A/HRC/35/21 37. Some obligations are not subject to progressive realization and must be implemented immediately, including certain freedoms and core obligations. Core obligations include the elaboration of a national public health strategy and non-discriminatory access to services. 28 In terms of the right to mental health, that translates into the development of a national mental health strategy with a road map leading away from coercive treatment and towards equal access to rights-based mental health services, including the equitable distribution of services in the community. B. International cooperation 38. International treaties recognize the obligation of international cooperation for the right to health, a responsibility reinforced by the commitment to a global partnership for sustainable development in Sustainable Development Goal 17. Higher-income States have a particular duty to provide assistance for the right to health, including mental health, in lower-income countries. There is an immediate obligation to refrain from providing development cooperation supporting mental health-care systems that are discriminatory or where violence, torture and other human rights violations occur. Rights-based development cooperation should support balanced health promotion and psychosocial interventions and other treatment alternatives, delivered in the community to effectively safeguard individuals from discriminatory, arbitrary, excessive, inappropriate and/or ineffective clinical care. 39. In view of that obligation, it is troubling that mental health is still neglected in development cooperation and other international policies on health financing. Between 2007 and 2013, only 1 per cent of international health aid went to mental health. 29 In times of humanitarian crises, in both the relief and recovery stages, international support must include psychosocial support to strengthen resilience in the face of enormous adversity and suffering. Elsewhere, where cooperation has been provided, it has prioritized the improvement of existing psychiatric hospitals and long-term care facilities that are inherently incompatible with human rights. 30 40. International assistance and cooperation also includes technical support for rightsbased mental health policies and practices. The WHO QualityRights initiative is a commendable example of such technical assistance. The Special Rapporteur also welcomes recent support by the World Bank and WHO for moving mental health to the centre of the global development agenda. However, he cautions that such global initiatives must incorporate the full range of human rights. In particular, multilateral agencies should give priority to ensuring the attainment of the right to health of those in the most vulnerable situations, such as persons with disabilities. A global agenda that focuses on anxiety and depression (common mental health conditions) may reflect a failure to include the persons most in need of rights-based changes in mental health services. Such selective agendas can reinforce practices based on the medicalization of human responses and inadequately address structural issues, such as poverty, inequality, gender stereotypes and violence. 41. States have an obligation to protect against harm by third parties, including the private sector, and should work to ensure that private actors support the realization of the right to mental health, while fully understanding their role and duties in that respect. C. Participation 42. The effective realization of the right to health requires the participation of everyone, particularly those living in poverty and in vulnerable situations, in decision-making at the legal, policy, community and health service level. At the population level, empowering everyone to participate meaningfully in decisions about their health and well-being requires 28 29 30 10 Committee on Economic, Social and Cultural Rights, general comment No. 14 (2000) on the right to the highest attainable standard of health, paras. 43-45. Seth Mnookin, “Out of the shadows: making mental health a global development priority”, World Bank Group and WHO (2016), p.13. Committee on Economic, Social and Cultural Rights, general comment No. 5, para. 15.