Trends in new psychoactive substances from surface and "dark" net monitoring.

16 www.thelancet.com/psychiatry Vol 4 January 2017 17% experienced changes in sleeping patterns (mostly lack of sleep), and 23% experienced increased anxiety. Participants noted that other areas of their lives were aff ected: 6% indicated confl ict within the family, 8% experienced fi nancial implications when they had to purchase the medication privately, 9% indicated that they had to travel to and from the clinic several times to check whether medication was available, and 2% had to take time off from work because their level of functioning was aff ected. A concern raised by participants was that they had not been adequately informed of the situation where the medications had been out of stock and when medication dosages had been reduced or substituted, even though South African policies and legislation emphasise the rights of users of mental health care to fully participate in their treatment plan. In conclusion, apart from the costs involved both for the health system as well as service users, when medication is not available it causes hardship in the lives of the individuals who are aff ected, especially service users in low-income and middle-income countries who are among the poorest. The provision of essential medications is a basic human right. Lack of medication ultimately denies individuals with mental disorders their right to access quality health-care services, enjoy a good quality of life, and to live with dignity. Lack of access to correct medication cannot be seen solely as a logistical or policy issue; it is a human rights issue because it violates an individual’s right to quality health care and dignity. The aspiration of the Sustainable Development Goals of “leaving no-one behind” must be honoured in the name of users of mental health care.