awareness of mental health symptoms, social stigma, and lack of adequate resources and facilities prevent people from getting the help they need. Regardless, there are only 5,000 psychiatrists in India, or 0.3 for every 100,000 persons, and less than 2,000 clinical psychologists (0.07 per 100,000). To compare, the ratio of psychiatrists in developed countries is 6.6 per 100,000 and the average number of mental hospitals globally is 0.04 per 100,000 persons, compared to 0.004 in India. This makes the treatment gap in India (the number of people with an illness who need treatment but do not get it) 70 to 92 percent, depending on the state. 

Countries such as the Philippines similarly have a scarcity of mental health professionals, with only a little over 500 practicing psychiatrists. The ratio of 0.52 psychiatrists per 100,000 persons is lower than other countries with similar income levels, and access to mental health services becomes unequally distributed across the country, as most psychiatrists work in for-profit or private sectors in larger urban cities. A 2017 study found that Singaporean respondents tended to view mental illness as a symbol of shame. Furthermore, compared to responders from other ethnic groups, Asians are reported to have a weaker sense of duty toward those with mental illness. This may be due to mental health interfering with moral status in society. Mental illness is blatantly ignored or trivialised as a result of the need to "save face" and maintain honour. Similarly, traditional ideas of masculinity prohibit males from displaying physical or mental weakness, which exacerbates the stigma associated with mental illness in Asian societies. Since these traditional norms are passed down and reinforced by successive generations, they contribute to the pervasive stigma associated with mental health in Asian nations such as  Singapore. According to a study on Asian immigrant adults, older generations are "more subjected to cultural misconceptions and stigma related to mental disorders." Natural disasters such as earthquakes, typhoons, volcanic eruptions, and cyclones are common in parts of Asia and have been linked to PTSD. Regardless, mental health is not given funding or prioritized in policy. 

Middle East and North Africa

The Middle East and North Africa have high rates of mental health disorders, which are predicted to increase due to  wars and conflict. Large community-based studies report that the prevalence of mental illness ranges from 15.6% to 35.5% in the Middle East and North Africa, with higher rates in nations with complex emergencies such as war and famine. Mental illness is associated with 11.9 million disability-adjusted life years (DALYs), which measure the overall burden of a condition by combining years of life lost due to premature death with years lived with reduced quality of life due to illness or disability. Between 1990 and 2019, Palestine, Lebanon, Iran, Djibouti and Somalia recorded the highest DALYs in the region due to mental health disorders.

Most countries in the Middle East and North Africa experience conflict such as war and terrorism due to the lingering effects of colonization; furthermore, cultural beliefs and the influence of the "magic" or "evil eye" can impact mental health. The most common mental disorders in the region are depression and anxiety, particularly in vulnerable groups such as female populations,  those experiencing poverty, unmarried populations, elderly populations, chronically ill populations, and refugees. Stigma attached to mental disorders is a common reason for not seeking mental health care in the Middle East and North Africa.

Notably, war and conflict are significant risk factors for mental health disorders, especially in Syria, Iraq, Iran, Yemen, Afghanistan, South Sudan, and Palestine. War can contribute to the development of mental illnesses such as depression, anxiety, and PTSD. It can also contribute to domestic violence, childhood behavioral problems, and harming oneself and others.  In Syria, hospital admissions due to psychosis and suicide increased when the Syrian war began (Jefee-Bahloul et al. 2015). Medical services failed, as many health workers fled the conflict, further exacerbating this issue (Maziak 2018). The prevalence of psychiatric illnesses in injured Syrian refugees in Turkey is also very high, with the most common diagnoses being major depression, adjustment disorders, and PTSD. Revolutions can similarly exacerbate mental health issues due to  loss, purposeful or accidental injuries, mental trauma, distress, and losing access to healthcare, one’s home, or one’s work or schooling. The Middle East consistently experiences financial and political instability due to war, which is a trigger for mental illness. Regardless, mental health treatment and awareness are adversely overlooked and underprioritized in national budgets, policies, and emergency response.

Religiosity can be a protective factor against mental health disorders, especially with depression. A meta-analysis of 147 studies with a full sample size of nearly 100,000 showed that depression was lower in those individuals with higher religiosity. Similarly, attending religious events leads to decreased suicidal attempts in both the general population and in those with mental disorders, a finding that also extends to Korean immigrants in Dubai, UAE. Muslims who utilized spiritually-modified cognitive therapy for anxiety and depression have a quicker response compared to treatment which is not tailored to Muslim populations.

Differences in Diagnoses Across Regions and Cultures

In 1999, researcher Paul Bolton used an “emic” approach to investigate mental health disorders in Rwanda post-genocide. An “emic” approach is used for researchers to investigate cultures from a viewpoint within that culture, as opposed to coming in as outsiders and using external viewpoints. Bolton compared Western symptoms of depression and PTSD to local diagnoses and found that a minority of those who have experienced genocide would qualify for a PTSD diagnosis. Most of Bolton’s sample would instead seek local diagnosis and healing. In his 2010 book, Crazy Like Us, Ethan Watters further sheds light on how Westernization and colonization have led us to assume that Western perceptions of mental health are the gold standard. In doing so, Western countries have exported their diagnoses and pharmaceutical and therapeutic treatments without a thought as to whether they may be helpful to other countries and cultures. This research must be taken into consideration when proposing innovative solutions to mental health crises in non-Western regions such as Asia, Africa, and the Middle-East.

Europe

One in six people in Europe lives with a mental disorder as reported by the World Health Organization (WHO)—with anxiety, depression, and bipolar disorder most commonly diagnosed. Individuals with severe mental illness may have a higher premature mortality rate than the general population. The WHO estimates that in Europe suicide is the cause of 140 thousand deaths a year, making it the 6th most common cause of death in people under 70 years of age and the 4th most common cause of death in people younger than 20. Lithuania and Latvia have the highest suicide rates, at 20.2% and 16.1%, respectively, per 100 thousand inhabitants, and with Greece (3.6%) and Cyprus (4.1%) having the lowest rates. In 2022, almost 210,800 deaths in the European Union (EU) resulted from mental and behavioural disorders, equivalent to 4.1% of all deaths that year. Relative to the population size, there were 42 deaths from mental and behavioural disorders per 100,000 people in the EU. 

The EU has taken consistent steps to prioritize mental health through enhancing mental health literacy and funding. On June 7, 2023, the European Commission adopted the Communication on a Comprehensive Approach to Mental Health, to help Member States and stakeholders to take swift action to deal with mental health challenges. A comprehensive, prevention-oriented, and multi-stakeholder approach to mental health was developed after extensive consultation with member states, stakeholders, and citizens. This new approach recognizes that improving mental health will involve the employment, education, research, digitalisation, urban planning, culture, environment, and climate sectors. This cross-sectoral approach aims to put physical health on par with mental health, and shows that with the right systems and support, mental health care can be upheld as a fundamental human right.

Recommendations

While it is true that environmental risk factors such as poverty and war that significantly impact mental health must be accounted for, mental health in itself must be addressed as well. According to the UN Secretary-General António Guterres, “There is no health without mental health.” We cannot speak of development without adequate prioritization or action to support mental health as a human right. There is an urgent need to take action to ensure adequate support, and the following recommendations are presented to guide interventions to strengthen mental health outcomes:

Growing the Sector's National Budget Allotments

• Mental health budgets must be increased by  at least 5% to strengthen the mental health sector and close access gaps. Significant portions of this budget should be allocated to adequately compensating mental health workers, improving their working conditions, and enhancing mental health facilities. 

• Funding and raising awareness of mental health resources such as mobile clinics, especially in rural communities.

• Launching initiatives to train mental health workers by providing professional development courses for psychologists, counselors, and peer educators.

• Fill the gaps in funding through international collaborations, such as the African Development Bank's sponsorship of mental health initiatives. In order to ensure continuous service delivery and scalability, cooperative agreements between the state and civil society can increase outreach and consolidate resources.

Increased research capacity

• There is currently limited research and information available on the full scale of the mental health crisis globally, which makes it difficult to see the impact objectively. With increased support for proper research and documentation of global mental health, interventions and shared knowledge will allow transformation and resolution, as data can provide insights and information that can be shared across various networks and states to ensure informed decision making and policy formulation.

• Using emic approaches in research where mental health is investigated by and for those within unique sociocultural communities can enhance this research.

Methodical and Regular Legislative Review

• To be successful and responsive, mental health laws should align with the World Health Organization's Mental Health Action Plan (WHO, 2021),  facilitated through regular legislative reviews and the establishment of interdisciplinary review committees to assess and revise mental health policies, comprising representatives from civil society, mental health experts, and legislators. 

Implementation of international best practices that focus on community-based care and incorporation of mental health services into primary healthcare.

• Using South Africa's National Mental Health Policy Framework (2013–2020) as a model, other countries can modify these existing practices to fit their environment.

Evaluation and monitoring of created systems to track the application of policies and assess the success of mental health initiatives.

• The provisions of Nigeria's Mental Health Bill for monitoring policy advancement (Gureje et al., 2007) may be used as a guide. By engaging stakeholders such as advocacy organizations, civil society, and service users in the legislative process, we can ensure laws reflect the true needs of the populace.

Provision of community-based therapy services.

• Accessibility requires the decentralization of mental health services. Useful strategies include extending successful models such as Zimbabwe's Friendship Bench initiative, which prepares community health professionals or civilian members to offer counseling in both urban and rural settings (Chibanda et al., 2016). These professionals should be trained to offer evidence-based mental health interventions, such cognitive behavioral therapy, especially in volatile environments such as conflict areas. Interventions must also be culture and trauma informed to be effective.

Leveraging  technology by using telehealth services, such as smartphone apps, to connect people in remote locations with mental health specialists and offer online counseling.

• One effective example of removing geographical obstacles to care is Uganda's mHealth effort (Nakimuli-Mpungu et al., 2017). Individualized community-based therapy, mHealth, and home visits may lessen need on institutionalization, and create anonymous safe spaces for patients to express mental health concerns.

• Collaboration with regional authorities to educate community and traditional leaders to promote mental health services, raising knowledge and acceptance of cultural differences. Decentralized services can lessen the stigma attached to mental health care while filling accessibility gaps, particularly in rural locations.

Taking Action Against Economic Shocks and the Causes of Poverty.

• Reducing socioeconomic pressures is essential to mental wellness. Economic stimulus plans can lessen financial strains that lead to mental health issues, offer financial support through cash transfer programs, and subsidize medical treatment. Programs to reduce poverty should emulate Rwanda's Vision 2020 by tackling housing insecurity, generating employment, and assisting small enterprises (Rwanda Ministry of Health, 2020). These programs have the potential to enhance general wellbeing and indirectly lessen pressures on mental health. Psychological assistance programs can be aimed at vulnerable groups, such as unemployed people or refugees. We can also extend social safety nets to provide economically disadvantaged people with free or inexpensive access to mental health care. This method acknowledges the connection between mental health and poverty and addresses both at the same time to provide long-lasting solutions.

Teaching Stakeholders to Handle Mental Health Issues

• In order to improve care and lessen stigma, healthcare professionals, community leaders, traditional healers and religious leaders must collaborate. Standardized training programs and culturally aware training materials can be used to inform interested parties about mental health concerns and evidence-based treatments. Such programs can take inspiration from Ethiopia's relationship between psychiatrists and traditional healers, which enhanced patient referrals and lessened stigma in rural communities (Fekadu et al., 2014). Similar cooperative initiatives might be put in place to promote collaboration. As demonstrated by Kenya's Ministry of Health program, we can address shortages of mental health professionals by offering scholarships for psychiatric training (Ndetei et al., 2019). Mental health professionals may be persuaded to work in underprivileged communities by additional incentives such as housing and professional development. Additionally, religious and cultural leaders should be trained to educate communities about mental health and offer first-line support for mental health issues. In conservative areas, this strategy has been successful in lowering stigma and improving accessibility. Involving a wide range of stakeholders helps improve mental health services' accessibility, teamwork and cultural fit.

Conclusion

Mental health is a fundamental human right that supports the dignity, well-being, and productivity of both individuals and societies. It is neither a privilege nor a secondary priority to physical health. This article has shown how deeply ingrained structural injustices, stigma and a lack of political will affect differences in access to mental health care throughout Africa, Asia, the Middle East, and North Africa compared to higher-resourced places such as Europe. Mental health disparities embody human rights violations that prolong cycles of poverty, marginalization, and vulnerability. Intentional, ongoing, and inclusive action is needed to address mental health crises worldwide.

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Glossary

• Anxiety Disorders — A group of mental health conditions involving excessive fear, worry or nervousness that can interfere with daily functioning.

• Community-Based Mental Health Care — Any mental health care that is provided outside of a psychiatric hospital. This includes services available through primary health care, specific health programmes district or regional general hospitals as well as relevant social services.

• Depression — A common mental disorder characterized by persistent sadness, loss of interest or pleasure in activities, fatigue and difficulty functioning in daily life.

• Disability-Adjusted Life Years (DALYs) — A measure used in public health to quantify the burden of disease by combining years of life lost due to premature death and years lived with disability.

• Human Rights-Based Approach — A conceptual framework for the process of human development that is normatively based on international human rights standards and operationally directed to promoting and protecting human rights.

• Mental Disorder — A clinically significant disturbance in a person's cognition, emotional regulation, or behavior that reflects a dysfunction in psychological, biological or developmental processes.

• Mental Health — A state of mental well-being in which individuals can cope with the stresses of life, realize their abilities, learn and work productively and contribute to their communities.

• Mental Health Literacy — The knowledge and beliefs people have about mental disorders which help their recognition, management or prevention.

• Mental Health Policy — A coherent framework for action, based on broad consultation among stakeholders. It serves to identify and promote guiding principles, values and standards for action, thus working to meet population needs for mental health promotion, prevention, treatment, rehabilitation and prevention of premature mortality.

• Post-Traumatic Stress Disorder (PTSD) — A mental health condition triggered by experiencing or witnessing a traumatic event such as war, natural disasters, violence or serious accidents.

• Psychiatrist — A medical doctor who diagnoses and treats mental, emotional, and behavioral disorders.

• Psychological Interventions — Psychological treatments or psychological counselling) can be highly effective for many mental health conditions, particularly depression and anxiety. They can be delivered by trained and supervised non-specialists. These include community workers, volunteers and peers, evidence-based therapeutic approaches such as counseling, cognitive behavioral therapy and problem-solving therapy used to treat mental health conditions.

• Psychologist — A person who specializes in the study of mind and behavior or in the treatment of mental, emotional, and behavioral disorders.

• Psychotropic Medicines — Medications used to treat the symptoms of mental disorders, reduce disability and prevent relapse, including antidepressants, antipsychotics, mood stabilizers and anti-epileptic medications.

• Socioeconomic Determinants of Mental Health — Socioeconomic factors, such as income, education, employment status and housing conditions, exert profound influences on individuals' vulnerability to mental health issues and substance misuse

• Stigma — A set of negative and unfair beliefs that a society or group of people have about something.

• Telehealth — Health care provided remotely to a patient in a separate location using two-way voice and visual communication (as by computer or cell phone

• Toxic Masculinity — Ideas about the way that men should behave that are seen as harmful, for example the idea that men should not cry or admit weakness:

• Treatment Gap — The number of people with a condition or disease who need treatment for it but who do not get it.

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References

1. Bolton, P. (2001). Local perceptions of the mental health effects of the Rwandan genocide. The Journal of nervous and mental disease, 189(4), 243-248. 

2. Chibanda, D., et al. (2016). The Friendship Bench: Providing psychological therapy for depression in Zimbabwe. The Lancet.

3. Dube, M. (2021). Mental health funding gaps in Zimbabwe: Implications for healthcare delivery. Health Economics Review.

4. Fekadu, A., Hanlon, C., & Alem, A. (2016). Developing integrated primary care for mental illness in Ethiopia: Implementation in a low resource setting. Global Mental Health, 3, e3. https://doi.org/10.1017/gmh.2015.21 

5. Fekadu, A., Medhin, G., Selamu, M., et al. (2014). Population level mental distress in rural Ethiopia. BMC Psychiatry, 14, 194. https://doi.org/10.1186/1471-244X-14-194 

6. Gureje, O., Kola, L., & Afolabi, E. (2007). Epidemiology of major depressive disorder in elderly Nigerians in the Ibadan Study of Ageing: A community-based survey. The Lancet, 370(9591), 957–964. https://doi.org/10.1016/S0140-6736(07)61446-9 

7. Ibrahim, N. (2020). Epidemiology of mental health problems in the Middle East.

8. Institute of Mental Health. (2018). Latest nationwide study shows 1 in 7 people in Singapore has experienced a mental disorder in their lifetime.

9. Jang, Y., Chiriboga, D., & Okazaki, S. (2009). Attitudes toward mental health services: Age-group differences in Korean American adults.

10. Kenya Ministry of Health. (2015). Kenya mental health policy 2015–2030. Ministry of Health.

11. Meshvara, D. (2002). Mental health and mental health care in Asia.

12. Nakimuli-Mpungu, E., et al. (2017). The role of mHealth in delivering mental health care in low-resource settings. Journal of Global Health.

13. Nair, D. (2019). Saving face in diplomacy: A political sociology of face-to-face interactions in the Association of Southeast Asian Nations.

14. National Council of Social Service. (2025). From stigma to support: Shifting conversations around mental health in Singapore.

15. Ndetei, D., & Nyamai, D. (2019). Psychiatric education in Africa Kenyan perspective. International Review of Psychiatry, 32(2), 157–160. https://doi.org/10.1080/09540261.2019.165571 

16. Ndetei, D. M. (2006). Traditional healers in East Africa: Engaging their untapped potential to bring about mental health awareness. World Psychiatry, 5(2), 114–117.

17. Our Better World. (2019). Mental health in Asia: The numbers.

18. Pang, S., Liu, J., Mahesh, M., Chua, B., Shahwan, S., & Lee, S., et al. (2017). Stigma among Singaporean youth: A cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population.

19. Rwanda Ministry of Health. (2018). Rwanda national mental health policy. Ministry of Health.

20. The Straits Times. (2025). Depression, anxiety, stress: 1 in 3 youth in S’pore reported very poor mental health, says IMH survey.

21. Watters, E. (2010). Crazy like us: The globalization of the American psyche. Free Press.

22. World Health Organization. (2018). Mental health atlas 2017. https://www.who.int/mental_health/evidence/atlas/mental_health_atlas_2017/en 

23. World Health Organization. (2021). Comprehensive mental health action plan 2013–2030. https://www.who.int/publications/i/item/9789240031029 

24. World Health Organization. (2023). Mental health action plan for the WHO South-East Asia Region 2023–2030. https://iris.who.int/server/api/core/bitstreams/d5677a6a-5553-4f6d-aabc-5ce2a34630af/content 

25. World Health Organization. (2025). World mental health today: Latest data. https://www.who.int/publications/i/item/9789240113817