These include e-trainings and guidance materials for mental health professionals, people with psychosocial disabilities and their families, and NGOs. It doesnt feel right; it makes me sad. 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. Urge national governments to ban shackling of people with real or perceived mental health conditions and develop adequate, quality, and voluntary community-based support mental health services. Spike in suicides in El Paso County jail highlights shortfalls of Its time for governments to step up so that families arent left to cope on their own. All of our clients from all of our programs are eligible to make appointments. [46] UNHRC, Report of the Special Rapporteur on the rights of persons with disabilities, Catalina Devandas-Aguilar, A/HRC/40/54, January 11, 2019, https://undocs.org/en/A/HRC/40/54 (accessed July 26, 2020), para. Cameroon: People With Disabilities Caught in Crisis, Human Rights Watch news release, August 5, 2019, https://www.hrw.org/news/2019/08/05/cameroon-people-disabilities-caught-crisis. 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. Share this via Telegram San Salvador/New York, July 9, 2020The health system in El Salvador is on the brink of collapse, with an increasing number of people dying from COVID-19 and other illnesses at home before they can receive medical care, said the international medical humanitarian organization Doctors Without Borders/Mdecins Sans Frontires (MSF). My family believed her mental health condition would stigmatize the whole family. [110] Fasting would help to starve evil spirits and enable God and prayer to heal them. A/39/51 (1984), entered into force June 26, 1987; Convention on the Rights of the Child (CRC), adopted November 20, 1989, G.A. And we promote greater understanding of mental wellbeing as a core component of comprehensive health and health care. 58 (1982), entered into force October 21, 1986. While most Americans have heard of telehealth as an option for treating mental health issues, only 7% have reported using it. Share this via Printer, Shackling of People with Psychosocial Disabilities Worldwide. 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. [87] Human Rights Watch, Prison is Not For Me: Arbitrary Detention in South Sudan, June 2012, https://www.hrw.org/sites/default/files/reports/southsudan0612ForUpload_1.pdf, pp. 25, 27, 52; I Needed Help, Instead I Was Punished: Abuse and Neglect of Prisoners with Disabilities in Australia, February 2018, https://www.hrw.org/report/2018/02/06/i-needed-help-instead-i-was-punished/abuse-and-neglect-prisoners-disabilities; Living in Hell: Abuses against People with Psychosocial Disabilities in Indonesia, March 2016, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf, pp. The main causes of death of these patients are related to metabolic disorders and respiratory and heart problems, which have increased fourfold compared to the first half of last year. 5, 21 I.L.M. In Indonesia, Human Rights Watch found approximately 90 women living in a room that could reasonably accommodate no more than 30, in Panti Laras 2, a state-run institution in Cipayung, on the outskirts of Jakarta. 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. [75], It is even more complex to account for chaining in small institutions and homes in which people are shackled behind closed doors. A young woman raised by her grandmother in Honduras leaves to reunite with her parents after more than a decade. To help retornados transition back into Salvadoran society, he has designed and facilitated workshops to help build peer psychosocial support relationships among those who have been deported. [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. 85. And why arent we more concerned about that?. [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. [PDF] Access to mental health care in El Salvador: a case study of According to the Results from the 2021 National Survey on Drug Use and Health: Detailed Tables, approximately 8.6 million nonmetropolitan adults reported having any mental illness (AMI) in 2021, accounting for 22.7% of nonmetropolitan adults. The program is an ambitious government initiative that seeks to ensure that even the most rural, isolated, and reluctant communities get access to health services. In Guatemala, we tend to be reactive, she says. The Maputo Protocol has been ratified by Benin, Burkina Faso, Cte dIvoire, Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Liberia, Mozambique, Nigeria, Senegal, Sierra Leone, South Africa, Tanzania, Togo, Uganda, and Zimbabwe; African Charter on the Rights and Welfare of the Child (ACRWC), OAU Doc. 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. People who are shackled to one another are forced to go to the toilet or sleep together. Addressing Mental Health as a Community Issue in El Salvador [18] Between 76 and 85 percent of people with mental health conditions who live in middle or low-income countries do not have access to mental health services. Treaty Series No. 15; CAT; ACHPR, art.5; ACHR, art. may well amount to torture.[161], The CRPD and the African Charter both explicitly prohibit all forms of exploitation, violence, and abuse. [64] In one case, an 8-year-old girl was tied to a tree by her grandparents for nearly six years in Henan province, in central China. [100] Human Rights Watch interview with Made, man with a psychosocial disability, Bali, Indonesia, November 19, 2020. As of 2018, more than two-thirds of all countries did not cover reimbursement for mental health services in national health insurance schemes. Lack of engagement with work. res. [165] CRPD, art. However, it will be a challenge for the country to maintain those numbers considering how the COVID-19 pandemic is impacting the economy and the exports the country relies on. [4] International Disability Alliance, Legal Opinion on Article 12 of CRPD, undated, https://www.internationaldisabilityalliance.org/sites/default/files/documents/legalopinionletterart12final_0.doc (accessed September 14, 2020). Living in Chains: Shackling of People with Psychosocial Disabilities What is the US national debt and how has it grown over time? Amina, who had a breakdown after her mother died and was taken to various Islamic healers, said she was tied with ropes, beaten, and spat on in one rehabilitation center in Kaduna, and then molested by a traditional healer in Abuja who came to her home: He told me to undress, that it is the part of the healing process, and then he started touching my body, Amina said. An additional 6,398 mental health providers are needed to fill the gaps. The 56-page report, Living in Chains: Shackling of People with Psychosocial Disabilities Worldwide, examines how people with mental health conditions are often shackled by families in their own homes or in overcrowded and unsanitary institutions, against their will, due to widespread stigma and a lack of mental health services. The nation needs an additional 6,398 mental health providers to fill these shortage gaps. The chain is so heavy. Subsequently, those with mental health impairment tend to be complex patients, which may convolute delivery of services. [130] Supreme Court Shocked at Chaining of Inmates in U.P. In Latin America, 5% of the adult population suffers from it, but most neither seek - nor receive - treatment, according to the WHO. [50] Human Rights Watch interview with a volunteer in a local organization providing services to people with disabilities, Buea, Cameroon, January 2019 (name and details withheld). Decades of trauma and violence in the Northern Triangleincluding civil wars in Guatemala and El Salvador and ongoing political instability in Hondurashave left behind a trail of crime, poverty, sociopolitical unrest and extreme income inequality in all three countries. The right to health care, particularly mental health care, on the basis of free and informed consent of the person with a real or perceived psychosocial disability is routinely ignored. 64. [153] CRPD Committee, General Comment No. [3] This encompasses the right to personhood, being recognized as a person before the law, and legal agency, the capacity to act and exercise those rights. Fighting Non-Communicable Diseases in El Salvador 61-62; Amnesty International, Our Hearts Have Gone Dark The Mental Health Impact of South Sudans Conflict, https://www.amnesty.org/download/Documents/AFR6532032016ENGLISH.PDF, pp. 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). [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. [26] When it comes to psychiatrists, the rate is even lower with low-income countries averaging at 0.1 psychiatrists and lower middle-income countries at 0.5 psychiatrists per 100,000 people. In addition, the person with a psychosocial disability and their family can visit the community health center for one-on-one counseling with a doctor or nurse, they can get medication, and they can participate in occupational therapy or other activities. These beliefs often lead people with psychosocial disabilities and their families to first consult faith or traditional healers and only seek medical advice or psychosocial support, such as counseling, as a last resort. 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. Shackling is also used as a temporary measure to restrain a person for short periods while the family goes out to work or when the person is having a crisis. The programs innovative family-based approach examines 12 measures that together reveal family health: access to clean water, hypertension, tuberculosis, smoking, family planning, access to government health insurance, maternal health, child nutrition, immunization, breast feeding, sanitation, and mental health. [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. [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). [36] The SDGs comprise 17 global goals that create a blueprint to achieve a better and more sustainable future for all. The United Nations General Assembly created the SDGs in 2015 and countries committed to achieving the goals set forth in the SDGs by 2030. Mental healthcare in the Philippines faces continued challenges including underinvestment, lack of mental health professionals and underdeveloped community mental health services. The announcement was made via a DOD press release. 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. [158] UN General Assembly, Interim Report of the Special Rapporteur on torture and cruel, inhuman or degrading treatment or punishment, Manfred Nowak, A/63/175, July 28, 2008, https://undocs.org/A/63/175(accessed September 23, 2020), para. They run away whenever they see me. [133] Of these, 1,355 had been chained in Habeb hospital in Mogadishu, the capital, and 417 in the surrounding community. Men, women, and children are chained or locked in confined spaces in 60 countries across Asia, Africa, Europe, the Middle East, and the Americas, simply because they have a mental health condition. 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. There is a shortage of bilingual or Spanish speaking mental health professionals. This should include development of psychosocial support services and integration of mental health services in the primary healthcare system. In a privately-run social care institution in Russia, staff regularly brought people with psychosocial disabilities to the dining hall chained to each other and forced them to eat in handcuffs. She expressed her appreciation to WHO for having focused its attention on this priority public health issue, since depression can be prevented. [83] Mohamed Rushdie, Torture, Rape and Death Are Crimes That Pursue 8 Million Psychiatric Patients in Egypt, January 29, 2018, https://www.tahrirnews.com/Story/866399/%D8%A7%D9%84%D8%AA%D8%B9%D8%B0%D9%8A%D8%A8-%D9%88%D8%A7%D9%84%D8%A7%D8%BA%D8%AA%D8%B5%D8%A7%D8%A8-%D9%88%D8%A7%D9%84%D9%85%D9%88%D8%AA-%D8%AC%D8%B1%D8%A7%D8%A6%D9%85-%D8%AA%D9%84%D8%A7%D8%AD%D9%82-8-%D9%85%D9%84%D8%A7%D9%8A%D9%8A%D9%86-%D9%85%D8%B1%D9%8A%D8%B6-%D9%86%D9%81%D8%B3%D9%8A-%D9%81%D9%8A-%D9%85%D8%B5%D8%B1/%D8%AC%D8%B1%D9%8A%D9%85%D8%A9 (accessed August 3, 2020). 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. 39/46, annex, 39 U.N. GAOR Supp. 3, entered into force January 3, 1976, art. 74(e). support MSFs lifesaving care with a gift. They are also involved in various charitable activities. According to the U.S. Department of Health and Human Services, one in five American adults have experienced a mental health issue, and one in 20 Americans live with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. In addition, compared to Americans living in urban and suburban areas, individuals living in rural areas are less likely to proactively seek mental health specialists they need, and instead go to their primary care doctor or community center for treatment. 25; 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; 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; Cameroon: People With Disabilities Caught in Crisis, Human Rights Watch news release, August 5, 2019, https://www.hrw.org/news/2019/08/05/cameroon-people-disabilities-caught-crisis; Human Rights Watch, From Cradle to Grave: Discrimination and Barriers to Education for Persons with Albinism, June 2019, https://www.hrw.org/video-photos/interactive/2019/06/13/cradle-grave; Treated Worse than Animals, https://www.hrw.org/report/2014/12/03/treated-worse-animals/abuses-against-women-and-girls-psychosocial-or-intellectual. [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. [156] ICCPR, art. https://www.hrw.org/sites/default/files/reports/zambia0714_ForUpload_1.pdf, p.16; A. Allen,andE.Green,Discrimination and Stigmatization of People with Epilepsy in Zambia: The Need for Integration of Social, Healthcare, and Policy Reform,, African [Banjul] Charter on Human and Peoples Rights (ACHPR), adopted June 27, 1981, OAU Doc. People with real or perceived psychosocial disabilities can be shackled for days and weeks, to months, and even years. [166] UNHRC, Report of the Special Rapporteur on the rights of persons with disabilities, A/HRC/40/54, https://undocs.org/en/A/HRC/40/54, para. The HRSA manages the Behavioral Health Workforce Education and Training program, which provides training funding for colleges, universities and training schools preparing people for behavioral health jobs with an emphasis helping people from underrepresented minority or disadvantaged backgrounds. While Gov. In El Salvador, Beckley has trained police officers, prosecutors, judges, community leaders, social workers and psychologists in trauma-informed care for people who are seeking justice through the courts. In prayer camps in Ghana, administrators and pastors told Human Rights Watch that fasting was a key component of curing a psychosocial disability. How is that Islamic?[125], In institutions visited by Human Rights Watch in Indonesia, male staff would enter and exit womens wards or sections at will or were responsible for the womens section, including at night, which put women and girls at increased risk of sexual violence, as well as subjected them to a constant sense of insecurity and fear. We send regular emails about upcoming events, member spotlights and updates in mental wellbeing. [112] 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. [13] WHO, Mental Health, https://www.who.int/news-room/facts-in-pictures/detail/mental-health); The World Bank, Mental Health, https://www.worldbank.org/en/topic/mental-health). [12] The World Health Organization (WHO) reports that one in five of the worlds children and adolescents have a mental health condition. On a larger scale, the nonprofit International Justice Mission (IJM) works to end impunity for slavery and other human rights violations through legal and justice reform. QualityRights also focuses on empowering advocates and self-advocates to influence policy-making and push for national legal reforms to meet the standard set by the CRPD. 24, 2016). Treaty Series No. 5, 21 I.L.M. Human Rights Watch research in 2013 in Cambodia found that people with real or perceived psychosocial disabilities are forcibly locked up and often chained in drug detention centers, or in sporadic crackdowns to clean the streets ahead of high-profile international meetings or visits by foreign dignitaries. [128] Human Rights Watch interview with Tina Mensah, Ghanas deputy health minister, Accra, November 8, 2019. In Nigeria, boys as young as 10 were chained together in rooms with adult men, leaving them at risk of abuse. [170] UN Human Rights Council, Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Dainius Pras, A/HRC/35/21, March 28, 2017, https://undocs.org/A/HRC/35/21 (accessed September 17, 2020), para.