Sant Joan de Déu and Fundació Hospitalàries make progress in setting up the Catalan mental health rights model

The Fundació Hospitalàries and the Sant Joan de Déu Hospital Order have already begun working on a joint project resulting from a collaboration agreement between both institutions to strengthen the human rights model in mental health care, commissioned by the Ministry of Health of the Generalitat of Catalonia. The project is based on the WHO’s QualityRights model and seeks to drive the transformation of mental health care in Catalonia. For now, the two institutions have started an initial diagnostic phase that will conclude in 2028 and will be carried out in seven centres across the region.

A model to transform mental health

The QualityRights model, inspired by the United Nations Convention on the Rights of Persons with Disabilities, seeks to transform mental health care through the active promotion of human rights, improved care quality, and empowerment of both service users and professional teams.

On an international level, this approach drives structural transformation in services: Fewer coercive practices, greater active participation of service users, and care focused on dignity, autonomy, and the recovery process.

Diagnosis underway in care centres

As a fundamental part of this process, the Mental Health and Addictions Master Plan has commissioned both institutions to conduct a detailed diagnosis of how this rights-based model is being applied in practice in Catalonia. The goal is to assess the extent to which commitments made with the approval of the National Mental Health Pact—resulting from prior collaboration between the Generalitat and the WHO between 2023 and 2024—are being fulfilled and to translate this framework into care practice.

As an example, some humanizing mental health care projects within the QualityRights model, already being developed in centres of the Fundació Hospitalàries and Sant Joan de Déu in Catalonia, include:

• Therapeutic garden, which promotes leisure, autonomy, and socialization.
• Individualized work plan sessions, where the service user shares their life goals and how treatment can be improved with their follow-up team.
• Snoezelen multisensory rooms, designed to promote relaxation, reduce anxiety and stress, as well as agitation and behavioural disorders.
• Adapted sports activity tailored to the interests and abilities of service users (with support from Sport2live).
• Special Employment Centre (Mennintegra’t Job), which facilitates labour and community integration for people with mental health issues or disabilities.
• Program aimed at reducing involuntary admissions of people with mental health issues through a system that facilitates converting involuntary admissions into voluntary ones.
• Addressing eating disorders through the autonomy and co-responsibility of the person in their therapeutic process.
• Anti-stigma card game on psychosis, co-created with users, improves psychoeducation, enhances empowerment, and fights stigma.
• Virtual reality glasses to reduce stress levels in prisons through a virtual reality project.
• Calm room, a space to reduce stress and anxiety that patients themselves request when needed.
• A virtual avatar that improves symptoms in 90% of people diagnosed with schizophrenia (Avatar VR).
• Therapeutic, educational, and residential unit for children and youth with mental health disorders (Acompanya'm).
• State-of-the-art patient monitoring and control centre for continuous contact (Córtex).

The diagnosis of the QualityRights application, which began on 9 March 2025, is expected to last three years and will be conducted in seven centres of both organizations. From the Fundació Hospitalàries, the Fundació Hospitalàries Barcelona, Fundació Hospitalàries Barcelona Nord, Fundació Hospitalàries Martorell, and Fundació Hospitalàries Sant Boi are participating. From Sant Joan de Déu, the Parc Sanitari Sant Joan de Déu, the Sant Joan de Déu Barcelona Hospital, and Sant Joan de Déu Terres de Lleida are participating.

At each centre, 115 items defined by the WHO will be analysed to assess whether the services ensure dignified treatment centred on the rights of the individual. The process includes visits to facilities, interviews with professionals, as well as service users and families. The results obtained will serve as a basis for extending the model throughout the territory.

The first entity to enter the analysis phase is the Fundació Hospitalàries Barcelona Nord, which has already completed interviews with professionals regarding the 115 established items. An example of good practice linked to QualityRights, soon to be implemented in this centre—and identified through these interviews—is the application of a time management system driven by the professionals themselves. The aim is to prevent service users from depending on common alarms, a practice closer to a deprivation of liberty regime than to healthcare.

A shared project to be replicated in Spain and Europe

This project is part of a joint strategy between the Fundació Hospitalàries and Sant Joan de Déu, coordinated by Magda Casamitjana, who leads professional team training and community awareness activities, in collaboration with the Ministry of Health.

Once the WHO’s QualityRights initiative is fully developed in the centres of the Fundació Hospitalàries and Sant Joan de Déu in Catalonia, the project will extend to the centres of both throughout Spain and, in a final phase, the actions will be replicated in other countries where they are present.

From 1 to 4 July, Dr. Michelle Funk, head of the WHO’s QualityRights program, visited Catalonia to directly learn about the mental health centres and facilities of the Fundació Hospitalàries and Sant Joan de Déu, and to share experiences with professionals, managers, and service users. During the visit, Dr. Funk was very surprised and impressed by the level of progress achieved in Catalonia and highlighted the real commitment and work already started by care teams in implementing the human rights-centred mental health care model.