Human Rights of Older Persons with Mental Health Conditions, Dementia, and Psychosocial Disabilities

Dear Chair, distinguished delegates, and colleagues,

I speak on behalf of the World Psychiatric Association, with deep appreciation for the dedicated work of the WPA Section of Old Age Psychiatry and colleagues engaged in this important process.

Human rights do not diminish with age. They become especially urgent when older persons experience brain health challenges, mental health conditions, cognitive impairment, dementia, psychosocial disability, increasing support needs, or situations of dependency. Too often, these older persons remain invisible in law, policy, health systems, and care systems, while also facing intersecting forms of discrimination, including ageism, ableism, mental health-related stigma, sexism, poverty, social exclusion, and neglect. They may be excluded from decisions about their own lives, placed in institutions without meaningful choice, subjected to unnecessary restraint or coercion, denied appropriate care and support, or deprived of opportunities for social participation. Human rights must therefore be realised in everyday life — in homes, communities, hospitals, long-term care settings, and support systems — not only expressed in legal language.

Population ageing is a global reality. In 2023, approximately 1.1 billion people worldwide were aged 60 years and over, a number projected to reach 2.1 billion by 2050. In 2021, 57 million people were living with dementia worldwide, with nearly 10 million new cases each year. Approximately 14% of adults aged 70 and over live with a mental disorder. These are not marginal issues. They are central to the dignity, autonomy, equality, participation, and wellbeing of millions of older persons and their families.

For these reasons, mental health, brain health, dementia, psychosocial disability, long-term care, community-based care and support, legal capacity, supported decision-making, and protection from abuse and neglect must be clearly reflected in the development of a United Nations Convention on the Rights of Older Persons. These are not only health or social policy issues. They are fundamental human rights concerns.

Supported decision-making should be recognised as an essential safeguard of autonomy, legal capacity, dignity, and agency. Older persons must receive the support they need to express their will and preferences, rather than having decisions made for them solely on the basis of age, diagnosis, disability, or perceived dependency. Institutionalisation must never become the default response to ageing, disability, mental illness, dementia, or care needs.

A future Convention should also support Member States with practical implementation grounded in five core principles: human rights-based care and support; person-centred and relationship-centred approaches; evidence-informed policy and practice; freedom from ageism, ableism, mental health-related stigma, and other intersecting forms of discrimination; and accountability through safeguards, monitoring, remedies, education, and training. These principles are essential to ensure that rights are not only recognized in law, but realised in everyday care and support.

Above all, the voices of older persons themselves must be central. Older persons are rights holders and experts through lived experience. Their meaningful participation in the development, implementation, monitoring, and evaluation of the Convention is essential.

A Convention on the Rights of Older Persons offers a historic opportunity to close longstanding protection gaps and affirm that dignity, equality, autonomy, participation, health, mental health, care, and support belong to every person throughout the life course. Its success will ultimately be measured not only by its legal provisions, but by whether these rights are realised in everyday practice — in health care, social care, communities, families, and society as a whole.

Thank you.