A new report of the UN High Commissioner for Human Rights debated in the UNs Human Rights Council this week stresses the urgent need for systemic reform of mental health systems. The report demand focusing on models that shift away from a narrow emphasis on biomedical approaches towards a more holistic and inclusive understanding of mental health. It further stresses a need for transition to community-based mental health care and support.

UN Human Rights Council debate

Ms. Peggy Hicks, Director at the UN Office of the High Commissioner for Human Rights presented the High Commissioner’s Comprehensive Report on Mental Health and Human Rights to the UN Human Rights Council last Friday which then was followed by a debate ending this week. The report had been requested by the Human Rights Council with a Resolution adopted in April 2023.

The new report contains an analysis of the main obstacles and challenges in applying a human rights-based approach to mental health. This includes addressing stigma, ensuring access to equitable care, and empowering persons with psychosocial disabilities, users of mental health systems, and survivors of involuntary hospitalization in policy-making.

“This shift requires changes in legislation and policies to align with human rights standards, destigmatizing mental health services, eliminating coercive practices, investing in community-based services and cross-sectoral collaboration, ensuring informed consent for all mental health interventions, and addressing systemic inequalities,” Ms. Peggy Hicks told the Human Rights Council.

As part of the debate in the Human Rights Council, Tina Minkowitz of the Center for the Human Rights of Users and Survivors of Psychiatry reminded the UN member states of their binding obligations under the Convention on the Rights of Persons with Disabilities to implement deinstitutionalization plans and strategies as called for in the 2022 Guidelines on Deinstitutionalization.

“Significantly, this includes elimination of all involuntary hospitalization and treatment in mental health settings, including in situations of individual crisis and the creation of supports for people dealing with extreme distress and unusual perceptions that do not require a mental health diagnosis and that respect the person’s self-knowledge as well as their will and preferences,” Tina Minkowitz pointed out.

The practice of legally authorizing and carrying out involuntary hospitalization in psychiatry is contrary to articles 12, 13, 14 and 19 of the UN Convention on the Rights of Persons with Disabilities (CRPD) the UN Committee on the Rights of Persons with Disabilities has clearly established.

The report points out that the right to health is recognized in several international human rights instruments, and States parties to the International Covenant on Economic, Social and Cultural Rights have the obligation to ensure the satisfaction of, at the very least, minimum essential levels of each of the rights, including the right to health. The same obligations apply as much to mental health as to physical health, the report points out.

Discrimination and stigmatization

The report notes that discrimination and stigmatization of persons with psychosocial disabilities and users of mental health services remain alarmingly pervasive around the globe. Those challenges manifest in multiple forms, through systematic undue restrictions on their human rights due to barriers that hinder their equal access to the basic services and facilities that they require.

The report also notes that persons with lived experience of mental health conditions or psychosocial disabilities often face stigma among health professionals.

Coercive practices

Laws and health practices continue to allow involuntary treatment and institutionalization, affecting, in particular, persons with psychosocial disabilities. Persons with psychosocial disabilities and users of mental health services remain in institutions, confined and subjected to involuntary treatment, often in inhumane conditions, including being chained, the report pointed out.

The report further noted that there is insufficient independent oversight and accountability to address the reoccurring violations in the context of compulsory admissions and use of outdated facilities.

Challenges in legislation and policy implementation

The vast majority of States in Europe have ratified relevant human rights treaties recognizing the right to the highest attainable standard of physical and mental health, including the Convention on the Right of Persons with Disabilities.

The new report in view of this notes that efforts are needed to ensure that international obligations are incorporated into national laws and that competent institutions have the necessary capacity to effectively uphold and enforce these rights.

In many contexts, the rights of persons with psychosocial disabilities are violated, restricting their autonomy, participation and ability to provide free and informed consent, the report points out. Those restrictions are widely recognized as systemic issues that require alignment with international human rights standards, including the Convention on the Rights of Persons with Disabilities.

Specifically the reports explains that many countries have laws that allow forced treatment or institutionalization, under specific circumstances, such as when a person is deemed to be a risk to themselves or others, for example through criteria such as ”last resort”, “medical necessity” or “incapacity”.

The report notes that those legal exceptions “are of concern as they result in restrictions on the rights set forth in the Convention on the Rights of Persons with Disabilities, unduly limiting the autonomy of persons with lived experience, their participation in decision-making processes and their ability to provide consent.” Denial of legal capacity, as outlined in the Convention, is one of the main gaps in domestic legislation, critically affecting the enjoyment and exercise of a wide range of human rights, including access to justice, effective remedy and reparation.

As a specific example the report notes that Articles 6, 7 and 8 of the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine (Oviedo Convention) of the Council of Europe establish exceptions to the principle of free and informed consent outlined in article 5 of the same treaty, based on multiple grounds.

And that since 2014, the Council of Europe has been drafting an additional protocol to the Oviedo Convention entitled “the protection of human rights and dignity of persons with mental disorder with regard to involuntary placement and involuntary treatment”. United Nations human rights mechanisms, civil society organizations and other stakeholders have called for the withdrawal of the current draft protocol, which, in their view, maintains an approach to mental health policy and practice that is based on coercion and is incompatible with contemporary human rights-principles and standards and the rights enshrined in the Convention on the Rights of Persons with Disabilities, particularly in relation to institutionalization.

Systemic reform of mental health systems

The UN High Commissioner underscores the urgent need to adopt a human rights-based approach to mental health as a fundamental element of the right to the highest attainable standard of health under international human rights law. That involves a transition away from a narrow emphasis on biomedical approaches towards a more holistic and inclusive understanding of mental health and, therefore, a transition to community-based mental healthcare and support is essential.

Further legislative reform efforts need to be accompanied by efforts to address stigma and discrimination, expand access to human rights-based mental healthcare and support.

In considering legal, policy and institutional reforms governments should consider as a matter of priority a shift of the paradigm “from punitive approaches to health- and human rights-centred measures.” That includes implementing a restorative approach that focuses on providing community-based mental healthcare rather than punishment.

As well as ensure that free and informed consent is the basis of all mental health-related interventions, recognizing that the ability of individuals to make decisions about their own healthcare and treatment choices is an essential element of the right to health.

“Consequently,” the UN High Commissioner recommends states to, “end coercive practices in mental health, including involuntary commitment, forced treatment, seclusion and restraints in order to respect the rights of persons using mental health services. Ensure that all mental healthcare systems respect the autonomy and informed consent of persons with psychosocial disabilities and users of mental health services, in accordance with international human rights law.”

At the 68th session of the Commission on Narcotic Drugs (CND68) in Vienna, a crucial side event titled Supporting Drug Education and Prevention Initiatives brought together experts, policymakers, and former users to discuss the dangers of drug use and the importance of prevention. The event was organized by Fundacion para la Mejora de la Vida la Cultura y la Sociedad (Foundation for the Improvement of Life Culture and Society), an international foundation covering many societal issues with an educational and learning approach, and an important program on drug prevention; it was co-organized with the support of the specialized network of the Foundation for a Drug Free Europe, which counts with over 100 grassroots groups in Europe that do one on one prevention with The Truth About Drugs campaign.

This side event underscored the urgent need for coordinated global action to curb the rising tide of drug abuse, which continues to devastate communities worldwide.

Julie Delvaux, UNODC representative for the ECOSOC recognized Fundacion Mejora, set the tone for the session, emphasizing the need for early intervention: “The earlier we act, the more lives we can save, and the more we can reduce the harm being created by drugs.” She stressed that drug use is not merely a health issue but a social crisis affecting multiple sectors, including crime rates, economic stability, and mental health. With millions of people affected globally, the challenge is immense, and prevention emerges as the most effective long-term solution.

The event featured a range of speakers, from scientists to former drug users, all advocating for strong educational tactics in the field of education to increase the awareness of the dangers of drugs and comprehensive prevention efforts. Their insights painted a stark picture of the drug problem, reinforcing that public health policies should focus on preventing first use, rather than managing addiction after it has already taken hold.

Synthetic Cannabinoids: The Hidden Danger

Robert Galibert, President of the Foundation for a Drug-Free Europe (FDFE) and an expert in biochemistry, gave a scientific breakdown of synthetic cannabinoids, a growing threat in drug markets worldwide. His presentation delved into the biochemical mechanisms through which these substances interact with the human body, explaining how they are far more potent than natural cannabis and pose significant risks to both mental and physical health.

“These substances are far more potent and dangerous than natural cannabis,” Galibert warned. He elaborated on how synthetic cannabinoids, initially developed for medical research, were hijacked by illicit manufacturers seeking to exploit legal loopholes. These unregulated substances have resulted in severe health complications, including heart problems, severe vomiting, hallucinations, and in some cases, fatal overdoses.

He explained how synthetic cannabinoids disrupt the body’s endocannabinoid system, which plays a crucial role in regulating mood, memory, and overall physiological balance. Similarly to phyto-cannabinoids (found in cannabis), these synthetic substitutes bind to cannabinoid receptors, but activate them much more violently, resulting in extreme and unpredictable effects.

He pointed out the fat solubility of cannabis, which allows it to accumulate in the body and cause prolonged impairment. “The elimination of THC takes weeks, meaning a user is under the influence long after consumption,” he said. Comparing it to alcohol, he added, “Alcohol is eliminated in 24 hours, but THC (like phyto- or synthetic-cannabinoids) remains in adipose tissue for weeks, making its effects long-lasting and underestimated.” This insight is particularly crucial in the debate surrounding cannabis legalization, as it challenges the misconception that marijuana use is harmless or easily manageable.

A Former Addict’s Testimony: Real Impact of Drug Use

Perhaps the most moving moment of the event came from Stephanie, a former drug user from Switzerland. Speaking in French, she detailed her descent into addiction, which started with cannabis and quickly escalated to LSD, cocaine, heroin, and methadone. Her candid account exposed the progressive nature of drug addiction, challenging the notion that cannabis use can remain recreational without leading to further substance abuse.

She described how peer pressure led her to experiment: “At first, I didn’t want to be part of the group. But as time passed, I felt isolated. So, I gave in.” Like many young people, she was drawn in by the social aspects of drug use, not realizing the long-term consequences. Her story is a stark reminder that drug addiction often starts with social normalization—what seems like a harmless decision can spiral into a devastating dependency.

Her turning point came when she found herself “in a place without money, without a home, and with a lot of pain”, destitute, and suffering from severe withdrawal symptoms. “I hit rock bottom. That’s when I knew I had to change,” she revealed. After enough attempts at rehabilitation, she finally succeeded in overcoming addiction and now, after recovering control over her life and building a company that gives work to some 30 people, she has made it her mission to help others avoid the same fate.

Her story was a powerful testament to the necessity of prevention and education. She emphasized that had she been properly educated about the dangers of drugs in her early teens, she might have avoided the path she took. She urged policymakers to implement early education programs in schools, providing children with the knowledge and resilience to resist peer pressure.

The Science and Policy Debate on Cannabis

Dr. Francis Nde, medical advisor to the Council of the European Union, focused on the health consequences of cannabis use. He cited studies linking cannabis consumption to testicular cancer, cardiovascular disease, and mental disorders like schizophrenia. “The effects of cannabis are not just short-term; they are passed down through generations,” he emphasized, referring to recent studies on epigenetic effects. He called on governments to take these scientific findings into account when considering cannabis legalization, arguing that public health should take precedence over economic incentives or political pressures.

A tense discussion emerged when a psychologist from Poland, questioned whether alcohol should be considered the primary gateway drug instead of cannabis. Galibert responded with scientific data, reinforcing that while alcohol is a risk factor, cannabis is a stronger predictor of progression to harder drugs due to its persistent impact on the brain. He detailed how THC alters brain chemistry, making individuals more susceptible to seeking stronger substances to achieve similar effects.

Another controversial topic was Ukraine’s potential legalization of medical cannabis. Dr. Olena Shcherbakova, a senior researcher from Ukraine’s National Academy of Medical Sciences, presented the findings of her research with Dr Heorhii Danylenko and warned against legalization efforts: “We understand the risks and are actively working to prevent legalization. But we face strong lobbying efforts.” Her remarks underscored the geopolitical and policy challenges surrounding cannabis regulation. The debate highlighted the global divide in drug policy, where some nations push for legalization while others fight to uphold strict regulations to protect public health.

The Road Ahead for Prevention and Policy

As the session wrapped up, Delvaux reiterated the key message: Prevention through education, early intervention, and international cooperation is crucial in the fight against drug abuse. She called for greater investment in public awareness campaigns, school-based prevention programs, and cross-border collaboration to tackle the evolving drug crisis.

Stephanie’s story, Galibert’s scientific analysis, Dr. Nde’s medical expertise, Dr Shcherbakova and Dr Danylenko, all pointed to the urgent need for stricter policies and widespread awareness campaigns. The speakers warned that legalization efforts, particularly for cannabis, pose a significant risk to public health and should be countered with robust prevention strategies.The event at CND68 made it clear: The fight against drug abuse is far from over. But with education, strong policies, and international collaboration, progress can be made in protecting the most vulnerable—especially the youth—from the devastating consequences of drug addiction.

In Glasgow, Scotland, a scandal that has captured the nation’s attention is now calling for urgent reforms to the country’s child psychiatric care system. Skye House, a psychiatric facility for children, is at the center of the storm. The 24-bed institution, which was intended to provide care for young people struggling with mental health issues, has instead become a place where physical, emotional, and psychological abuse thrived. These horrifying practices were recently revealed through a shocking BBC documentary, which has now prompted widespread calls for change.

The documentary exposed what was hidden behind the hospital’s walls—forced drugging, restraints, emotional and physical abuse, and a toxic environment created by the staff. Former patients of the facility, some of whom were there for years, shared their traumatic experiences, painting a stark picture of what life was really like inside. One former patient described her time at Skye House as “almost as if I was getting treated like an animal” (Blosser, Freedom Magazine, 2025). This sentiment was echoed by others, who said the culture at the hospital was “quite toxic” and abusive.

A particularly unsettling story came from Abby, who entered the hospital at the age of 14 and spent over two years there. She shared that during her time, she and other patients were heavily sedated to the point where they were left in a zombie-like state. “A lot of the patients were like walking zombies,” Abby recalled in the Freedom Magazine article. “We were just sedated to the point where our personalities were dimmed.” Unfortunately, this kind of mistreatment wasn’t limited to medication. Patients were often subjected to physical restraint, dragged down corridors, or restrained without explanation. One of the young women, Cara, spent over two years at Skye House and was placed in restraints more than 400 times according to John Blosser’s article in Freedom Magazine.

The horrors at Skye House also extended to verbal abuse. Patients who self-harmed were mocked by staff, further deepening their emotional trauma. One girl, reflecting on how she was treated after a self-harm incident, shared that the staff member told her, “You’re disgusting, like that’s disgusting, you need to clean that up” (Blosser, Freedom Magazine, 2025). The constant punishment, ridicule, and physical force left patients feeling isolated, powerless, and dehumanized.

The revelations from the Freedom Magazine article further highlight the system’s alarming failings. Skye House’s treatment of these vulnerable young people didn’t just fall short of expectations—it was, in many cases, outright cruel. According to Scotland’s Mental Health Act, patients could be institutionalized involuntarily and treated without their consent, which allowed for the practice of forced drugging, electroshock therapy, and indefinite detainment. This Act, while intended to protect those with mental health issues, has been criticized for enabling severe mistreatment, as evidenced by the horrors at Skye House (Blosser, Freedom Magazine, 2025).

Perhaps the most heart-wrenching detail mentioned in the article was the tragic suicide of 14-year-old Louise Menzies, who hanged herself in a so-called “suicide-proof” room at Skye House in 2013. Despite the “suicide-proof” design, Louise’s death highlighted the significant failings of the facility’s care and the lack of proper attention to its patients’ needs. Even after this tragedy, the abuse continued, leading to the BBC investigation and subsequent media outcry.

The Scottish government has been forced to address the issues raised by the documentary. Maree Todd, the Minister for Mental Wellbeing, expressed her shock in Parliament, acknowledging that what was revealed in the program was deeply troubling. She promised that actions would be taken to ensure such a situation would not be allowed to continue. Meanwhile, Dr. Scott Davidson, medical director for NHS Greater Glasgow and Clyde, conceded that the level of care provided at Skye House was “below the level we would expect for our young people”.

This scandal is just one piece of a larger issue facing Scotland’s mental health care system, which has been criticized for failing to protect its most vulnerable citizens. The abuse at Skye House is symptomatic of a broken system that needs comprehensive reform. The government’s promises to implement more inspections of psychiatric facilities are only a small step toward the necessary overhaul of the system. The current framework, particularly the power granted to psychiatrists under the Mental Health Act, has allowed for unchecked abuses to take place, as was the case with Skye House.

As Scotland grapples with the fallout from these revelations, it’s crucial that the government takes immediate and meaningful action to address the abuse and neglect that took place in its psychiatric facilities. The young people subjected to such horrors deserve better than a broken system that punishes rather than cares for them. The time for reform is long overdue, and the survivors of Skye House are now speaking out to ensure that no other children will have to endure the same fate. The victims’ stories must not be forgotten, and their courage in sharing them should serve as a rallying cry for change.

It’s clear that Scotland’s mental health care system needs a complete overhaul, beginning with the protection and proper treatment of vulnerable children. Only by holding these institutions accountable can we hope to prevent further abuses like those that took place at Skye House.