Virtual Conference
Mental Health 2022

Carlos Augusto de Mendonça Lima

Centre Médical de Mézières, Switzerland

Title: Towards a WPA Position Document on the Human Rights of Older Adults with Mental Health Conditions


“There is no older adults’ mental health in case of violation of their Human Rights”. This statement is the leitmotiv of this presentation, which settles the World Psychiatric Association position on Human Rights of Older Adults with Mental Health Conditions, as proposed by the Section of Old Age Psychiatry jointly with the International Psychogeriatric Association. The rapid ageing of world population will contribute to increase the proportion of persons aged 65 years and more from 9% in 2020 to 16% by 2050, when 1.5 billion people will be over 65 years. This growth is not restricted purely to developed countries. It is estimated that approximately 20% of these persons will have mental health conditions such as dementia, depression, anxiety, and substance abuse, often complicated by physical and psychosocial comorbidities culminating in disability. In a world of limited resources and with the majority of mental health systems around the globe in crisis, the gap between older people’s mental health and well-being needs and the offer of support is increasing sharply, accompanied by several violations of basic human rights. Older adults may experience multiple jeopardies of discrimination and stigma conferred by age itself (ageism) and by having mental conditions (mentalism). They often are segregated in institutions where they have to live far from other members of the community, their voices being ‘invisible’, with no support to protect themselves against abuse, neglect, or violence. These victims of ageism and mentalism are often sidelined and disproportionately excluded from all kinds of protection, including those sustaining life: this was particularly observed during the COVID-19 pandemic. This “grossly unmet need” for rights-based mental health and psychosocial care is the result of a combination of factors, including the failure to incorporate the voices of those most affected in health and government policies, including environmental, social, home, and family support programs. Such lack of support often leads to over-reliance on the biomedical model, psychotropic drug use, and physical restraints, especially in institutional care, despite evidence based and best practices recommendations to the contrary. A global organization able to articulate the needs of older adults experiencing the highest disease burden remains absent. The non-existence of an institution with the capacity to ensure the protection of that rights of older adults may be understood as being a consequence of the fact that when the United Nations and the WHO were created in 1945 and 1948, respectively, demography was not in favor of older adults. The global life expectancy at that time was still quite low, and the number of older adults worldwide was not particularly significant. This has dramatically increased due to improved life-expectancy: if in 1950 there were seven children aged less than 15 for per older adult, by 2050 this ratio will be in the region of 1:1. In terms of sheer numbers, this appears concerning as the population which is vulnerable and needs human rights protection is massive, and indeed is continuing to grow. WPA and IPA strongly recommends integration of future generations of older persons in all future developments related to the Human Rights of older persons in coordination with other agencies to support the humanity-enhancing need to age well. WPA and IPA has identified key strategies to promote, sustain and protect these rights including: 

• the publication of a United Nations convention on the rights of older persons that could provide a framework for limiting social and economic inequities, insecurities and vulnerabilities; to promote opportunities to improve older persons quality of life and to articulate further developments in the future; 
• the creation of an international agency with capacity and resources to lead and coordinate UN acti