challenges

 

Inter­na­tion­al human rights vio­la­tions against men­tal­ly ill and men­tal­ly dis­abled people

 

Human rights vio­la­tions (HRV) against the men­tal­ly ill are wide­ly per­pe­trat­ed in count­less coun­tries – both with­in and out­side of psy­chi­atric insti­tu­tions – with­out pub­lic knowledge:

- arbi­trary, unnec­es­sary, and exces­sive depri­va­tion of lib­er­ty, phys­i­cal and psy­chic mis­treat­ment, sexual
abuse

- iso­la­tion and stigmatization

 - extreme­ly bad liv­ing con­di­tions (water, hous­ing, hygiene), under con­sid­er­a­tion of low local standards

- miss­ing or gross­ly false and harm­ful treat­ment (with med­ica­tion, ECT=electro-convulsive therapy,
para­med­ical practices)

- a lack of edu­ca­tion, par­tic­i­pa­tion, legal advice, the pos­si­bil­i­ty of court appeals, legal recourse in regard to
forced mea­sures and mistreatment

- vio­la­tion of the the human right to health (Uni­ver­sal Dec­la­ra­tion of Human Rights pro­claimed by the
Gen­er­al Assem­bly of the Unit­ed Nations in 1948).

These HRV are com­mit­ted in- and out­side of psy­chi­atric insti­tu­tions, or in insti­tu­tions run by heal­ers. The chain­ing or fix­a­tion of limbs to wood­en stakes or in the open usu­al­ly occurs out­side the sphere of psy­chi­atric treat­ment. Spe­cial prob­lems include the expul­sion of healthy indi­vid­u­als into psy­chi­atric insti­tu­tions by fam­i­ly mem­bers (affects women in India) or the incar­cer­a­tion of men­tal­ly ill indi­vid­u­als (in the US).

One main cause of such HRV can sure­ly be found in the under­sup­ply of psy­chi­atric treat­ment (miss­ing sup­ply struc­tures or poor equip­ment and train­ing). Anoth­er fac­tor of such cru­el­ty is the still wide­spread belief in “pos­ses­sion” or “demons” as the cause for incom­pre­hen­si­ble, dis­turb­ing, and per­haps vio­lent behav­ior. The demons are sup­posed to be dri­ven out by using vio­lence. Men­tal ill­ness­es, as well as men­tal dis­abil­i­ties, or epilep­sy are not under­stood as sick­ness­es. About 76–85% of peo­ple in “low- and mid­dle-income coun­tries” have no access to psy­chi­atric treat­ment, and often only 0–1% of already small health bud­gets are spent on men­tal health. On the oth­er hand, approx­i­mate­ly 5% of the glob­al pop­u­la­tion suf­fer from severe men­tal ill­ness­es and men­tal dis­abil­i­ties at moment X (“point preva­lence”). In regard to severe ill­ness­es the num­bers to not dif­fer sig­nif­i­cant­ly from coun­try to coun­try. Mod­er­ate­ly severe forms of depres­sion, anx­i­ety dis­or­ders, and post-trau­mat­ic stress dis­or­ders, which can be encoun­tered espe­cial­ly often in poor coun­tries with a his­to­ry of civ­il war in past or present, are not includ­ed in the num­bers ref­er­enced above. Heal­ers or “prayer camps” (both Mus­lim and Chris­t­ian) often take care of the treat­ment, in many cas­es how­ev­er engag­ing in the depri­va­tion of lib­er­ties and abus­es of all kinds. The vic­tims are usu­al­ly not allowed to decide on their treat­ment or the length of their stay in these camps.

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A gen­er­al overview of the sit­u­a­tion of Glob­al Men­tal Health and the strate­gies that can be used to improve the sit­u­a­tion can be found in a com­pre­hen­sive arti­cle of the “Lancet Com­mis­sion on Glob­al Men­tal Health and sus­tain­able devel­op­ment” of 2018:

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)31612‑X.pdf

This text can be read for free, but requires reg­is­tra­tion. A non-offi­cial ver­sion can be found here:

https://ora.ox.ac.uk/objects/uuid:dbd7597d-11b9-4491-b48d-574caef3a9e8/download_file?safe_filename=2018_The%2BLancet%2BCommission%2Bon%2BGlobal%2BMental%2BHealth%2Band%2BSustainable%2BDevelopment_AAM.pdf&file_format=application%2Fpdf&type_of_work=Journal+article

An overview of Glob­al Men­tal Health Care Sta­tis­tics you may find on:

WHO ‑Men­tal Health Atlas (2017)
http://apps.who.int/iris/bitstream/handle/10665/272735/9789241514019-eng.pdf

Address­ing the bur­den of men­tal, neu­ro­log­i­cal, and sub­stance use dis­or­ders: key mes­sages from Dis­ease Con­trol Pri­or­i­ties, 3rd edition.
http://www.ncbi.nlm.nih.gov/pubmed/26454360

The legal sit­u­a­tion in var­i­ous coun­tries:
www.mindbank.info

The state of research on psy­chi­atric care, par­tic­u­lar­ly in African coun­tries, has recent­ly been crit­i­cal­ly pre­sent­ed in :
https://www.thelancet.com/action/showPdf?pii=S2214-109X%2818%2930303–6

 

 

In the fol­low­ing, we point to fla­grant exam­ples of such human rights violations:

 

1. Ein Beitrag zur Sit­u­a­tion psy­chisch kranker Men­schen in Indi­en mit Schw­er­punk­ten auf der Situation
der Frauen und der Rolle der Heiler:
http://www.deutschlandfunkkultur.de/weggesperrt-in-indien-hilfe-statt-heiler-fuer-psychisch.979.de.html?dram%3Aarticle_id=411995

A video from vice news focus­ing the sit­u­a­tion of men­tal­ly ill women in India (2015):
https://www.youtube.com/watch?v=Ux14_DEw7Hs

 

2. Films und arti­cles con­cern­ing the sit­u­a­tion in Westafrika:

 An arti­cle in The New York Times “In West Africa a Mis­sion to Save Minds” (2015–10-11):
   https://nyti.ms/1VMcbQl

The world´s worst place to be dis­abled? (BBC about Ghana)
www.youtube.com/watch?v=l_J15G03aSE

Ghana: Deal­ing with the Men­tal­ly Ill/Global 3000 (BBC)
www.youtube.com/watch?v=C‑XA9KMDsK4

Ein Bericht aus der Süd­deutschen Zeitung über die Sit­u­a­tion in Sier­ra Leone:
http://www.sueddeutsche.de/wissen/medizin-kettenmenschen‑1.3888471

Ein weit­er­er Bericht zu Sier­ra Leone von 2019:
Break­ing the chains – Sier­ra Leone’s uphill strug­gle to reform men­tal health (The New Human­i­tar­i­an, 13. 11. 2019):
https://www.thenewhumanitarian.org/feature/2019/11/13/Sierra-Leone-mental-health

 

3.    in Soma­lia
by channel4 news: https://www.youtube.com/watch?v=IWuZJeBJ-Vs

 

4.   in Cam­bo­dia by channel4 news: https://youtu.be/dxq-busFi8M

 

5.    in Indone­sia:

A video report about a pro­gramme to unchain chained, men­tal­ly ill peo­ple on Bali, Indone­sia, led by the psy­chi­a­trist Dr. Suryani. The report has been made by the french jour­nal­ist Elodie Chazet.

The fol­low­ing report has been made by the jour­nal­ist Chris­t­ian Wern­er for the “Leica Fotografie Inter­na­tion­al Mag­a­zine”. It comes with Ger­man subtitles.

The fol­low­ing mate­r­i­al has been pro­vid­ed by the grass­root jour­nal­ism web­site “Free Speech Radio News (FSRN)”.

This report is pro­vid­ed by the asso­ci­a­tion for psy­cho­log­i­cal sci­ence (aps; http://www.psychologicalscience.org/).

A video from Human Rights Watch about the sit­u­a­tion in Indonesia:

[More detailed the report the cam­paign of HRW con­cern­ing Indonesien:
https://www.hrw.org/report/2016/03/20/living-hell/abuses-against-people-psychosocial-disabilities-indonesia]

 

6.    in Guatemala

Video con­cern­ing the only „Psy­chi­atric Hos­pi­tal“ (Men­tal Dis­abil­i­ty Rights Inter­na­tion­al, 2014):
https://www.youtube.com/watch?v=bEAYETfqA5M

 

7.    in the USA

In the USA, men­tal­ly ill peo­ple are often placed in pris­ons. You will find sev­er­al videos on their sit­u­a­tion under:
https://www.youtube.com/results?search_query=USA+mentally+ill+prison