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GRF-07856 |
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submitted/soumis: 06.12.2023 |
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Multistakeholder pledge: Health – Fostering Mental Health and Psychosocial Wellbeing; Health – National Health System Inclusion |
Engagement multipartite : Santé – Favoriser la santé mentale et le bien-être psychosocial ; Santé – Inclusion dans le système national de santé |
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Support CoE States achieving inclusion in national health systems; fostering mental health and psychosocial wellbeing. |
Soutenir les États membres du CoE dans leurs efforts pour intégrer la santé mentale et le bien-être psychosocial dans leurs systèmes de santé nationaux. |
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Within the framework of the decisions taken by its Committee of Ministers and of available resources, the Council of Europe will support national authorities in designing and adopting national legislative frameworks facilitating inclusion of refugees through promotion of its standards, advocacy and assistance in policy changes. It will also support the strengthening of knowledge and capacities to adapt national policies, aiming to the inclusion of refugees into national social health protection schemes. Through the standards and activities of, inter alia, the Steering Committee for Human Rights in the fields of Biomedicine and Health, of the office of the Special Representative of the Secretary General on Migration and Refugees, coordinating the Action Plan on Protecting Vulnerable Persons in the context of migration and Asylum in Europe (2021-2025), and of the programme of Human Rights Education for Legal Professionals (HELP courses), the Council of Europe will promote and support the implementation of the relevant standards and principles regarding inclusion of refugees in national health systems. The treaty-based standards are set out in article 11 of the European Social Charter (right to protection of health) and article 3 of the Convention on Human Rights and Biomedicine (Oviedo convention) on the equitable access to healthcare. Also relevant are the Recommendation CM/Rec(2023)1 of the Committee of Ministers to member States on equitable access to medicinal products and medical equipment in a situation of shortage, notably to ensure that no person in need of medicinal products or medical equipment should a priori be excluded from access to them; the Guide to health literacy to support decision makers, health professionals and health providers identify the needs of individuals, including migrants and refugees, in accessing healthcare; and the (draft) Guide on children participation in decision-making process on matters relevant to their health. Inclusion in national health systems: The Council of Europe commits to carry out the following activities which will contribute to assist Member States in establishing legislation, policies and procedures at local, regional and national levels to implement these standards: (i) Call for ratification of the 1996 European Social Charter (revised) and for acceptance of the Collective Complaints Procedure by all the Member States of the Council of Europe. (ii) Monitor compliance with the Charter through national reports drawn up by States and collective complaints lodged by the social partners and non-governmental organisations. (iii) disseminate the Guide to health literacy in a range of languages. (iv) raise awareness of the needs of individuals and the corresponding responsibilities of healthcare providers in accessing healthcare, as referred to in the Guide to health literacy. (v) disseminate Recommendation CM/Rec(2023)1 of the Committee of Ministers to member States on equitable access to medicinal products and medical equipment in a situation of shortage. (vi) advance pan-European reflections on access to equitable access to appropriate innovative treatments and technologies in healthcare. (vii) draft and disseminate the Guide on children participation in decision-making process on matters relevant to their health, in different language versions. Such support to Member States will materialise through intergovernmental events, expert meetings, analysis of the national context through fact-finding missions, reports and recommendations, and dissemination through publications and social medias. Fostering mental health and psychosocial wellbeing for refugees and host communities: The Council of Europe will contribute to supporting states and non-state actors in: (i) preparing for mental health and psychosocial outcomes due to displacement-related emergencies in order to protect the mental health and psychosocial well-being of forcibly displaced and stateless people and host communities. (ii) raising awareness and supporting efforts in member states that favour approaches that are person-centred and that value personal choices and decision-making. (iii) identifying possible actions and tools which would contribute to the further development and application of human rights-based responses in mental health care services. (iv) develop capacity building events and online training, including through the programme of Human Rights Education for Legal Professionals (HELP courses). |
Dans le cadre des décisions prises par son Comité des ministres et des ressources disponibles, le Conseil de l'Europe aidera les autorités nationales à concevoir et adopter des cadres législatifs nationaux facilitant l'inclusion des réfugiés grâce à la promotion de ses normes, à des actions de sensibilisation et à une assistance en matière de changements politiques. Il soutiendra également le renforcement des connaissances et des capacités nécessaires pour adapter les politiques nationales, dans le but d'inclure les réfugiés dans les systèmes nationaux de protection sociale et de santé. Grâce aux normes et aux activités, entre autres, du Comité directeur pour les droits de l'homme dans les domaines de la biomédecine et de la santé, du bureau du Représentant spécial du Secrétaire général sur les migrations et les réfugiés, qui coordonne le Plan d'action pour la protection des personnes vulnérables dans le contexte des migrations et de l'asile en Europe (2021-2025), et du programme d'éducation aux droits de l'homme pour les professionnels du droit (cours HELP), le Conseil de l'Europe encouragera et soutiendra la mise en œuvre des normes et principes pertinents concernant l'inclusion des réfugiés dans les systèmes de santé nationaux. Les normes conventionnelles sont énoncées à l'article 11 de la Charte sociale européenne (droit à la protection de la santé) et à l'article 3 de la Convention sur les droits de l'homme et la biomédecine (Convention d'Oviedo) sur l'accès équitable aux soins de santé. Sont également pertinents la recommandation CM/Rec(2023)1 du Comité des ministres aux États membres sur l'accès équitable aux médicaments et aux équipements médicaux en situation de pénurie, notamment pour garantir qu'aucune personne ayant besoin de médicaments ou d'équipements médicaux ne soit a priori exclue de l'accès à ceux-ci ; le Guide sur la littératie en santé destiné à aider les décideurs, les professionnels de la santé et les prestataires de soins à identifier les besoins des personnes, y compris les migrants et les réfugiés, en matière d'accès aux soins de santé; et le (projet de) Guide sur la participation des enfants au processus décisionnel sur les questions relatives à leur santé. Intégration dans les systèmes de santé nationaux : Le Conseil de l'Europe s'engage à mener les activités suivantes qui contribueront à aider les États membres à mettre en place une législation, des politiques et des procédures aux niveaux local, régional et national pour appliquer ces normes: (i) Appeler à la ratification de la Charte sociale européenne (révisée) de 1996 et à l'acceptation de la procédure de réclamation collective par tous les États membres du Conseil de l'Europe. (ii) Contrôler le respect de la Charte au moyen de rapports nationaux établis par les États et de réclamations collectives déposées par les partenaires sociaux et les organisations non gouvernementales. (iii) Diffuser le Guide sur la littératie en santé dans plusieurs langues. (iv) Sensibiliser aux besoins des individus et aux responsabilités correspondantes des prestataires de soins de santé en matière d'accès aux soins, comme indiqué dans le Guide sur la littératie en santé. (v) Diffuser la Recommandation CM/Rec(2023)1 du Comité des Ministres aux États membres sur l'accès équitable aux médicaments et aux équipements médicaux en situation de pénurie. (vi) faire avancer la réflexion paneuropéenne sur l'accès équitable à des traitements et technologies innovants appropriés dans le domaine des soins de santé. (vii) rédiger et diffuser le Guide sur la participation des enfants au processus décisionnel sur les questions relatives à leur santé, dans différentes versions linguistiques. Ce soutien aux États membres se concrétisera par des événements intergouvernementaux, des réunions d'experts, l'analyse du contexte national au moyen de missions d'enquête, des rapports et des recommandations, ainsi que par la diffusion de publications et sur les réseaux sociaux. Promouvoir la santé mentale et le bien-être psychosocial des réfugiés et des communautés d'accueil : Le Conseil de l'Europe contribuera à soutenir les acteurs étatiques et non étatiques dans les domaines suivants : (i) préparer les mesures à prendre en matière de santé mentale et de bien-être psychosocial en cas d'urgence liée à des déplacements afin de protéger la santé mentale et le bien-être psychosocial des personnes déplacées de force et apatrides ainsi que des communautés d'accueil. (ii) sensibiliser et soutenir les efforts des États membres qui favorisent des approches centrées sur la personne et qui valorisent les choix et la prise de décision individuels. (iii) identifier les actions et les outils susceptibles de contribuer au développement et à la mise en œuvre de réponses fondées sur les droits de l'homme dans les services de santé mentale. (iv) développer des événements de renforcement des capacités et des formations en ligne, notamment dans le cadre du programme d'éducation aux droits de l'homme pour les professionnels du droit (cours HELP). |
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Reporting on progress, March 2025 |
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Summary |
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The CoE Human Rights based approaches to healthcare is founded in Convention on Human Rights and Biomedicine (OVIEDO Convention). CoE continues efforts aiming at the fostering mental health and psychological wellbeing through different activities, including trainings, guides etc., currently focusing on conflict- and post-conflict context, including trauma informed care and war-affected children. |
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Brief description of the steps taken in implementing the pledge |
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Armenia The Council of Europe implements cooperation project Protection of Human Rights in Biomedicine II within the Council of Europe Action Plan for Armenia 2023-2026 . As part of the Comprehensive-Response-Package-to-the-Refugee-Influx-in-Armenia, the project has been expanded with special component aimed at supporting national authorities to facilitate the inclusion of refugees into Armenian healthcare system. In the framework of the project, the following activities to foster mental health and psychological support have been carried out as part of the commitment of the Council of Europe to assist Member States in establishing legislation, policies and procedures at local, regional and national levels to implement the standards referred to by the above-mentioned pledge: § HELP Course Mental health and human rights has been developed and launched on the Council of Europe HELP platform. The launch of the course in Armenian is expected at the beginning of 2025 (iii). § Trainings for refugee healthcare professionals from Karabakh region between July and November 2024 as part of psychosocial support activities within the Council of Europe Comprehensive-Response-Package-to-the-Refugee-Influx-in-Armenia. Training sessions reflected on prevention and healing of emotional burn-out, different aspects of phycological healing and trauma prevention, emotional literacy, methods of communication, as well as soft skills on patient-centred communication and public speaking in theory and practice (iv). § The Council of Europe Report on Human Rights Based Approaches to healthcare was translated and disseminated within healthcare professionals and national authorities. To outline the international human rights standards applicable to health care, the expert-disscussion on the topic of human rights-based approaches to healthcare was organized with different stakeholders, decision makers and civil society in the field of healthcare focusing on the relevance of human rights principles and standards in the context of healthcare and how international human rights standards can inform and protect patients' rights in Council of Europe member states (ii). As part of inclusion in national health systems: § A comprehensive analysis of national legislation in compliance with the Oviedo Convention was conducted and with recommendations provided to the national authorities. Based on the legislative improvements, Armenia signed the Council of Europe Oviedo Convention on 16 May 2024. In the meantime, recommendations were provided to the national authorities provided to the draft Law on “Comprehensive health insurance system” according to the 3rd article of the Convention on the equitable access to healthcare services. § A joint expert discussion was organised on the “Right to Protection of Health in the Framework of Article 11 of the European Social Charter and Article 3 of the Oviedo Convention” to discuss the significance of full protection of the right to health in the framework of the reform agenda of the Government of Armenia in the field of healthcare system (i). § Guide to health literacy: contributing to trust building and equitable access to healthcare has been translated into Armenian and disseminated with relevant stakeholders. The Guide has been also published on the official website of the Council of Europe cooperation webpage in line with point (iii). § In April 2024 the Council of Europe released a Guide to children’s participation in decisions about their health which aims to promote a child-friendly, participatory approach to care and research and provides information and advice, primarily for healthcare professionals, about how to involve children in decision-making processes regarding their health. The Guide has been translated into Armenian, disseminated with relevant stakeholders in Armenia, as well as published on the official website of the Council of Europe cooperation webpage. § An expert disscussin focusing on the involvement of the children in decision-making processes concerning their health was organised in Yerevan in November 2024 and the guide was disseminated with relevant stakeholders, including the National Assembly of the Republic of Armenia, Ministry of Health of the Republic of Armenia, Ministry of Labour and Social Affairs of the Republic of Armenia, Ministry of Justice of the Republic of Armenia, Office of the Human Rights Defender of Armenia, etc. The event focused on the discussion of the role of policymakers, healthcare professionals, and other professionals involved in supporting and promoting children to participate in the process of decision making concerning their personal health (vii). § The Manual on Mental Health and Psychosocial Support for Armenian children in post-conflict context is a direct answer to the need for child-focused psychosocial support identified by the SRSG on Migration during an assessment visit to Armenia in October 2023. The Manual targets psychologists as well as professionals working for and with children and provides them with knowledge and skills on how to identify, refer, and/or support children in need of psychological support. The Manual combines theory and practice and will be accompanied by a series of trainings scheduled in Armenia early 2025. The Manual has been developed in close consultation with local experts, relevant representatives of national authorities, international organisations (UNICEF, UNHCR, ICRC) and civil society organisations. Ukraine Consultation Group on the Children of Ukraine (CGU), in particular its thematic Dialogue Group on psychological support and trauma-informed care, is supporting the development of an English language Master copy of a Manual on Psychological Support and Assistance to Children Who Have Experienced Traumatic Events. It is based on the Manual developed under the Ukraine project, which forms the basis of the HELP course on specificities of trauma informed care for social psychologists working with children that has been launched in Ukraine in July 2024. Using the Master version, Council of Europe member states can subsequently adapt to their national contexts. In addition, it is looking to organise a hearing on understanding the specific trauma of children having returned to Ukraine following unlawful deportation to the Russian Federation and temporarily controlled or occupied territories. |
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The impact of the pledge |
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§ Citizens of the Republic of Armenia enjoy the rights and benefits guaranteed by the Oviedo Convention (i). § Participation of refugee healthcare professionals from Karabakh region in the trainings on psychosocial well-being strengthened their awareness on the need to emotional self-care, introduced them to mechanisms of prevention and healing of emotional burn-out, equipped participants with tools to address challenges arising during interaction with difficult patients and engage in effective patient-centred communication, strengthened their ability to deal with their own complex feelings and navigate through challenging situations, gave an opportunity to practice public speaking and self-representation which will overall contribute to their social integration in Armenia. (iv) § The standards in the Guide to health literacy: contributing to trust building and equitable access to healthcare have been made available and accessible for healthcare professionals in Armenia to be implemented in daily medical practice. (iii) § The standards in the Guide to children’s participation on decisions about their health have been made available and accessible for relevant stakeholders in Armenia. (vii) |
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Beneficiaries reached |
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Approximately 200 refugee healthcare professionals from Karabakh region in Armenia. |
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Links to relevant content |
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Publications Guide to Children’s participation in decisions about their health in Armenian. Report on Human Rights Based Approaches applicable to Healthcare Trainings on psychosocial well-being of refugee healthcare professionals: Council of Europe targets psychological support activities for refugee healthcare professionals |
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Involvement of refugees |
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Refugee healthcare from Karabakh region participated in needs assessment to better identify and structure the training sessions and actively participated capacity building events on psychosocial well-being. |
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Pledge consideration of the age, gender and diversity |
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§ Trainings for refugee healthcare professionals from Karabakh region engaged adult refugees regardless of gender or any other characteristic. § The end beneficiaries of the Guide to health literacy: contributing to trust building and equitable access to healthcare are all members of the society regardless of age, gender and diversity, including refugees who have access to healthcare system in Armenia. § Guide to children’s participation on decisions about their health has a specific focus on children regardless of the gender or any other characteristic. |
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