It is typically an administrative process and does not contain any provisions for judicial oversight. It is also essential to guarantee access to primary health care and improve case detection and follow-up to prevent cases from becoming serious, whether they are COVID-19 or not.". Inability to afford proper care. Exacerbated by such close and unsanitary living conditions, lice and scabies are a major problem in many institutions.[97]. In order to show the scale and scope of shackling of people with real or perceived psychosocial disabilities worldwide, Human Rights Watch conducted a study of mental health legislation, relevant policies, and practices across 60 countries around the world. In June 2020, President Maada Bio of Sierra Leone inaugurated the renovated and chain-free Sierra Leone Psychiatric Teaching Hospital. In comparison, 1,560 did in the 2014-2015 academic year. Retornados often struggle to find work, become targets of gangs who assume they have money, and have problems with addiction and suicidality, Garca Rivera says. [2] See Disabled Peoples International, Constitution of Disabled Peoples International, 1993, http://www.disabledpeoplesinternational.org/Constitution (accessed January 15, 2016), art. [7] Christian faith healers typically use prayer, religious counseling, fasting, and spiritual healing as treatment methods. 11, 69-71; sjcintern and Zoya Aleem, Chaining the Mentally Ill, post to The Upstream Journal (blog), January 2012, https://www.upstreamjournal.org/chaining-the-mentally-ill/ (accessed August 17, 2020). [98] Human Rights Watch interview with Aisha [not her real name], family member, Gaza, February 15, 2020. Furthermore, younger Americans (i.e., Gen Z and Millennials) are less sure about resources for mental health services, compared to older generations. Around the world, hundreds of thousands of men, women, and children with mental health conditions have been shackledchained or locked in confined spacesat least once in their lives. In Honduras, a population of nearly 9 million relies on just 185 mental health professionals, and in El Salvador, 225 mental health workers serve more than 6 million people (Mental Health Atlas Country Profiles, World Health Organization, 2017). 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 People with psychosocial disabilities, including children, who are shackled in homes or institutions are routinely forced to take medication or subjected to alternative treatments such as concoctions of magical herbs, vigorous massages by traditional healers, Quranic recitation in the persons ear, and special baths. A/34/46, entered into force September 3, 1981; Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (Convention against Torture), adopted December 10, 1984, G.A. In many countries, it is a profitable business. Associations between racism and mental health are stronger than those between racism and general medical health ( 2 ). [66] Human Rights Watch, Living in Hell, https://www.hrw.org/report/2016/03/20/living-hell/abuses-against-people-psychosocial-disabilities-indonesia, p. 35; Ministry of Health of Republic of Indonesia, Stop Stigma and Discrimination to People with Mental Disorder, October 10, 2014, http://www.depkes.go.id/article/view/201410270011/stop-stigma-dan-diskriminasi-terhadap-orang-dengan-gangguan-jiwa-odgj.html (accessed August 20, 2015); Marsel Rombe, Indonesian Mental Health Law Passed after Five Years, Jakarta Globe, July 13, 2014, http://jakartaglobe.beritasatu.com/news/indonesian-mental-health-law-passed-five-years (accessed August 19, 2015). 55. The WHOs World Mental Health Survey found that only 1 in 5 people with depression receive minimally adequate mental health services in high-income countries and it falls to 1 in 27 in low and middle-income countries. I was chained, beaten, and given devil incense. In other cases, people have to use a drain or an open toilet in the room. [152], The Committee on the Rights of Persons with Disabilities, an independent expert body created under the CRPD, clarified that a persons mental capacity, the ability to make decisions, can vary depending on environmental or social factors. L.J. Nearly 1 in 5 Americans has some type of mental health condition. Kessler says that mental disorders are treated as acute, episodic ailments instead of chronic illnesses. 49) at 167, U.N. Doc. In the same period this year, it has happened 37 times18 times in June alone.. There is a shortage of bilingual or Spanish speaking mental health professionals. [1] Convention on the Rights of the Child (CRC), adopted November 20, 1989, G.A. Pixabay. In the 2018-2019 academic year, 4,104 people completed behavioral health training programs funded by the HRSA. res. The large majority of Americans (76%) also believe mental health is just as important as physical health. Retornados carry a lot of stigma because of the criminal label that comes with deportation, says Juan Carlos Garca Rivera, a marriage and family therapist from El Salvador who is pursuing his doctorate in critical social/personality psychology at the City University of New York. 85. The offices of the first two are filled through popular elections; the president serves for five years and members of the legislature serve for three years. Res. 14, 2019). [121] UN General Assembly, Report of the Special Rapporteur on violence against women, its causes and consequences, Rashida Manjoo, Advancement of women, A/67/227, August 3, 2012, http://www.ohchr.org/Documents/Issues/Women/A.67.227.pdf (accessed December 10, 2013), pp. In China, about 100,000 people are shackled or locked in cages in Hebei province alone, near Beijing. Typically, people in these centers have been placed there by their families or by local police, some forcibly. People shackled in homes typically ate the same meal as the family. [105], Shackling affects a persons mental as well as physical health. Share this via Telegram His loving parents found him nonresponsive, with a heart rate near 200 beats per minute. Other ways to share [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). [32] Graham Thornicroft et al., Undertreatment of People with Major Depressive Disorder in 21 Countries, The British Journal of Psychiatry 210,2 (2017), doi:10.1192/bjp.bp.116.188078 (accessed September 16, 2020), pp. [49], A volunteer from an organization providing services to people with disabilities in Cameroon said: People in Cameroon have negative perceptions about disability. [139] After long-term advocacy by organizations such as the Mental Health Coalition of Sierra Leone, chaining was banned in policy. Liberation psychology, for example, established in the 1970s by Jesuit priest Ignacio Martn-Bar, PhD, calls on psychologists to redefine their role as sociopolitical and to support oppressed communities. [117] Human Rights Watch, Like a Death Sentence, https://www.hrw.org/report/2012/10/02/death-sentence/abuses-against-persons-mental-disabilities-ghana; Chained Like Prisoners," https://www.hrw.org/report/2015/10/25/chained-prisoners/abuses-against-people-psychosocial-disabilities-somaliland; Living in Hell, https://www.hrw.org/report/2016/03/20/living-hell/abuses-against-people-psychosocial-disabilities-indonesia; "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. The organization provided psychosocial support to survivors during the Sepur Zarco trial, which resulted in the first conviction for sexual slavery during an armed conflict by a national court (Sepur Zarco: In Pursuit of Truth, Justice and Now Reparations, UN Women, 2017). In Tanzania, Malaki, a boy with an intellectual disability was chained to a pole by his family to ensure he remained safe in his home in Nyarugusu refugee camp in Kigoma province in Tanzania in 2017. The governments target was to ensure full coverage of over 65 million households in Indonesia through all 9,909 community health centers by the end of 2019. [180] UN General Assembly, Report of the Special Rapporteur on the rights of persons with disabilities, A/73/161, July 16, 2018, https://undocs.org/en/A/73/161 (accessed September 17, 2020), para. The NSDUH defines mental health services as having received inpatient treatment/counseling or outpatient treatment/counseling or having used prescription medication for problems with emotions, nerves, or mental health. [74] In Togo, prophets can lock up and chain up to 150 people in a single prayer camp. In a few countries, government efforts at the national level to eradicate shackling have had some success in creating a roadmap to ending the practice. The study offers a comprehensive analysis of the state of mental health care in the U.S. No mother on earth wants to chain her son.[57], Human Rights Watch has also found evidence of shackling or chaining in psychiatric hospitals in some countries. [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. Human Rights Watch phone interview with Joshua Duncan, program manager, Mental Health Coalition of Sierra Leone, September 25, 2020. Government data from over 70 sources organized to show how the money flows, the impact, and who "the people" are. This inhumane practicecalled shacklingexists due to inadequate support and mental health services as well as widespread beliefs that stigmatize people with psychosocial disabilities. In none of the hundreds of cases that Human Rights Watch documented were people with psychosocial disabilities allowed or given the opportunity to challenge their detention. 7; CRC, art. [5]. While mental illness, including addictions, has become more top of mind for the media and Canadians in general over the past few years, it's fair to say that most people still don't have a true understanding of just how big, onerous, and potentially damaging the crisis really ison both a societal and personal level. However, legal capacity is a universal attribute inherent in all persons by virtue of their humanity and people can therefore not be stripped of it. L Guan et al., Unlocking Patients with Mental Disorders Who Were in Restraints at Home: A National Follow-Up Study of Chinas New Public Mental Health Initiatives, PLOS ONE 10(4) (2015), https://doi.org/10.1371/journal.pone.0121425 (accessed September 22, 2020). The deadline was extended to 2019. A/44/49 (1989), entered into force September 2, 1990, art. 1. Existing mental health services are often under-utilized or do not comply with international human rights standards because of limited understanding and awareness of mental health. [80] Human Rights Watch interview with Paul [not his real name], man with a psychosocial disability, Kenya, February 2020 (details withheld). CRPD/C/GC/1 (2014), http://daccess-ods.un.org/access.nsf/Get?Open&DS=CRPD/C/GC/1&Lang=E, para. We are particularly grateful to the law firm Borden Ladner Gervais LLP (BLG), to students at the University of Torontos International Human Rights Program and Rotman School of Management, and to Hope Blain, Jason Han, Paras Shah, Sophie Tarazi, Emma Tehrani, and Elena Zarabozo, Attorneys at OMelveny & Myers LLP, who provided invaluable research support. Participants were 383 high school students (50.9% boys) aged 11-18 years (M = 14.12, SD = 1.91) in El Salvador. It was heart-breaking.[51]. Amid such far-reaching and systemic challenges, many have fought to defend Central Americans right to migrate, but Lykes says its also time to start considering another inalienable rightthe right to remain. (No.16) at 52, U.N. Doc. Shackling is practiced across socio-economic classes. 2 (2); ICCPR, art. CAB/LEG/67/3 rev. The Protocol of San Salvador has been ratified by Argentina, Bolivia, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, and Peru. Three charts on diversity in the federal government's workforce. Gangs often threaten teens or adults with rape or murder, forcing entire families to flee their homes (World Report 2019, Human Rights Watch). Using metallic chains, iron manacles or spreader rods, metal leg or hand cuffs, or wooden stocks; Tying or binding them with rope or makeshift cloth; or. COVID-19 presents a serious threat to both physical and mental health, but policymakers in Indonesia have so far mostly . 24-64; Treated Worse Than Animals: Abuses against Women and Girls with Psychosocial or Intellectual Disabilities in Institutions in India, December 2014, https://www.hrw.org/sites/default/files/report_pdf/india1214.pdf, p. 34; We Are Also Dying of AIDS: Barriers to HIV Services and Treatment for Persons with Disabilities in Zambia, July 2014, https://www.hrw.org/report/2014/07/15/we-are-also-dying-aids/barriers-hiv-services-and-treatment-persons-disabilities; Like A Death Sentence: Abuses against Persons with Mental Disabilities in Ghana, October 2012, https://www.hrw.org/sites/default/files/reports/ghana1012webwcover.pdf, pp. Thus, an The losses of productivity caused by poor mental health include but are not limited to the following: Negative job performance. [70] 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. Human Rights Watch research in 2019 at an NGO-run marastoon (institution) in Herat, Afghanistan, found dozens of men with psychosocial disabilities chained in pairs to others ankles. Accessibility means that health services should be affordable, situated within easy physical reach, and be offered to everyone without discrimination. 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. Mental Health Services Help Health Workers Improve HIV Services in Central America . People with psychosocial disabilities who are shackled in homes and institutions experience physical abuse if they try to run away from institutions or dont obey the staff. [52] Human Rights Watch interview with Mahmud Suleiman, a psychiatric nurse, occupational therapist, and member of the Islamic Medical Association of Nigeria, Kano, September 19, 2019. In some cases, the health center facilitates formation of peer support groups through the messaging application WhatsApp, links people to training on how to start a small business, and helps them get funding to start the business. [133] Of these, 1,355 had been chained in Habeb hospital in Mogadishu, the capital, and 417 in the surrounding community. The CRPD establishes the right of all persons with disabilities to live in the community, with choices equal to others, and obligates governments to take the appropriate measures to ensure their full inclusion and participation in the community. CAB/LEG/24.9/49 (1990), entered into force November 29, 1999, art 14. Its a crucial part of larger efforts to strengthen our social fabric and to repair the damage caused by sociopolitical violence.. El Salvador is divided politically into 14 departments and 262 municipalities, 31, The Right to Health, http://www.ohchr.org/Documents/Publications/Factsheet31.pdf (accessed September 22, 2020), pp. Those who experience sexual violence encounter many barriers to reporting the abuse safely and confidentially, and are unlikely to access time-sensitive health care, for example to prevent sexually transmitted infections or pregnancy or to access This younger generation was also more likely to find it too hard to figure out legitimate resources online. [86] Civil Society Organizations Call for the Draft Law on Public Order to be Immediately Discarded, joint statement, August 13, 2020, https://www.hrw.org/news/2020/08/13/civil-society-organizations-call-draft-law-public-order-be-immediately-discarded. [88] Human Rights Watch, Prison is Not For Me, https://www.hrw.org/report/2012/06/21/prison-not-me/arbitrary-detention-south-sudan, pp. While there are formal procedures governing admission in social care institutions, the healing centers Human Rights Watch visited in a number of countries had no formal admission or discharge processes. [22] The emphasis on tertiary facilities means that people are compelled to travel further and to a psychiatric hospital, a location that is more stigmatizing, which studies have shown are often deterrents in seeking support. UN, Take Action for the Sustainable Development Goals, undated, https://www.un.org/sustainabledevelopment/sustainable-development-goals/ (accessed September 22, 2020). She expressed her appreciation to WHO for having focused its attention on this priority public health issue, since depression can be prevented. I really wanted to help my aunty but couldnt. Please give now to support our work, Share this via Facebook [46], For example, many people in countries such as Afghanistan, Bangladesh, Burkina Faso, Egypt, Ethiopia, Ghana, Guatemala, India, Indonesia, Iraq, Kenya, Mexico, Morocco, Mozambique, Nigeria, Oman, Pakistan, Palestine, Peru, Philippines, Saudi Arabia, Senegal, Sierra Leone, Somalia, including in Somaliland, Sudan, and Yemen believe that psychosocial disabilities are the result of possession by evil spirits or witchcraft. I want to look around outside, go to work, plant rice in the paddy fields. We need to do something.. Anxiety and depression levels are the lowest since the pandemic began, 48% of Americans are feeling down, depressed, or hopeless during the COVID-19 pandemic, How many teens are vaping? [138] Until 2018, people with mental health conditions being admitted to the psychiatric hospital were asked to pay for a padlock and chain prior to admission. When the Special Olympics team had Malaki released, he got the opportunity and training to play football. 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. [23] ngela Carbonell, Jos Javier Navarro Prez, Maria Vicenta Mestre, Challenges and Barriers in Mental Healthcare Systems and Their Impact on the Family: A Systematic Integrative Review, Health and Social Care in the Community vol.28:5, September 2020, https://doi.org/10.1111/hsc.12968 (accessed September 25, 2020), pp.
