States must do more to safeguard adolescent health rights – UN expert

15 June 2016 – A United Nations human rights expert today called on States to remove all legal barriers to access health facilities, goods and services interfering with the rights of adolescents to be heard and taken seriously, and that limit their right to make autonomous decisions.

“Governments must strike a balance between adolescents’ emerging autonomy and their right to protection in particular when it comes to mental health, the rights to sexual and reproductive health, and substance use and drug control, given the specific challenges these issues pose,” said Dainius Puras, UN Special Rapporteur on the right to health, in a statement released by the Office of the UN High Commissioner for Human Rights (OHCHR) after the presentation of his latest report to the UN Human Rights Council.

“The foundations laid down during adolescence have profound implications for the social, economic and political development of society as a whole. Hence, the costs of failing adolescents are simply too high,” he added.

In his report, the human rights expert highlights that health-care services should ensure respect for adolescents’ rights to privacy and confidentiality, address their different cultural needs and expectations, and comply with ethical standards.

“This is particularly important when it comes to providing mental health services for adolescents,” the Special Rapporteur said. “Psychosocial interventions should be provided at the community level in a manner that is ethical and consistent with adolescents’ rights, and on the basis of available evidence, with a view to avoid institutionalization and the excessive use of psychotropic medications.”

Moreover, Mr. Puras emphasized that States should adopt or integrate a comprehensive sexual and reproductive health policy for all adolescents into national strategies and programmes to ensure universal access to sexual and reproductive health-care services.

In that regard, he makes a number of recommendations in his report, including that abortion should not be criminalized, as this only leads to higher number of maternal deaths, and poor mental and physical health outcomes; all adolescents should have access to confidential, adolescent-responsive and non-discriminatory sexual and reproductive health information, services and goods; and age-appropriate, comprehensive and inclusive sexuality education, based on scientific evidence and human rights, should be part of the school curriculum.

The Special Rapporteur also called on States to seek alternatives to punitive or repressive drug control policies, including decriminalization and legal regulation and control, and foster the international debate on these issues with the right to health at the core.

“All drug detention centres for adolescents should be closed, and the provision of prevention, harm reduction and dependence treatment services, without discrimination, should be ensured,” he said.

The Special Rapporteur noted that adolescents should be protected from violence and neglect, including in family settings, by the upholding of their right to confidential services and counselling without parental consent. He also called on States to support families to increase the abilities of parents to raise children and adolescents in a competent and confident manner, and reinforce skills to manage situations in a non-violent way.

“Policies designed to protect families and family values should avoid measures that undermine the human rights of individual family members, including women, adolescents and younger children,” Mr. Puras said.

“Such approaches can be detrimental as they may, in the name of traditional values, condone violence, reinforce unequal power relations within family settings and, therefore, deprive adolescents from the opportunity to exercise their basic rights,” he added.

The Special Rapporteur also urged States to meet their core obligation to recognize adolescents as rights holders by respecting their evolving capacities and their right to participate in the design, delivery and evaluation of policies and services that affect their health and well-being.