39-72; Mental Disability Advocacy Centre and Mental Health Users Network of Zambia, Human Rights and Mental Health in Zambia, July 2014, http://www.northriseuniversity.com/wp-content/uploads/2017/07/Human-rights-and-mental-health-in-Zambia.pdf (accessed July 31, 2020), pp. [142] WHO, "Transforming services and promoting human rights in mental health and related areas," undated, https://www.who.int/activities/transforming-services-and-promoting-human-rights-in-mental-health-and-related-areas (accessed September 25, 2020). These beliefs are driven by several perceived barriers in Americans ability to seek mental health treatment, including: Several individuals blamed the U.S. government and insurers for not providing enough funding and support for access. For the purpose of this report, shackling is used in a broader sense to refer to the practice of confining a person with a psychosocial disability using chains, locking them in a room, a shed, a cage, or an animal shelter. In other cases, people have to use a drain or an open toilet in the room. Men, women, and children, some as young as 10, are chained or locked in confined spaces for weeks, months, and even years, in about 60 countries across Asia, Africa, Europe, the Middle East, and the Americas. [174], The committee further stated that it is the governments responsibility to ensure that health services are available, accessible, acceptable, and of good quality. The large majority of Americans (76%) also believe mental health is just as important as physical health. 72. A 2019 evaluation conducted by the Institute of Mental Health, University of Nottingham found that people who completed the QualityRights e-training course showed significant improvements in attitudes and practices towards a human rights based approach to mental health, including the need to end force and coercion in mental health services and to provide information and choice as well as respect peoples decisions concerning treatment. 19. In many countries, Covid-19 has disrupted mental health services, which can put people with psychosocial disabilities at risk of being shackled. Human Rights Watch calls on the international community and national governments to ban shackling, adopt measures to reduce stigma against people with psychosocial disabilities, and develop adequate, voluntary, and community-based mental health services. Support national government efforts to develop adequate, quality, and voluntary community-based support and services, including access to housing, education, employment, and mental health services. Rodriguez supports the Shelter City Network, which relocates human rights defenders forced to move because of threats to their safety and provides psychotherapeutic treatment to Honduran survivors of torture, sexual violence and other crimes as they seek recourse through national and international justice systems. Mexico ignores mental health - El Universal [140] Partners in Health, Celebrating New Possibilities at Sierra Leones Only Psychiatric Hospital, June 5, 2020, https://www.pih.org/article/celebrating-new-possibilities-sierra-leones-only-psychiatric-hospital (accessed September 17, 2020). The nature of shackling means that people live in very restrictive conditions that reduce their ability to stand or move at all. Three charts on diversity in the federal government's workforce. [130] Supreme Court Shocked at Chaining of Inmates in U.P. [85] In June 2020, the Ministry of Interior proposed a draft Public Order Law, which will further entrench discrimination against people with psychosocial disabilities as well as against other at-risk groups in society and add to existing deep concerns of the continuing practice of shackling in Cambodia. Addressing Mental Health as a Community Issue in El Salvador Mental health project offers a series of workshops to help the residents of Arcatao work through trauma. More in This Topic Guide. Based on research on shackling across 60 countries, Human Rights Watch has found that the key factors to ensuring the success of governmental programs to end shackling include: With the right kind of support, people with mental health conditions can live and thrive in their communities. COMMENTARY: Redrawing the battle lines: Vote yes for mental health [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. [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. In addition to research conducted by Human Rights Watch researchers, pro-bono desk research was conducted by students at the International Human Rights Program at the University of Toronto Faculty of Law and at the Rotman School of Management at the University of Toronto, Canada, as well as by lawyers at Borden Ladner Gervais LLP, Canada, and OMelveny & Myers LLP in the United States. Its a crucial part of larger efforts to strengthen our social fabric and to repair the damage caused by sociopolitical violence.. 38-39; Jasmine Bauomy, In South Sudan, Stigma and Underfunding Plague Mental Health Care, Al Jazeera, January 18, 2019, https://www.aljazeera.com/indepth/features/south-sudan-stigma-underfunding-plague-mental-health-care-190117180739562.html (accessed August 3, 2020). 5 (2). 12; CRC, art. Even educated and well to-d0 families can resort to shackling. In addition, the local and national governments dont have coordinated detection and hospitalization mechanisms for COVID-19 cases. Areas are designated as having a shortage if they meet certain criteria: the ratio of mental health providers (e.g., psychiatrists, clinical social workers, therapists, etc. At the core of this initiative is respect for the rights of people with psychosocial or intellectual disabilities, including the right to live independently in the community. Ensure coordination between mental health professionals and staff at prayer camps to offer mental health services based on free and informed consent. [105] 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. [32], The cost of neglecting mental health is significant; the global economy loses roughly $2.5 to $8.5 trillion per year as a result of reduced economic productivity. In El Salvador, for instance, an underfunded and corrupt police force, unable to maintain public safety, has helped spur the formation of gangs as de facto authorities across most of the country (Life Under Gang Rule in El Salvador, International Crisis Group, 2018). 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. Its not how a human being is supposed to be. In Kenya, which launched in November 2019, almost 3,260 people have enrolled and around 732 have completed the training. Although it is noteworthy that some governments have put in place measures to tackle the practice of shackling, their laws and policies are not always effectively implemented, and on-the-ground monitoring remains weak overall. [165] CRPD, art. 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). Shackling is typically practiced by families, faith healers, or staff in institutions who believe that the person with the psychosocial disability is possessed or are worried that they may run away or might hurt themselves or others. CMS recognized that, for many mental health services, visualization between the patient and clinician may be less critical to provision of the service: "[M]ental health services are different from other services because they principally involve verbal exchanges between patient and practitioner." CMS also responded to comments requesting . When it comes to seeking mental health care, the Latinx community has always struggled with stigmaboth in and outside of the United States. [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. Human Rights Watch interviews with Benjamin Ballal, February 15, 2020; Archbishop Danokech, February 18, 2020; and Fiera [not her real name], November 20, 2019. [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). In El Salvador, learning disabilities and speech and language disorders are not considered disabilities for purposes of statistical reporting at the national level (MINED, 2015). [145], The Latin American countries discussed here are party to the American Convention on Human Rights and the Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights (Protocol of San Salvador). 24, 2016). Mental health services in the Philippines - Cambridge Core Spending on mental health treatment and services reached $225 billion in 2019, according to an Open . [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. [101] Ghana: Faith Healers Defy Ban on Chaining, Human Rights Watch news release, November 27, 2019, https://www.hrw.org/news/2019/11/27/ghana-faith-healers-defy-ban-chaining. On March 20, the Salvadoran government declared a state of national emergency, suspending primary health care services in hospitals and health units and imposing and absolute lockdown, preventing people from leaving their homes. Education is crucial to help people understand more about life in the United States as a migrant, says Maria Elena Humphrey, PhD, former executive secretary for Mexico, Central America and the Caribbean at the Interamerican Society of Psychology. At night I sleep inside the house. [139] After long-term advocacy by organizations such as the Mental Health Coalition of Sierra Leone, chaining was banned in policy. [18] The Asia Foundation, Model Disability Survey Of Afghanistan 2019, 2020, https://asiafoundation.org/wp-content/uploads/2020/05/Model-Disability-Survey-of-Afghanistan-2019.pdf (accessed June 18, 2020), p. 26; The World Bank, Disability Inclusion, May 15, 2020, https://www.worldbank.org/en/topic/disability (accessed June 22, 2020). Crosby, A., et al., Journal of Genocide Research, 2016, One Session at a Time: When You Have a Whole Hour CVN focuses on improving mental health outcomes, with a goal to build a network of outpatient mental health clinics for veterans and their families in high-need communities, in which trained clinicians deliver holistic evidence-based care to treat mental health conditions. Keep up with the latest data and most popular content. [19], Governments have long neglected to invest in mental health services. The Social Services Department of The Salvation Army recently (March 1) released a youth survey, and found that more than 70% of the respondents suffered from mental health problems to varying degrees, and 30% of them did not seek external assistance. (No. Raising awareness on mental health and specifically combating negative stereotypes and beliefs that a mental health condition is the result of being possessed by spirits; A coordinated and inter-ministerial approach that includes the ministries of justice, health, social affairs, housing, education, and employment; Independent and regular monitoring to ensure the ban on shackling is implemented; A targeted program that not only releases people from shackling but also regularly follows up to ensure that once released, people do not go back to being shackled; Access to affordable and quality community-based support and mental health services that help prevent shackling and support someone who is freed from chains in reintegrating the community. 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. The term psychosocial disability is preferred as it expresses the interaction between psychological differences and social or cultural limits for behavior, as well as the stigma that society attaches to people with mental health conditions. People are dying at home amid collapsing health system in El Salvador