Gronholm Petra C, Gill Neeraj, Carter Grace, Watson Danielle, Helmchen Hanfried, Thornicroft Graham, Sartorius Norman
Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
School of Medicine and Dentistry, Griffith University, Australia; Mental Health Policy Unit, Health Research Institute, University of Canberra, Australia; and Mental Health and Specialist Services, Gold Coast Health, Australia.
BJPsych Open. 2023 Mar 27;9(2):e56. doi: 10.1192/bjo.2023.41.
Protecting all human rights of people with mental health conditions is globally important. However, to facilitate practical implementation of rights, it is often necessary to decide which of these rights should be given priority, especially when they conflict with each other.
The aim of the Priorities of Human Rights and Mental Health (PHRAME) project is to develop a replicable approach to establish a proposed set of high-priority human rights of people with mental health conditions, to facilitate practical decision-making and implementation of such rights.
A two-stage Delphi-style study with stakeholders was conducted to generate a list of key rights of people with mental health conditions, and rank priorities among these rights in terms of feasibility, urgency and overall importance.
The stakeholders in this study consistently ranked three rights as top priorities: (a) the right to freedom from torture, cruel inhuman treatment and punishment; (b) the right to health and access to services/treatment; and (c) the right to protection and safety in emergency situations.
Insights from PHRAME can support decision-making about the priority to be given to human rights, to guide practical action. This approach can also be used to assess how human rights are prioritised in different settings and by different stakeholders. This study identifies the clear need for a central voice for people with lived experience in research and implementation of decisions about the priority of human rights, ensuring that action respects the opinion of people whose rights are directly affected.
保护精神健康状况者的所有人权具有全球重要性。然而，为便于切实落实这些权利，往往有必要决定哪些权利应优先考虑，尤其是当它们相互冲突时。
人权与精神健康优先事项（PHRAME）项目的目的是开发一种可复制的方法，以确定一套拟议的精神健康状况者的高度优先人权，便于此类权利的实际决策和落实。
与利益相关者开展了两阶段的德尔菲式研究，以生成精神健康状况者的关键权利清单，并根据可行性、紧迫性和总体重要性对这些权利进行优先排序。
本研究中的利益相关者一致将三项权利列为首要优先事项：（a）免受酷刑、残忍不人道待遇和惩罚的权利；（b）健康权以及获得服务/治疗的权利；（c）在紧急情况下获得保护和安全的权利。
PHRAME项目的见解可支持关于人权优先顺序的决策，以指导实际行动。这种方法还可用于评估不同背景下以及不同利益相关者如何确定人权的优先顺序。本研究明确指出，在研究和落实关于人权优先顺序的决策时，需要有精神健康状况者的实际经历发出核心声音，确保行动尊重其权利直接受到影响者的意见。
