This system effectively gives mental health the same importance as all other indicators and ensures that community health workers provide immediate and ongoing mental health services to meet their target of 100 percent coverage. [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. Rafael Serrano psychiatric hospital in Puebla shackled him naked with a padlock during the nights for two-and-a-half weeks, and he was forced to defecate and urinate in his bed. [51] Human Rights Watch interview with Ying (not her real name), November 2019 (location and details withheld). Mental healthcare in the Philippines faces continued challenges including underinvestment, lack of mental health professionals and underdeveloped community mental health services. In countries where people believe mental health is a spiritual issue and robust mental health services are lacking, private institutions and faith-healing facilities flourish. 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. [75] Human Rights Watch phone interview with Pascal Douti, Association Vie Libre, September 3, 2019; Benedict Carey, The Chains of Mental Illness in West Africa, New York Times, October 11, 2015, https://www.nytimes.com/2015/10/12/health/the-chains-of-mental-illness-in-west-africa.html (accessed July 30, 2020). As a result, they urinate, defecate, eat, and sleep in a radius of no more than one to two meters. For example, in Bali, Indonesia, a mother from a wealthy family said: We are from a high caste and when my son gets lost and wanders on the streets without proper clothing, without showering, its a cause for shame. support services. 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. In order to accomplish these goals, El Salvador increased its public health expenditure by 33.7% from 2009 to 2019. While much attention is focused on the humanitarian crises at the U.S. border, researchers, clinicians and activists are also working to address problems at their source in Guatemala, Honduras and El Salvador. Many are forced to eat, sleep, urinate, and defecate in the same tiny area. [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. CBP data echo the demographic shiftthe majority of migrants detained at the border are now families or unaccompanied children rather than adult men (Recent Migration to the United States From Central America: Frequently Asked Questions, Congressional Research Service, 2019). Many think disability is a curse resulting from evil spirits. 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. I feel sad, locked in this cell. Track how COVID-19 is spreading in the US, plus key indicators for pandemic recovery. More than three-quarters (78%) report the same or higher levels of severity as this time last year. Clinical psychologists usually need a Doctor of Philosophy in psychology (PhD) or a Doctor of Psychology (PsyD) degree. Many are held in overcrowded, filthy rooms, sheds, cages, or animal shelters and are forced to eat, sleep, urinate, and defecate in the same tiny area. [8] World Health Organization (WHO), Gender and Women's Mental Health, undated, https://www.who.int/mental_health/prevention/genderwomen/en/ (accessed July 21, 2020); WHO, Mental disorders, November 28, 2019, https://www.who.int/news-room/fact-sheets/detail/mental-disorders (accessed June 22, 2020); WHO, Mental health in the workplace, May 2019, https://www.who.int/mental_health/in_the_workplace/en/ (accessed June 22, 2020); WHO, Mental Health, October 2, 2019, https://www.who.int/news-room/facts-in-pictures/detail/mental-health (accessed June 22, 2020). However, Human Rights Watch estimates that globally hundreds of thousands of people with mental health conditions have been shackledchained or locked in confined spacesat least once in their lives. The trained staff in turn educate additional health center staff about the program and mental health. The Cohen Veterans Network and National Council for Mental Wellbeing believe that more must be done to improve access to care for everyday Americans. [110] Fasting would help to starve evil spirits and enable God and prayer to heal them. [5] World Network of Users and Survivors of Psychiatry, Implementation Manual for the United Nations Convention on the Rights of Persons with Disabilities, February 2008, http://www.wnusp.rafus.dk/documents/WNUSP_CRPD_Manual.doc (accessed December 20, 2015), p. 9. [134] WHO, Building Back Better Sustainable Mental Health Care after Emergencies, https://apps.who.int/iris/bitstream/handle/10665/85377/9789241564571_eng.pdf?sequence=1, p. 73. She expressed her appreciation to WHO for having focused its attention on this priority public health issue, since depression can be prevented. In one case, a man with a psychosocial disability spent 37 years chained in a dark, sweltering cave in the mountains in Wadi Al-Sabab, Saudi Arabia. Last Updated: 04/22/2022. MSF has launched health initiatives in San Salvador and Soyapango, focusing on socially vulnerable people whose access to health services has been affected by insecurity. TRADEMARKS. Governments should include people with disabilities and their representative organizations in developing and carrying out the plans. Train and sensitize government health workers, mental health professionals, and staff in faith-based and traditional healing centers to the rights and needs of people with mental health conditions. CAB/LEG/24.9/49 (1990), entered into force November 29, 1999, art 14. [144] The CRPD has been ratified by 181 countries around the world. Beckley also teaches professionals to use open-ended questions to obtain important information from survivors without retraumatizing them. [133] WHO, Building Back Better: Sustainable Mental Health Care after Emergencies, 2013, https://apps.who.int/iris/bitstream/handle/10665/85377/9789241564571_eng.pdf?sequence=1 (accessed August 17, 2020), pp. There are no statistics on the scale of shackling at a global level. 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. 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 Since the launch of QualityRights in Ghana in February 2019, around 15,000 people have enrolled in the course and around 7,430 people have completed the training. These include the International Covenant on Civil and Political Rights (ICCPR), International Covenant on Economic, Social and Cultural Rights (ICESCR), Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) Convention on the Rights of the Child (CRC), and Convention on the Rights of Persons with Disabilities (CRPD) and its Optional Protocol. Child: The word child, boy, or girl in this report refers to someone under the age of 18. In many of the countries where Human Rights Watch conducted research for this report, there is a widespread belief that mental health conditions are the result of possession by evil spirits or the devil, or the consequence of some form of sin, displaying immoral behavior, orfor those whose families are adherents of certain religionshaving a lack of faith. For more information on the comprehensive study results and how CVN and National Council are working to address mental wellness and accessibly across the country, please visit www.cohenveteransnetwork.org/AmericasMentalHealth or www.TheNationalCouncil.org. 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). [4], Psychosocial disability: The preferred term to describe people with mental health conditions such as depression, bipolar, schizophrenia, and catatonia. [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). [101] Most cages are so narrow that the men cannot even stretch out their arms. Even though the healthcare system has many hospitals, clinics, and care centers, the quality of healthcare they provide is deemed inadequate. August 28, 2022 by Sandra Hearth. A human being should be free. In Nigeria, boys as young as 10 were chained together in rooms with adult men, leaving them at risk of abuse. About 80 percent of people with disabilities live in middle or low-income countries where it is often challenging to access healthcare, particularly mental health care. [54] Human Rights Watch interview with mother of a man with a mental health condition, Bali, Indonesia, November 19, 2020 (full name and details withheld). Participants were 383 high school students (50.9% boys) aged 11-18 years (M = 14.12, SD = 1.91) in El Salvador. I have to go to the toilet in a bucket. [27] For example, there are 0.19 psychiatrists per 100,000 people in Kenya and 0.12 16; ACRWC, art. ", "It is vital to improve coordination, increase the number of available beds [in health facilities] and ensure protective measures in hospitals to guarantee the safety of staff and patients, said Romero Pineda. In certain cases throughout the report, people with disabilities and their family members are identified with pseudonyms, and identifying information, such as location or date of interview, has been withheld in order to respect confidentiality and protect them from reprisals from family or staff in institutions. 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 . In Russia, residents with psychosocial disabilities were being chained by their wrists or ankles to beds, radiators, and other objects in the Trubchevsk Psycho-Neurological Institution near Briansk, located southwest of Moscow. [179] UN General Assembly, Report of the Special Rapporteur on the Right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Anand Grover, A/64/272, August 10, 2009, https://undocs.org/en/A/64/272 (accessed September 23, 2020), para. 202-621-1631. In some states, over 80% of the population lives in a mental health professional shortage area. We are suffering. [113] Human Rights Watch visits to Yaysan Galuh Rehabilitation Center, Yayasan Bina Lestari, Samyul Institution, 2016-2018. Provide adequate food, shelter, and health services to people with psychosocial disabilities. [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. For example, the Health Resource and Services Administration (HRSA) administers the National Health Service Corps, which provides loan repayment or scholarship for those providing health care services in underserved communities. ), 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. Portland students sat down with U.S. Department of Health and Human Services Secretary Xavier Becerra at Faubion K-8 in Northeast Portland Monday to discuss youth mental health. Malakis story helped shape his community to be more inclusive and accepting. Therefore, people first consult faith or traditional healers and often only seek medical advice as a last resort. James, a man with a psychosocial disability who has been chained for several years in a Christian healing institution in Kenya, said: They cane us if we make a mistake. To be a young person in El Salvador, Guatemala or Honduras is extremely stressful, he says. 119. Many of MSFs ambulance calls in recent months have been related to respiratory diseases. [153], In its interpretation of the treaty provisions, the committee stated, At all times, including in crisis situations, the individual autonomy and capacity of persons with disabilities to make decisions must be respected.[154], The UN special rapporteur on torture has noted that shackling unequivocally amount(s) to torture even if committed by non-State actors under conditions in which the State knows or ought to know about them.[155], The core human rights treaties prohibit subjecting any person to torture or to cruel, inhuman, or degrading treatment or punishment, including non-consensual medical or scientific experimentation. [174], The committee further stated that it is the governments responsibility to ensure that health services are available, accessible, acceptable, and of good quality. [127] Human Rights Watch, Living in Hell, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf; 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. Treaty Series No. To date, about 20 out of Indonesias 34 provincesincluding Central Java, West Nusa Tenggara, East Java, Jambi, Yogyakarta, and Acehhave a functional pasung-free initiative. 108(e); United Nations Educational, Scientific, and Cultural Organization (UNESCO), Universal Declaration on Bioethics and Human Rights, adopted October 2005, SHS/EST/05/CONF.204/3 REV, arts. 16-18. (No. [160] UNHRC, Report of the Special Rapporteur on torture, and other cruel, inhuman or degrading treatment or punishment, Juan E. Mndez, A/HRC/22/53, February 1, 2013, https://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_English.pdf, para. In Guatemala, we tend to be reactive, she says. This is the case for Sodikin, a 34-year-old man with a psychosocial disability, who had been released from chains after over 8 years shackled in a shed outside his family home in Cianjur, West Java in Indonesia. The chaining of people with mental health conditions needs to stop it needs to stop. [135] The Chinese government program to scale-up basic mental health services became known as 686 after initial funding of CNY 6.86 million. They have scars.[77] Esther, 37, a woman with a psychosocial disability who lived with her parents in a rural community in Apodaca, Nuevo Len, in northeastern Mexico, was shackled from the time she was a young girl. [24], Globally, there is a severe shortage of trained mental health professionals, but the shortfall is particularly acute in low-income countries. In one institution,near Briansk, Russia, residents who were unruly, would be chained, forcibly sedated.[118]. Victor, a patient from Soyapango, told MSF that his grandfather has chronic health problems and has to have his catheter changed every few months. [29] WHO, Mental Health, https://www.who.int/news-room/facts-in-pictures/detail/mental-health. [70] Across these 28 facilities, the youngest child chained was a 10-year-old boy and the oldest person who was chained was an 86-year-old man. [15] WHO, Gender and Women's Mental Health, https://www.who.int/mental_health/prevention/genderwomen/en/; WHO, Mental disorders, https://www.who.int/news-room/fact-sheets/detail/mental-disorders; WHO, Mental health in the workplace, https://www.who.int/mental_health/in_the_workplace/en/; WHO, Mental Health, https://www.who.int/news-room/facts-in-pictures/detail/mental-health. Specifically, younger Americans need more information on how and where to access care. In Nigeria, Human Rights Watch visited 28 state-run and private facilities between 2018 and 2019, across which a few hundred people were arbitrarily detained, and where people were regularly chained or shackled.
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