A/HRC/35/21 can be effective in managing certain conditions is not disputed, but there are increasing concerns about their overprescription and overuse in cases where they are not needed. 20 There is a long history of pharmaceutical companies not disclosing negative results of drug trials, which has obscured the evidence base for their use. That denies health professionals and users access to the information necessary for making informed decisions. 21 28. Powerful actors influence the research domain, which shapes policy and the implementation of evidence. Scientific research in mental health and policy continues to suffer from a lack of diversified funding and remains focused on the neurobiological model. In particular, academic psychiatry has outsize influence, informing policymakers on resource allocation and guiding principles for mental health policies and services. Academic psychiatry has mostly confined its research agenda to the biological determinants of mental health. That bias also dominates the teaching in medical schools, restricting the knowledge transfer to the next generation of professionals and depriving them of an understanding of the range of factors that affect mental health and contribute to recovery. 29. Because of biomedical bias, there exists a worrying lag between emerging evidence and how it is used to inform policy development and practice. For decades now, an evidence base informed by experiential and scientific research has been accumulating in support of psychosocial, recovery-oriented services and support and non-coercive alternatives to existing services. Without promotion of and investment in such services and the stakeholders behind them, they will remain peripheral and will not be able to generate the changes they promise to bring. IV. Evolving normative framework for mental health 30. The Constitution of WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Like all aspects of health, a range of biological, social and psychological factors affect mental health. 22 It is from this understanding that duty bearers can more accurately understand their corresponding obligations to respect, protect and fulfil the right to mental health for all. Most of the current discussions around mental health and human rights have focused on informed consent in the context of psychiatric treatment. While that discourse is deeply meaningful, it has emerged as a result of systemic failures to protect the right to mental health and to provide non-coercive treatment alternatives. 31. The evolving normative context around mental health involves the intimate connection between the right to health, with the entitlement to underlying determinants, and the freedom to control one’s own health and body. That is also linked to the right to liberty, freedom from non-consensual interference and respect for legal capacity. While informed consent is needed to receive treatment that is compliant with the right to health, legal capacity is needed to provide consent and must be distinguished from mental capacity. The right to health also includes a right to integration and treatment in the community with appropriate support to both live independently and to exercise legal capacity (see, for example, E/CN.4/2005/51, paras. 83-86, and A/64/272, para. 10). 23 The denial of legal capacity frequently leads to deprivation of liberty and forced medical interventions, which raises questions not only about the prohibition of arbitrary detention and cruel, inhuman or degrading treatment, but also the right to health. 32. Prior to the adoption of the Convention on the Rights of Persons with Disabilities, various non-binding instruments guided States in identifying their obligations to protect the rights of persons with disabilities in the context of treatment (see General Assembly resolutions 37/53, 46/119 and 48/96). While some of them recognized important rights and 20 21 22 23 8 See Ray Moynihan, “Preventing overdiagnosis: how to stop harming the healthy”. See Irving Kirsch and others, “Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration”, PLOS Medicine (February 2008). See WHO, Mental Health Action Plan 2013-2020 (2013), p. 7. See also Committee on the Rights of Persons with Disabilities, general comment No. 1 (2014) on equal recognition before the law, para. 13.