A human rights indicator for the mental health context: A scoping review and analysis

Since the introduction of the Convention on the Rights of Persons with Disabilities (CRPD), there have been calls to develop standards for evaluating compliance and implementation. Human rights ‘indicators’ are a recognized, if somewhat contested, way to measure states' compliance with human rights treaties. The additional CRPD requirement for active involvement of people with disabilities in monitoring and implementation has sparked efforts towards participatory design of such tools. We present a rationale for the development of a CRPD indicator in the mental health context. We adopted a combined doctrinal analysis and scoping review approach to examining literature on human rights indicators. Unsurprisingly, a much wider literature exists on indicators concerning the rights of people with disabilities generally. For mental health-focused efforts, compliance tools have focused on either (1) the implementation of specific CRPD provisions, (2) mental health-related legislation, or (3) consisted of audit and service quality assessment tools that consider human rights at the service level. We observe that no tools or indicators have been developed in the mental health context that include a full, integrated assessment of the CRPD across society (both including and extending beyond healthcare services to include areas like housing, employment, and anti-discrimination law). To address this gap, we conclude by proposing the development of a co-designed indicator that is inclusive of the full spectrum of rights contained within the CRPD.