The world's population over age 60 years, estimated to be 1 billion in the year 2020, is projected to reach 2.1 billion by 20501. Of these, 20% are estimated to have a mental health condition, and 60% reside in low- and middle-income countries, where the challenging living circumstances elevate the risk of human rights violations2. Despite increasing awareness, older persons continue to face multiple barriers to mental health care: denial, fear, lack of knowledge, normalization of symptoms, desire to maintain independence, and absence of support networks. Most critical among these is stigma, in the form of ageism, mentalism and ableism, three overlapping forces that constitute a profound violation of human rights. The 1948 Universal Declaration of Human Rights3, a landmark achievement, failed to anticipate today's demographic realities. When it was adopted, global life expectancy was only 43 years4. In 2024, it is nearly 74 years. This stark shift has made the lack of specific protections for older persons more pressing. To address this, the international community has made notable progress in recent years. The Madrid International Plan of Action on Ageing called for comprehensive mental health care for older persons, spanning prevention to treatment. This led to the establishment of the Open-Ended Working Group on Ageing (OEWGA) by the United Nations (UN) General Assembly in 2010 to assess protection gaps in the human rights of older persons. In 2024, the OEWGA concluded its work and adopted the Decision 14/1, recommending the creation of an international legally binding instrument to promote and protect the rights of older persons5. On March 28, 2025, during the 58th session of the Human Rights Council, this recommendation was advanced with the establishment of an intergovernmental working group to draft a new UN Convention on the Rights of Older Persons. Comparable progress has occurred in the mental health domain. In 2023, the UN Human Rights Council passed the Resolution 52/12, calling for a human rights-based approach to mental health6. The resulting report, published in January 2025, emphasized dignity, autonomy, and the need to end coercive practices in mental health systems. It called for coherence across global efforts and integration of human rights into mental health frameworks. In April 2025, the World Health Organization published its Guidance on Mental Health Policy and Strategic Action Plans7, articulating five reform areas aligned with international rights standards. The document recognizes the need for policies that are person-centred, recovery-oriented, and grounded in respect for autonomy and dignity. It also includes special considerations for diverse groups, including older adults. In response to these global advances, national and civil society actors have begun operationalizing human rights principles in mental health care for older persons. One noteworthy example is from Canada, where the Canadian Coalition Against Ageism (CCAA) and the International Longevity Centre Canada (ILC Canada) have emerged as leaders in embedding dignity and rights into care systems. Their recent national forum called for systemic reforms to eliminate ageism through intergenerational strategies, policy change, and public education. This work explicitly positions older persons not as passive recipients of care, but as active rights-holders and contributors to society. Building on these efforts, the CCAA and ILC Canada have proposed a Five-Pillar Framework for Dignity and Rights-Based Care8. This approach supports science- and evidence-based practices, a person-centred model of care, a Prism lens to address intersecting forms of discrimination, a human rights foundation, and accountability across all levels of care. This framework is both pragmatic and ethical, aiming to safeguard older persons’ rights and promote holistic well-being. It also proposes the formation of a Global Alliance for Dignity and Rights-Based Care, bringing together stakeholders to promote international standards, knowledge sharing, and shared accountability. These developments reaffirm that dignity must no longer be treated as an abstract principle, but as an actionable foundation for health and social care9. A growing body of literature has sought to define and operationalize dignity, including identity, autonomy, relational behavior, and structural inclusion. In mental health care, dignity is closely tied to ethical practice, quality of life, and legal protections, particularly in the context of reduced autonomy due to conditions such as dementia or psychosocial disabilities. Upholding dignity is essential to countering systemic exclusion and fostering positive clinical outcomes10. While the Convention on the Rights of Persons with Disabilities offers indirect protections, it does not address the full spectrum of mental health and aging-related concerns. A new UN Convention would fill this gap. However, progress depends on political will, sustained advocacy, and the active involvement of older persons and their representative organizations. To advance this vision, national governments and multilateral institutions must prioritize mental health as a distinct and essential component of aging policy. Health systems must adapt to address older persons’ unique needs through appropriate training, trauma-informed and culturally sensitive care, and integrated service delivery. Human rights protections must be expanded beyond legal declarations to everyday practices in mental health and long-term care systems. This is particularly urgent given the disproportionate impacts of the COVID-19 pandemic on older adults, where failures in rights protection became tragically visible. The convergence of global momentum – the UN Decade of Healthy Ageing, the Madrid International Plan of Action on Ageing, the Resolution 52/12, and the OEWGA's final report – provides a critical opportunity. If seized, it could catalyze meaningful change. Dignity-centered, human rights-based care must become the new norm, not only to ensure ethical standards but to build inclusive societies where all people, regardless of age or ability, can thrive. As our global population continues to age, protecting the mental health and rights of older persons is not just a policy imperative. It is a moral one.
Lima et al. (2026) studied this question.