People with psychosocial disabilities and mental health conditions are commonly exposed to human rights violations within the mental health care system and the general community. The negative consequences of such violations have been widely documented but attempts to change the status quo have met with little success. The present dissertation aims to challenge this situation and advance the human rights-based global agenda for mental health by promoting a change within the mental health care system and the general community.
Chapter 2 is a scoping review that comprehensively examines the literature on interventions that apply a human rights-based approach to promote the rights of persons with psychosocial disabilities and mental health conditions in health settings and the general community. Chapter 3 is an empirical paper that evaluates the psychometric properties of three instruments that can be used to assess the effect of future interventions aiming to promote the rights of persons with psychosocial disabilities and mental health conditions.
Chapter 4 is an empirical paper that assesses the efficacy of the WHO QualityRights e-training, a new intervention to promote the human rights of persons with psychosocial disabilities and mental health conditions. The scoping review indicated that there is a growing body of literature on interventions that apply a human rights-based approach to promote the rights of people with psychosocial disabilities and mental health conditions. However, many of the studies evaluating these interventions are currently low-quality and there is urgent need for additional and methodologically robust research on this topic.
Additionally, our findings showed that worldwide there are many promising practices and interventions that are currently unexamined or insufficiently evaluated. The psychometric analyses in Chapter 3 indicated that the three instruments developed to assess the knowledge about the rights of persons with mental health conditions and psychosocial disabilities (WHO QualityRights Knowledge), the attitudes towards them and their role as rights holders (WHO QualityRights Attitudes), and mental health professionals’ practices related to substitute decision-making and coercion (WHO QualityRights Practices) are sufficiently valid and reliable and could be used in future research.
Finally, the data analyzed in Chapter 4 demonstrated that the WHO QualityRights e-training, compared with a placebo intervention, is effective in improving mental health professionals’ knowledge about human rights and attitudes towards people with psychosocial disabilities and mental health conditions and their role as rights-holders. Furthermore, these improvements are maintained over time. The WHO QualityRights e-training was also effective in reducing self-reported practices related to substitute-decision making and restraint both at 3 and 6 months. Given the impact that human rights violations have on the health and wellbeing of persons with psychosocial disabilities and mental health conditions, more efforts are needed to develop new interventions and carry out methodologically strong research in this area. This dissertation is a right step in this direction.
| Identifer | oai:union.ndltd.org:columbia.edu/oai:academiccommons.columbia.edu:10.7916/2fj8-sn60 |
| Date | January 2023 |
| Creators | Moro, Maria Francesca |
| Source Sets | Columbia University |
| Language | English |
| Detected Language | English |
| Type | Theses |
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