For a long time, mental health care was organised around custody. People were removed from their communities, confined, sometimes chained or heavily sedated, and deprived of the right to speak for themselves.
Their diagnosis became their identity. The human rights approach that has developed over the last few decades, most clearly expressed in the Convention on the Rights of Persons with Disabilities, asks us to turn that history inside out.
It asks us to see a person first, not a condition. It reminds us that every person, regardless of their mental state or diagnosis, retains the right to dignity, privacy and freedom from cruel or degrading treatment, as well as the right to make choices about their own body and life, with support when needed.
This shift changes how care is given. It moves the conversation away from force and towards consent. It replaces solitary confinement and chemical restraint with de-escalation, listening and safe spaces. It insists that confidentiality is not a courtesy but a right, and that living in the community, rather than in an institution far from home, is the norm that should be protected.
And inevitably, a practical question arises: Does this way of working cost too much? Is it efficient? Managers and policymakers ask it quietly, while families ask it with concern. On the surface, a coercive system can look fast. It may seem quicker to sedate than to sit and talk, or to give orders than to explain and seek agreement.
But that kind of speed can be an illusion. When trust is broken by force, people may not return. They may avoid services until they are in acute crisis, be brought back in emergencies, stay longer, and then disengage again.
It can become a revolving door that places additional pressure on staff, affects patients and strains budgets. Wards that rely on restraint may face more injuries, legal claims and staff burnout. Large institutions that keep people away from their communities for months or years can also be costly for health systems.
A system built on rights, by contrast, can build efficiency that lasts. When a person helps develop their own treatment plan, they are more likely to follow it. When peer workers — people who have themselves lived through mental distress — are part of the team, hospital stays can become shorter and hope more tangible, at a relatively modest cost.
When services are open and respectful, complaints can fall, and cooperation can rise. Real efficiency is not simply how many people you can process in a day. It is how many people actually get better and stay well.
This same logic is central to how we understand disability. Disability is not simply something that resides inside a person. It can emerge from the interaction between a person and a world full of barriers.
A person living with depression is not inherently unable to work; they may become disabled when the workplace allows no flexibility, no time for healing and no understanding of fluctuating capacity.
A child with autism is not unable to learn; they may become disabled when the classroom insists on only one way of learning and one way of being.
To speak of people as differently abled is not just to use a polite term. It is to recognise that human ability does not run on a single track. Many people who live with psychosocial disabilities develop, alongside their struggles, profound capacities — resilience forged in crisis, deep empathy for the suffering of others, creativity and careful attention to detail. These are not sentimental claims; they are lived realities that workplaces and schools can lose when they exclude.
Seen this way, accommodation is not an act of charity. It is an investment. Flexible hours, a quieter place to work, clear written instructions, access to counselling and the freedom to attend a clinic appointment are small adjustments that can unlock significant amounts of talent and loyalty.
Evidence from inclusive employers is consistent on this point: when properly supported, employees with disabilities can show equal or greater productivity and may stay longer in their jobs.
Ultimately, upholding human rights in mental health asks us to do something more demanding than protecting people from harm, though that is essential. It asks us to invite them into the room where decisions are made. Services designed with, not just for, people who use them are more humane, relevant and effective.
A rights-based system is not a compromise between compassion and practicality. It is the point where the two meet. It tells us that we cannot be efficient without being humane, and that a society is measured not by how fast it moves, but by whether it leaves anyone behind.
The writer is a wellness doctor passionate about social change, gender, and mental health advocacy
