A/6316 (1966), 999 U.N.T.S. The study offers a comprehensive analysis of the state of mental health care in the U.S. [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). 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. Provide adequate food, shelter, and health services to people with psychosocial disabilities. [80] Human Rights Watch interview with Paul [not his real name], man with a psychosocial disability, Kenya, February 2020 (details withheld). 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. Therefore, people first consult faith or traditional healers and often only seek medical advice as a last resort. [68] In the Greater Accra Region, there are an estimated 70 prayer camps. But through this program, we are working to create a culture of prevention., Other psychologists have turned their attention to a frequently overlooked populationthose who have been deported from the United States, known as retornados.. 16; ACRWC, art. In 2025, demand may outstrip supply by 6,090 to 15,600 psychiatrists, according to a 2017 National Council for Behavioral Health report that explores the shortage's causes and suggests solutions. Under the 686 unlocking initiative, 266 people were given mental health medication and 88 percent of all those who were unlocked were admitted to a psychiatric hospital. [75], It is even more complex to account for chaining in small institutions and homes in which people are shackled behind closed doors. Teaming up with locally run organizations, such as Grupo de Mujeres Mayas KAQLA, an indigenous group based in Guatemala, can also help foreign psychologists gain cultural competency and establish trust with indigenous people, who may be reluctant to partner with outsiders, says Lykes. [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). There is a shortage of bilingual or Spanish speaking mental health professionals. [78] Human Rights Watch interview with a lawyer, Nuevo Len DIF, Monterrey, Mexico, April 11, 2019. Warren County Public Schools Director of Student Services Todd Hazel speaks about the increase in WCPS students' mental health issues since the pandemic and the December 2021 tornadoes beside Lt . [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. 2(1); CEDAW, art. 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). [120] In addition, the UN special rapporteur on violence against women has condemned forced psychiatric treatment as a form of violence.[121]. [69] In 2019, large prayer camps such as Mount Horeb detained dozens of people in chains. For others, poverty and lack of work opportunities are the driving forces behind migrationin Honduras, more than 60% of the population lives below the poverty line (World Bank, 2018). Bobele, M., & Slive, A.In Hoyt, M.F., & Talmon, M. 95(d). [177], The CRPD further provides that health information be accessible to persons with disabilities and that the delivery of health services not discriminate on the basis of disability. [28] WHO, Mental Health ATLAS 2017 Member State Profile: Kenya, 2018, https://www.who.int/mental_health/evidence/atlas/profiles-2017/KEN.pdf?ua=1 (accessed June 22, 2020); Mohan Isaac et al., Postgraduate training in psychiatry in Asia, Current Opinion in Psychiatry, vol. If we understand the individual reasons that force people to migrate, we may be closer to finding the interventions that are relevant and effective, she says. In many institutions in Indonesia, people with psychosocial disabilities were fed meals devoid of proper nutrition such as instant noodles for most meals.[113]. [60] Human Rights Watch visit to Lawang Mental Hospital, East Java, Indonesia, August 12, 2015. Discover how we bring lifesaving care to those who need it most, Explore our work in more than 70 countries, Learn about the diseases and medical conditions we treat, Understand the complex crises we're responding to, A global movement providing lifesaving care, Get our annual financial statements and nonprofit tax filings, Understand our founding principles and the history of our work, Get the latest from our projects around the world, Read features from our quarterly magazine, Become a part of MSFs most important lifesaving work today, Discover the many ways you can support our lifesaving work, Individuals like you provide 90% of our funding, We make it easy to raise money to support the MSF movement, Learn how to get involved with our university student groups. [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. Many of the African countries considered in this report are also party to the African Charter on Human and Peoples Rights (ACHPR) and the Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa (the Maputo Protocol). [129] The Mental Healthcare Act, 2017, https://www.prsindia.org/uploads/media/Mental%20Health/Mental%20Healthcare%20Act,%202017.pdf (accessed September 22, 2020), art. For many, mental illness can be challenging to manage on one's own. 2 Such changes may include increased sadness or irritability, loss of appetite, weight changes, insomnia, reduced energy, loss of interest in pleasurable activities, feelings of guilt and hopelessness, difficulty concentrating, and/or While the use of restraints can be seen as a spectrum, this report specifically examines the practice of shackling, the most egregious, archaic, and rudimentary form of physical restraints practiced predominantly in non-medical settings. Human Rights Watch would also like to thank the many disabled persons organizations, nongovernmental organizations, activists, lawyers, and mental health professionals working in the fields of disability rights and mental health who shared their insights and analyses with us or otherwise provided assistance. The disappointing irony goes beyond unheeded history repeating itself. 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 Not only can it be dangerous to live in the United States as an undocumented person, but leaving behind ones home, family and culture is often very painful.. [136] The program demonstrated that accessible community-based mental health services were key to ensuring people remained free from chains and proved to be an example of how non-healthcare workers could be mobilized to deliver services in rural and low-resource settings. In 15-minute interviews conducted while the Salvadoran immigration authorities processed migrants who had been deported from the United States for reentry into El Salvador, Gaborit and his colleagues assessed children and teens for depression, anxiety and somatization. Explain to me, how is that part of a healing process? [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. As a result, they urinate, defecate, eat, and sleep in a radius of no more than one to two meters. This report includes field research and testimonies collected by 16 Human Rights Watch researchers working in their own countries, including Afghanistan, Burkina Faso, Cambodia, Ghana, Indonesia, Kenya, Liberia, Mexico, Mozambique, Nigeria, Sierra Leone, Palestine, Russia, the self-declared independent state of Somaliland, South Sudan, and Yemen. Other ways to share A/6316 (1966), 999 U.N.T.S. The deadline was extended to 2019. Islamic faith healers often use Quranic recitations or herbal medicine, including the burning of herbs, as a treatment method. 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. Conduct regular, unannounced monitoring visits to government and private social care institutions as well as faith healing centers, with unhindered and confidential interaction with both staff and patients. Many think disability is a curse resulting from evil spirits. [147] ICESCR, art. 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. 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. Sophia Majlessi Along with hundreds of thousands of others, these Central Americans are migrating north this year seeking asylum, employment and family reunification. Despite this strong demand and growing societal awareness of the importance of mental health in the U.S., the study revealed that the overwhelming majority of Americans (74%) do not believe such services are accessible for everyone, and about half (47%) believe options are limited. [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. However, one of the main concerns about the 686 program was that it predominantly took a medical approach to mental health that focused on freeing people from chains and then admitting them to a psychiatric hospital for treatment or putting them on a regimen of mental health medication. (No. Poor communication with health care providers is often an issue. From health insurance to prescription drug prices, the cost of healthcare has been a political issue for decades. 12. Mental Health and Substance Use. The UN special rapporteur on the right to health noted that: In her 2018 report, the UN special rapporteur on the rights of persons with disabilities called on states to ensure that all health-related services include a human rights-based approach to disability, are non-discriminatory, seek informed consent prior to any medical treatment, respect privacy and are free from torture or other cruel, inhuman or degrading treatment.[180]. [7] In Indonesia, traditional healers who are versed in magic or dealing with spirits are usually referred to as paranormal or dukun, while Islamic faith healers who use Quranic recitations as a treatment method are known as ustad or kiai. 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. Governments are to ensure access to a range of in-home, residential, and other community support services to prevent isolation from the community, including personal assistance, and ensure that community services and facilities are available and responsive to their needs. Many facilities have low-grade medical equipment, are almost always understaffed, and often run out of medicine. Engage spiritual and religious leaders to challenge discriminatory beliefs and practices related to psychosocial disabilities, and offer education opportunities on mental health and the rights and needs of people with psychosocial disabilities. Nearly one in five of Americans, or 17%, noted they have had to choose between getting treatment for a physical health condition and a mental health condition due to their insurance policy. Res. She expressed her appreciation to WHO for having focused its attention on this priority public health issue, since depression can be prevented. 16-18. In the case of private institutions and healing centers, the management may have an incentive to detain people as they are paid by the family. [13] Every 40 seconds, someone dies by suicide. El Salvador's own 2015 National Survey on Non-communicable Diseases (NCDs) in the Adult Population -which the World Bank helped fund- revealed high levels of factors that can trigger non-communicable diseases, such as sedentary lifestyles, at-risk drinking, smoking, poor nutritional choices on salt, sugar or highly processed foods. [95] Human Rights Watch, Living in Hell, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf, p. 45. We send regular emails about upcoming events, member spotlights and updates in mental wellbeing. The nature of shackling means that people live in very restrictive conditions that reduce their ability to stand or move at all. Additionally, the Social Affairs Ministry has 12 rapid response teams attached to 20 state-run institutions (pantis) across the country that conduct community outreach activities including rescuing people from pasung when they come across them. [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. 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. I forgot him. Human Rights Watch, Like a Death Sentence, https://www.hrw.org/report/2012/10/02/death-sentence/abuses-against-persons-mental-disabilities-ghana ;Treated Worse than Animals, https://www.hrw.org/report/2014/12/03/treated-worse-animals/abuses-against-women-and-girls-psychosocial-or-intellectual. Carlos, a man with a psychosocial disability who has been chained and treated against his will in faith healing institutions in Mozambique, told Human Rights Watch: In healing centers, individuals with psychosocial disabilities are forced to partake in all sorts of rituals, including taking baths with special water or chicken blood, and undergo therapeutic massages as part of their treatment. [99] Human Rights Watch interview with Archbishop Danokech, Archbishop at the Holy Ghost Coptic Church of Africa, Kisumu, Kenya, February 18, 2020. [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. Encourage governments to collect quantitative and qualitative data on the current number of people shackled, the reasons families continue to practice shackling, and examine the support or services they would need to discontinue the practice. 316, No. 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. 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. Feb 28, 2023. But Garca Rivera says that in light of the crisis in Central America, psychologists must do more than conduct research, provide clinical services and design community interventions. Many had old and leaking roofing. In some instances, people are provided with a small bucket in which to urinate and defecate, but these are only emptied once a day leaving a putrid smell in the room for most of the day.
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