A/HRC/35/21 breakdown of communities, systemic socioeconomic disadvantage and harmful conditions at work and in schools. Approaches to mental health that ignore the social, economic and cultural environment are not just failing people with disabilities, they are failing to promote the mental health of many others at different stages of their lives. 14. With the adoption of the 2030 Agenda for Sustainable Development and recent efforts by influential global actors such as WHO, the Movement for Global Mental Health and the World Bank, mental health is emerging at the international level as a human development imperative. The 2030 Agenda and most of its sustainable development goals implicate mental health: Goal 3 seeks to ensure healthy lives and promote well-being at all ages and target 3.4 includes the promotion of mental health and well-being in reducing mortality from non-communicable diseases. How national efforts harness the momentum of the 2030 Agenda to address mental health has important implications for the effective realization of the right to health. 15. The current momentum and opportunity to advance are unique. It is from this juncture in history, within a confluence of international processes, that the Special Rapporteur seeks to make a contribution with the present report. III. Global burden of obstacles 16. An effective tool used to elevate global mental health is the use of alarming statistics to indicate the scale and economic burden of “mental disorders”. While it is uncontroversial to note that millions of people around the world are grossly underserved, the current “burden of disease” approach firmly roots the global mental health crisis within a biomedical model, too narrow to be proactive and responsive in addressing mental health issues at the national and global level. The focus on treating individual conditions inevitably leads to policy arrangements, systems and services that create narrow, ineffective and potentially harmful outcomes. It paves the way for further medicalization of global mental health, distracting policymakers from addressing the main risk and protective factors affecting mental health for everyone. To address the grossly unmet need for rightsbased mental health services for all, an assessment of the “global burden of obstacles” that has maintained the status quo in mental health is required. 17. Three major obstacles which reinforce each other are identified in the following sections. A. Dominance of the biomedical model 18. The biomedical model regards neurobiological aspects and processes as the explanation for mental conditions and the basis for interventions. It was believed that biomedical explanations, such as “chemical imbalance”, would bring mental health closer to physical health and general medicine, gradually eliminating stigma. 6 However, that has not happened and many of the concepts supporting the biomedical model in mental health have failed to be confirmed by further research. Diagnostic tools, such as the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders, continue to expand the parameters of individual diagnosis, often without a solid scientific basis.7 Critics warn that the overexpansion of diagnostic categories encroaches upon human experience in a way that could lead to a narrowing acceptance of human diversity. 8 19. However, the field of mental health continues to be over-medicalized and the reductionist biomedical model, with support from psychiatry and the pharmaceutical 6 7 8 See Derek Bolton and Jonathan Hill, Mind, Meaning and Mental Disorder: the Nature of Causal Explanation in Psychology and Psychiatry (Oxford, Oxford University Press, 2004). See Thomas Insel, “Transforming diagnosis” (April 2013), available from www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml. See Stefan Priebe, Tom Burns and Tom K.sJ. Craig, “The future of academic psychiatry may be social”, British Journal of Psychiatry, vol. 202, No. 5 (May 2013). 5