[57] Human Rights Watch interview with mother of a man with a mental health condition, Bali, Indonesia, November 19, 2020 (full name and details withheld). Publicly denounce the practice of shackling and actively oppose all forms of shackling, including by affiliated leaders and institutions. Of the Americans that have not sought mental health treatment, more than half, or 53%, were in low-income households. A Guatemalan farmer abandons his coffee farm after years of drought destroy his crops. Depression in Mexico: Stigma and its Policy Implications I was chained, beaten, and given devil incense. [164], The CRPD introduces strong safeguards against arbitrary detention and deprivation of liberty for people with disabilities, stating that the existence of a disability shall in no case justify a deprivation of liberty.[165], In her 2019 report, the UN special rapporteur on the rights of persons with disabilities stated that: The deprivation of liberty on the basis of impairment is a human rights violation on a massive scale. Over 400 million people worldwide lack access to essential health services typically delivered through primary healthcare. [3] This encompasses the right to personhood, being recognized as a person before the law, and legal agency, the capacity to act and exercise those rights. Rather, the critical issue is the inhumane treatment of people with psychosocial disabilities forced to stay there. New Jersey and Massachusetts have the lowest proportions, at 0.4% and 4.0%, respectively. The study offers a comprehensive analysis of the state of mental health care in the U.S. Mexico ignores mental health - El Universal In a privately-run social care institution in Russia, staff regularly brought people with psychosocial disabilities to the dining hall chained to each other and forced them to eat in handcuffs. How is that Islamic?[125], In institutions visited by Human Rights Watch in Indonesia, male staff would enter and exit womens wards or sections at will or were responsible for the womens section, including at night, which put women and girls at increased risk of sexual violence, as well as subjected them to a constant sense of insecurity and fear. At the Edumfa Heavenly Ministry Prayer Camp in Cape Coast, Ghana, people with real or perceived psychosocial disabilities are confined in cages and are rarely allowed out of such cages. (No. 2018 Oct 10;42:e172. L.J. [48] Karolina Kozik and Jean-Sbastien Spulchre, Disability Rights Bill Offers Hope in Congo, commentary, Human Rights Watch Dispatch, March 11, 2020, https://www.hrw.org/news/2020/03/11/disability-rights-bill-offers-hope-congo; Sophie Morgan, The country where disabled people are beaten and chained, BBC News Online, July 28, 2015, https://www.bbc.com/news/blogs-ouch-33523742 (accessed September 21, 2020); Shantha Rau Barriga (Human Rights Watch), Torture Comes in Many Forms, commentary,The Huffington Post, June 29, 2015, https://www.huffpost.com/entry/torture-comes-in-many-for_b_7691390?guccounter=1 (accessed September 16, 2020). (Eds. 14(1)(b); CRPD Committee, Statement on article 14 of the Convention on the Rights of Persons with Disabilities, September 2014, http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=15183&LangID=E#sthash.ErjRRg0s.9wBvLiwR.dpuf (accessed August 12, 2020). Stark Disparities in Accessibility at State and Income Levels. I was taken to a traditional healing center where they cut my wrists to introduce medicine and another one where a witch doctor made me take baths with chicken blood. [147] Non-discrimination is one of the cardinal principles on which the CRPD is grounded. [15] Discrimination, gender-based violence, socioeconomic disadvantage, income inequality, subordinate social status and the pressure of multiple roles are among the most cited at-risk factors that contribute to poor mental health among women. [72] Disability Rights International, Still in Harms Way - International Voluntourism, Segregation and Abuse of Children in Guatemala, July 16, 2018, https://www.driadvocacy.org/wp-content/uploads/Still-in-Harms-Way-2018.pdf (accessed August 1, 2020), p. V. [73] Moroccan Minister of Health to Close Bouya Omar Shrine, Morocco World News, April 16, 2015, https://www.moroccoworldnews.com/2015/04/156319/moroccan-minister-of-health-to-close-bouya-omar-shrine/ (accessed April 1, 2020). The following are trademarks of NAMI: NAMI, NAMI Basics, NAMI Connection, NAMI Ending the Silence, NAMI FaithNet, NAMI Family & Friends, NAMI Family . In Guatemala, she has helped organize a group of survivor leaders to raise public awareness of the psychological impacts of sexual violence and problems with the countrys justice system. In situation of conflict or crises, and more recently during the Covid-19 pandemic, people who are shackled are at greater risk because they are unable to leave or flee. 61-62; Amnesty International, Our Hearts Have Gone Dark The Mental Health Impact of South Sudans Conflict, https://www.amnesty.org/download/Documents/AFR6532032016ENGLISH.PDF, pp. [37] Despite this, less than 1 percent of international development assistance for health is allocated toward mental health.[38]. ), the poverty rate, the proportion of the area that is either young or elderly, the prevalence of alcohol and substance abuse, and travel time to a facility. Access to mental health care in El Salvador: a case study of - PubMed When it comes to seeking mental health care, the Latinx community has always struggled with stigmaboth in and outside of the United States. [25] In Africa, on average, there is fewer than one mental health worker per 100,000 people, compared with 2.5 in South-East Asia and 50 in Europe. Compared to middle- and high-income households, low-income Americans are less likely to know where to go for treatment and more likely to use a community center verses a qualified mental health center. Res. A combined federal, state, local view of how funds flow in and out. As a result, documenting shackling cases is extremely challenging. 2 July 2020. There is also a large disparity in access to mental health care based on level of income and location. 10. Celina de Sola, Glasswing's co-founder, says people in these places, where violence is endemic, urgently need help. It is typically an administrative process and does not contain any provisions for judicial oversight. Locking them in a confined space such as a room outside or within a house, shed, hut, cage, or animal shelter (including chicken coops, pig pens, or goat sheds). Listening and telling peoples stories is a first step to start humanizing migrants in a society where blaming the victim tends to be the norm., Children on the Run: Unaccompanied Children Leaving Central America and Mexico and the Need for International Protection [19] UN, Policy Brief: COVID-19 and the Need for Action on Mental Health, May 13, 2020, https://www.un.org/sites/un2.un.org/files/un_policy_brief-covid_and_mental_health_final.pdf (accessed June 22, 2020), p. 5; The World Bank, Mental Health, https://www.worldbank.org/en/topic/mental-health; WHO, Mental disorders, https://www.who.int/news-room/fact-sheets/detail/mental-disorders; see also Rudi Eggers (WHO Kenya Representative) statement in Kenya launches initiative to promote mental health for citizens, Xinhua, November 21, 2019, http://www.xinhuanet.com/english/2019-11/21/c_138573442.htm (accessed June 17, 2020). A young woman raised by her grandmother in Honduras leaves to reunite with her parents after more than a decade. Covid-19 is an extreme threat to people with psychosocial disabilities who are shackled in homes or overcrowded institutions without proper access to sanitation, running water, soap, or even basic health care. Federal tax ID#: 13-3433452. [144] International Covenant on Civil and Political Rights (ICCPR), adopted December 16, 1966, G.A. As of 2012, 92 percent of the people who had been unlocked in China remained free from chains. [120] In addition, the UN special rapporteur on violence against women has condemned forced psychiatric treatment as a form of violence.[121]. Share this via LinkedIn Since then Ive been living on the streets. Participants were 383 high school students (50.9% boys) aged 11-18 years (M = 14.12, SD = 1.91) in El Salvador. Mental health"Total Student Guidance Service" that cannot accommodate [18] Between 76 and 85 percent of people with mental health conditions who live in middle or low-income countries do not have access to mental health services. [4], Psychosocial disability: The preferred term to describe people with mental health conditions such as depression, bipolar, schizophrenia, and catatonia. [125] Nigeria: People With Mental Health Conditions Chained, Abused," Human Rights Watch news release, https://www.hrw.org/news/2019/11/11/nigeria-people-mental-health-conditions-chained-abused. [106] Human Rights Watch, Living in Hell, https://www.hrw.org/report/2016/03/20/living-hell/abuses-against-people-psychosocial-disabilities-indonesia. hospital bed.[60]. Mental Health Services. El Salvador is a republic with three branches of government: the Executive, the Legislature, and the Judiciary. People with psychosocial disabilities face pervasive stigma and bias and are among the most marginalized, enduring stigma and discrimination in every sphere of lifepersonal, professional and public. Third-party data was gathered to determine access based on four pillars: providers, facilities, funding and satisfaction. [135] By 2012, the program had unlocked 271 people who had been shackled for periods ranging from 2 weeks to 28 years across 26 provinces. [16] According to WHO, given the high incidence of sexual violence they suffer, women are also disproportionately affected by Post-Traumatic Stress Disorder (PTSD). In one center in northern Nigeria, Human Rights Watch found a dozen people who showed researchers scars on their arms, chests, and backs that they said were from floggings by staff. The term psychosocial disability describes conditions commonly referred toparticularly by mental health professionals and mediaas mental illness or mental disorders. The Convention on the Rights of Persons with Disabilities recognizes that disability is an evolving concept and that it results from the interaction between people with impairments and social, cultural, attitudinal, and environmental barriers that prevent their full and effective participation in society on an equal basis with others. https://www.hrw.org/sites/default/files/reports/zambia0714_ForUpload_1.pdf, p.16; A. Allen,andE.Green,Discrimination and Stigmatization of People with Epilepsy in Zambia: The Need for Integration of Social, Healthcare, and Policy Reform,, African [Banjul] Charter on Human and Peoples Rights (ACHPR), adopted June 27, 1981, OAU Doc. In Indonesia, Human Rights Watch found approximately 90 women living in a room that could reasonably accommodate no more than 30, in Panti Laras 2, a state-run institution in Cipayung, on the outskirts of Jakarta. In the same period this year, it has happened 37 times18 times in June alone.. El Salvador - Forum on "Depression and Mental Health" Share this via Email A/44/49 (1989), entered into force September 2, 1990; United Nations Convention on the Rights of Persons with Disabilities (CRPD), adopted December 13, 2006, G.A. 31, no. [60] Human Rights Watch visit to Lawang Mental Hospital, East Java, Indonesia, August 12, 2015. Travel restrictions have since been lifted but outpatient consultations at hospitals and health units remain suspended. In Germany, initial annual mental health service use and general health service use for Syrian refugees with untreated PTSD were much lower than for the local population with similar mental health needs, potentially because of barriers such as mental health stigma, language, coverage restrictions and a lack of awareness of services among . Marylin Beckley, a licensed professional counselor and doctoral student in the international psychology program at the Chicago School of Professional Psychology in Washington, D.C., works with IJM in Guatemala, El Salvador and other Latin American countries. COVID-19 and mental health in Indonesia - Policy Forum [35] Mental health is not just a human right but a public good that is key to achieving the United Nations Sustainable Development Goals (SDG). [45]In urban as well as rural areas in numerous countries there is a widespread belief that mental health conditions are the result of a variety of factors, including witchcraft, black magic, a curse, past sins, or possession by evil spirits or the devil. A doctor working at a psychiatric hospital in southern Nigeria said: We have to use chains in some cases.[59] In eastern Indonesia, Human Rights Watch witnessed a woman being tied around the waist with a twisted cloth and restrained to her The nation needs an additional 6,398 mental health providers to fill these shortage gaps. I eat porridge in the morning and if Im lucky, I find bread at night, but not every night. Urge national governments to ban shackling of people with real or perceived mental health conditions and develop adequate, quality, and voluntary community-based support mental health services. Students and Human Rights Watch researchers also conducted phone interviews with activists, representatives of local NGOs, mental health professionals, and journalists. Globally, an estimated 792 million people or 1 in 10 people, including 1 in 5 children, have a mental health condition. Human Rights Watch interviewed people with psychosocial disabilities who were shackled to trees, logs, pillars in a courtyard, dilapidated sheds without a roof over their heads, protection from the sun or rain, and with constant exposure to mosquitoes and pests. [173], According to the UN Committee on Economic, Social and Cultural Rights, the international expert body charged with monitoring compliance with the ICESCR, access to health facilities, goods and services should be non-discriminatory, especially for the most vulnerable or marginalized sections of the population, including individuals with disabilities. This is critical to help attract new providers into the field and more must be done to train and retain providers to help ensure people can get help when they need it. [141] Irmansyah, Free from Pasung one decade on?, Inside Indonesia, July 24, 2020, https://www.insideindonesia.org/free-from-pasung-one-decade-on (accessed September 25, 2020). Faith healers in Ghana, Indonesia, Kenya, and Nigeria reported sharing the little food available among all the residents, especially because some families did not provide food for their relatives, and prayer camps and institutions said they did not have the resources to buy enough food for everyone. Throughout this program, increasing equity of access to health services, improving the quality of these services and strengthening the monitoring and oversight capacity of the Ministry of Health have been top priorities. Inability to afford proper care. (No. [42] Families can find it challenging to take relatives with psychosocial disabilities out for events or social occasions due to societal stigma and fear the person might say or do something to cause embarrassment. Traditional or spiritual healing centers are also considered types of rudimentary institutions. [41], While data disaggregated by disability is hard to come by, available evidence shows that people with psychosocial disabilities often grow up in the confines of their home or an institution, excluded from community life, rarely attending school, getting married and having children, seeking employment, or participating in society. (No. We need to do something.. Many people are afraid to leave their homes for fear of being judged for transmitting the disease or being taken away from family members if they are hospitalized. Although faith healing centers can be registered with a government department or religious authority, they are not always regulated or monitored. [46] UNHRC, Report of the Special Rapporteur on the rights of persons with disabilities, Catalina Devandas-Aguilar, A/HRC/40/54, January 11, 2019, https://undocs.org/en/A/HRC/40/54 (accessed July 26, 2020), para. [64] Mentally Ill Confined at Home Due to Lack of Resources and Public Education, Global Times, June 25, 2015, https://www.globaltimes.cn/content/928917.shtml (accessed July 28, 2020); Caged People, The Beijing News, July 11, 2013, http://www.bjnews.com.cn/feature/2013/07/11/272800.html (accessed July 28, 2020); Chinese Healthcare: The Rural Reality, Collective Responsibility, July 23, 2018, https://www.coresponsibility.com/chinese-healthcare-the-rural-reality/ (accessed May 2020); 26-year-old Mentally Disturbed Man in China Locked in Cage by His Parents, Hong Kong Free Press, January 15, 2016, https://www.hongkongfp.com/2016/01/15/26-year-old-mentally-disturbed-man-in-china-locked-in-cage-by-his-parents/ (accessed May 2020); A Mentally Ill Chinese Man Has Been Locked In A Cage By His Family For 11 Years, Business Insider, May 28, 2013, https://www.businessinsider.com/chinese-man-kept-in-cage-for-11-years-2013-5 (accessed July 28, 2020); Chinese Mentally Ill Woman, Chained in Room for Decades by Family, to Get Medical Treatment, South China Morning Post, undated, https://www.scmp.com/news/china/society/article/1815641/chinese-mentally-ill-woman-chained-room-decades-family-get (accessed July 28, 2020). In 2019 at Adwumu Woho Herbal and Spiritual Centre in Senya Beraku, Ghana, about 60 kilometers from the capital, Accra, several men who were shackled and arbitrarily detained shouted out to a Human Rights Watch researcher: Help us get out of the chains. Share this via Telegram 69 (1988), signed November 17, 1988. [169], In his 2017 report, the UN special rapporteur on the right to health noted that [s]ervices must support the rights of people with intellectual, cognitive and psychosocial disabilities and with autism to live independently and be included in the community, rather than being segregated in inappropriate care facilities.[170], The highest attainable standard of physical and mental health is a fundamental human right enshrined in numerous international human rights instruments. According to the U.S. Department of Health and Human Services, one in five American adults have experienced a mental health issue, and one in 20 Americans live with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. Lack of or poor communications with coworkers. Access to mental health care in El Salvador: a case study of progress El Salvador's public healthcare system is considered poor. Once the person is committed to an institution, they have no right to appeal or leave until the institution discharges them. Share this via Reddit [41] Human Rights Watch, Better to Make Yourself Invisible: Family Violence against People with Disabilities in Mexico, June 2020, https://www.hrw.org/report/2020/06/04/better-make-yourself-invisible/family-violence-against-people-disabilities-mexico; Nigeria: People With Mental Health Conditions Chained, Abused, Human Rights Watch news release, November 11, 2019, https://www.hrw.org/news/2019/11/11/nigeria-people-mental-health-conditions-chained-abused; "Cameroon: People With Disabilities Caught in Crisis," Human Rights Watch news release, August 2019, https://www.hrw.org/news/2019/08/05/cameroon-people-disabilities-caught-crisis; Human Rights Watch, On the Margins: Education for Children with Disabilities in Kazakhstan, March 2019, https://www.hrw.org/sites/default/files/report_pdf/kazakhstan0319_web3.pdf, pp. We offer counseling appointments in our center with a psychologist. [76] Yulia Gorbunova, Held in Chains in Russia, commentary, Human Rights Watch Dispatch, August 8, 2017, https://www.hrw.org/news/2017/08/08/held-chains-russia. To be a young person in El Salvador, Guatemala or Honduras is extremely stressful, he says. Deprivation of liberty is permissible only when it is lawful and not arbitrary, and includes initial and periodic judicial review. Human Rights Watch researchers interviewed more than 350 people with psychosocial disabilities, including those who were shackled at the time of research or had been shackled at least once in their lives, and more than 430 family members, caregivers or staff working in institutions, psychiatrists, psychologists, nurses and other mental health professionals, faith healers, lawyers, government officials, representatives of local nongovernmental organizations (NGOs), including organizations of persons with disabilities, and disability rights advocates. [148] The CRPD states that all persons are equal before and under the law and are entitled without discrimination to the equal protection and equal benefit of the law.[149] The CRPD requires governments to prohibit all discrimination on the basis of disability and guarantee to persons with disabilities equal and effective legal protection against discrimination on all grounds and to take all appropriate steps to ensure that reasonable accommodation is provided.