RESUMEN
Mental health, historically framed as the mere absence of mental health disorders, has led to unequal treatment, resulting in more persons living with mental health challenges. This limited framing of mental health, often woven into policy and practices across a broad range of governance structures, programs, and services, has led to individual and collective discrimination and structural and systemic inequities, culminating in the infringement of fundamental human rights. Using a broader framework for viewing mental health (e.g., mental health as a continuum), the authors of this article propose that a right to mental health should form the basis of mental health policy. The article also considers the impact of stigma and discrimination and the implications of social determinants of health in forwarding a rights-based approach to mental health policy. The authors conduct a trends analysis of 80 years of United States' mental health policy and reflect on how social determinants and efforts to reduce stigma and discrimination have led to measurable progress toward achieving mental health equity. The Call-to-Action highlights opportunities to further support mental health and wellness through the use of interdisciplinary policy and practice recommendations that include the framing of mental health as a human right. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Asunto(s)
Política de Salud , Derechos Humanos , Salud Mental , Estigma Social , Humanos , Estados Unidos , Determinantes Sociales de la Salud , Historia del Siglo XX , Trastornos Mentales/terapia , Historia del Siglo XXI , Servicios de Salud Mental/organización & administración , Servicios de Salud Mental/legislación & jurisprudenciaRESUMEN
Women living with HIV (WLWH) experience depression, anxiety, and posttraumatic stress symptoms at higher rates than their male counterparts and more often than HIV-unaffected women. These mental health issues affect not only the well-being and quality of life of WLWH, but have implications for HIV management and transmission prevention. Despite these ramifications, WLWH are under-treated for mental health concerns and they are underrepresented in the mental health treatment literature. In this review, we illustrate the unique mental health issues faced by WLWH such as a high prevalence of physical and sexual abuse histories, caregiving stress, and elevated internalized stigma as well as myriad barriers to care. We examine the feasibility and outcomes of mental health interventions that have been tested in WLWH including cognitive behavioral therapy, mindfulness-based interventions, and supportive counseling. Future research is required to address individual and systemic barriers to mental health care for WLWH.