联合国和世界卫生组织参与治疗全球精神卫生,特别关注痴呆症

Daniela Fisichella
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摘要

21世纪以来,国际法和许多国际组织对精神卫生和精神疾病给予了高度关注。由于人权的广泛扩展,心理健康现在是国际努力的一个目标,努力处理国家的选择和国际成就。世界卫生组织(世卫组织)明确参与,但联合国(UN)在九十年代初开辟了法律途径,联合国大会(UNGA)于1991年12月17日通过了第46/119号决议,《保护精神病患者和改善精神保健》,其中指出了精神保健和设施;如果精神疾病无法定义,则本决议的原则4(确定精神疾病)对于指导下一步的改进布局至关重要。从那时起,联合国和世卫组织一直在采取一种独特的精神卫生方法,具有约束力和不具有约束力的国际行为、调查和准则证明了这一点,如经各国协商通过的2010年世卫组织《卫生和精神卫生行动计划干预指南》,现已更新为2016年版。2015年10月21日,联合国大会第70/1号决议《变革我们的世界:2030年可持续发展议程》提出了17项可持续发展目标(并最终取代了2015年将实现的8项千年发展目标),这是从人类整体观点出发,采取全球方法解决身心健康问题的最后一步。正如《宣言》导言所述,“不让任何人掉队”。本文旨在将精神健康作为一个广义的国际法律问题进行研究,不仅与精神疾病的缺乏进行比较,而且从实施国际人权法的角度全面看待这一问题。在国内经济和社会平衡的全球框架中,人们认为痴呆症的预防和护理高于其他精神疾病(2012年世卫组织将痴呆症列为公共卫生重点),尽管国家卫生保健系统在投资资产方面仍依赖于国家政策。但是,各国对精神卫生保健服务的态度现在应以国际法当前的发展为导向。
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United Nations and World Health Organisation Engagement in TreatingGlobal Mental Health, with a Special Focus on Dementia
A sharp attention is devoted to mental health and mental illness by International Law and many International Organizations (IO’s) in XXI century. As a consequence of human rights huge extension, mental health is nowadays a target of international efforts striving to address both States national choices and international achievements. World Health Organization (WHO) is expressly engaged, but United Nations (UN) opened up the legal path in early nineties, by UN General Assembly (UNGA) 46/119 of 17 December 1991, The protection of persons with mental illness and the improvement of mental health care, where mental health care and facilities are pointed out; and if mental illness couldn’t be defined, Principle 4 (Determination of mental illness) of this Resolution is crucial to direct next improvements layout. From there, UN and WHO have been carrying on a unique approach to mental health, as proved by binding and non-binding international acts, surveys, guidelines – as the 2010 WHO mhGAP Intervention Guide, now updated in its 2016 version – adopted as a result of States consultation. UNGA Resolution 70/1 of 21 October 2015, Transforming Our World: the 2030 Agenda for Sustainable Development, envisaging 17 Sustainable Development Goals (and replacing past 8 Millennium Development Goals to be gained in 2015 at last) is the last step on the road of a global approach to health, both physical and mental in an holistic view of human beings. As stated in Declaration’s Introduction, “no one will be left behind”. This article aims to investigate mental health as an international legal issue on a broad sense, not only compared to lack of mental illness, but in a comprehensive view dealing with it by implementing International Law on Human Rights. Dementia prevention and care above other mental diseases is perceived in a global framework of domestic economic and social balance (2012 WHO Dementia, a Public Health Priority), even though national health care systems still depend upon national policies in investments assets. But States’ attitude to healthcare services in mental health should now be oriented by International Law current evolution.
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