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. [123] Human Rights Watch interview with Halima Gani, woman with a psychosocial disability, Kano, Nigeria, September 23, 2019. 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 government identifies shortage areas so it can address them with proper resources. Authors Samuel V Nickels 1 , Mariely Campos Tomasino 2 , Nelson A Flamenco Arvaiza 2 , Cynthia A Hunter 3 Affiliations The nation needs an additional 6,398 mental health providers to fill these shortage gaps. Conduct public information campaigns to raise awareness about mental health conditions and the rights of people with disabilities, especially among alternative mental health service providers and the broader community, in partnership with people with lived experiences of mental health conditions, faith leaders, and media. [85] Human Rights Watch, They Treat Us Like Animals: Mistreatment of Drug Users and "Undesirables" in Cambodias Drug Detention Centers, December 2013, https://www.hrw.org/sites/default/files/reports/cambodia1213_ForUpload_1.pdf, p.3. [48] In March 2019, six people with mental health conditions, including three children, were chained to logs in a Christian faith healing center in Montserrado, Liberia because they were accused of witchcraft. Using metallic chains, iron manacles or spreader rods, metal leg or hand cuffs, or wooden stocks; Tying or binding them with rope or makeshift cloth; or. We have to wait for authorization from the public health system to be able to move patients to a care center, since we cannot transfer the patient from [their] home without prior coordination and authorization from the public health system, said Wendy. 24; CEDAW, art 12; CRPD, art. [30] Even when mental health services are free or subsidized, in many countries the distance and transport costs are a significant barrier.[31]. In addition, the local and national governments dont have coordinated detection and hospitalization mechanisms for COVID-19 cases. People with real or perceived psychosocial disabilities can be shackled for days and weeks, to months, and even years. In 2019, this happened to [our teams] 11 times from January to June. [102] When children are shackled, they are deprived of playing, making friends, going to school, growing up in a family, and having a normal childhood. The term psychosocial disability describes conditions commonly referred toparticularly by mental health professionals and mediaas mental illness or mental disorders. The Convention on the Rights of Persons with Disabilities recognizes that disability is an evolving concept and that it results from the interaction between people with impairments and social, cultural, attitudinal, and environmental barriers that prevent their full and effective participation in society on an equal basis with others. [139] After long-term advocacy by organizations such as the Mental Health Coalition of Sierra Leone, chaining was banned in policy. But even as psychologists seek a broader impact, says Cbar Cataln, its important to remember that the trauma and disenfranchisement driving Central Americans north are deeply personal. An estimated 122 million Americans, or 37% of the population, lived in 5,833 mental health professional shortage areas as of March 31. Res. The Protocol of San Salvador has been ratified by Argentina, Bolivia, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, and Peru. [57] Human Rights Watch interview with mother of a man with a mental health condition, Bali, Indonesia, November 19, 2020 (full name and details withheld). 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. The impoverished often live in overcrowded areas. 39/46, annex, 39 U.N. GAOR Supp. In El Salvador, we have strengthened the supply chain to improve availability of essential medicines and worked with the Ministry of Public Health to implement a continuous quality improvement of care model in hospitals. As a community, we need to attend to the physical, psychological, emotional, social, economic and familial needs of our people, says Ana Alicia Cbar Cataln, PhD, a clinical psychologist at Proyecto Aigl Guatemala and professor at Universidad del Valle de Guatemala (UVG). [120] In addition, the UN special rapporteur on violence against women has condemned forced psychiatric treatment as a form of violence.[121]. 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. [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). 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. In Nigeria, amongst the people Human Rights Watch interviewed, the youngest child chained was a 10-year-old boy and the oldest person was an 86-year-old man. 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. [39] Human Rights Watch interview with Carlos [not his real name], man with a psychosocial disability, Maputo, Mozambique, November 20, 2019. Keep up with the latest data and most popular content. [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. [And] increase the response capacity of the emergency transfer services in critical cases. Just because it is painful, we cannot look away. Listening and telling peoples stories is a first step to start humanizing migrants in a society where blaming the victim tends to be the norm., Children on the Run: Unaccompanied Children Leaving Central America and Mexico and the Need for International Protection 5 (2018), p. 397; WHO, Mental Health Atlas 2017 Member State Profile: Bangladesh, 2018, https://www.who.int/mental_health/evidence/atlas/profiles-2017/BGD.pdf?ua=1 (accessed June 18, 2020). Existing mental health services are often under-utilized or do not comply with international human rights standards because of limited understanding and awareness of mental health. [14] Yet, psychosocial disabilities draw only limited government attention. In prayer camps and institutions in some countries, many interviewees spoke of persistent, gnawing hunger from forced fasting or inadequate food, and many looked emaciated. Bobele, M., & Slive, A.In Hoyt, M.F., & Talmon, M. In 2019 at Adwumu Woho Herbal and Spiritual Centre in Senya Beraku, Ghana, about 60 kilometers from the capital, Accra, several men who were shackled and arbitrarily detained shouted out to a Human Rights Watch researcher: Help us get out of the chains. [75], It is even more complex to account for chaining in small institutions and homes in which people are shackled behind closed doors. When the Special Olympics team had Malaki released, he got the opportunity and training to play football. [139] 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). Travel restrictions have since been lifted but outpatient consultations at hospitals and health units remain suspended. Improve quantitative and qualitative data collection at the local and national levels on the current number of people shackled, the reasons families continue to practice shackling, and the support or services they would need to discontinue the practice. 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. 14; Protocol of San Salvador, art. [46], For example, many people in countries such as Afghanistan, Bangladesh, Burkina Faso, Egypt, Ethiopia, Ghana, Guatemala, India, Indonesia, Iraq, Kenya, Mexico, Morocco, Mozambique, Nigeria, Oman, Pakistan, Palestine, Peru, Philippines, Saudi Arabia, Senegal, Sierra Leone, Somalia, including in Somaliland, Sudan, and Yemen believe that psychosocial disabilities are the result of possession by evil spirits or witchcraft. The study, which assesses Americans' current access to and attitudes towards mental health services, revealed American mental health services are insufficient, and despite high demand, the root of the problem is lack of access - or the ability to find care. 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). As a result, many governments do not have any data on the number of private institutions in their country, much less the number of people who are detained or shackled in them. Pixabay. [161] UNHRC, Report of the Special Rapporteur on torture and other cruel inhuman or degrading treatment or punishment, A/HRC/43/49, March 20, 2020, https://undocs.org/en/A/HRC/43/49, para. [104] In a privately-run social care institution near Briansk, southwest of Moscow, Russia, staff regularly brought people with psychosocial disabilities to the dining hall chained to each other, and forced them to eat in handcuffs. They always beat me up, at times they assigned my own children to beat me up, for instance this one who takes care of my drugs bill. The desk research included online search, analyses of national mental laws and policies, and review of relevant literature and domestic and international news reports. Download (593.4 kB) WHO Team. Res. 1, 3. In order to show the scale and scope of shackling of people with real or perceived psychosocial disabilities worldwide, Human Rights Watch conducted a study of mental health legislation, relevant policies, and practices across 60 countries around the world. Anxiety and depression levels are the lowest since the pandemic began, 48% of Americans are feeling down, depressed, or hopeless during the COVID-19 pandemic, How many teens are vaping? Many think disability is a curse resulting from evil spirits. 2. 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. Human Rights Watch phone interview with Pascal Douti, September 3, 2019. 61/106, Annex II, UN GAOR, 61st Sess., Supp. 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. [132] Human Rights Watch, Ghana Breaks the Chains on Mental Health, video, https://www.youtube.com/watch?v=7idmUmMccgw; Shantha Rau Barriga, Ghana Breaks The Chains On Mental Health, commentary, Human Rights Watch Dispatch, October 16, 2017, https://www.hrw.org/news/2017/10/16/ghana-breaks-chains-mental-health; Ghana: Oversight Needed to Enforce Shackling Ban, Human Rights Watch news release, October 9, 2018, https://www.hrw.org/news/2018/10/09/ghana-oversight-needed-enforce-shackling-ban. El Salvador's public healthcare system is considered poor. Families who struggle to cope with the demands of caring for a relative with a psychosocial disability may feel they have no choice but to shackle them. Please give now to support our work, Share this via Facebook Liberation psychology, for example, established in the 1970s by Jesuit priest Ignacio Martn-Bar, PhD, calls on psychologists to redefine their role as sociopolitical and to support oppressed communities. Your gift helps us provide medical humanitarian aid for hundreds of thousands of people each year. Yet, there are very few mental health professionals, especially for the majority of the population who rely on the public health system. More than three-quarters (78%) report the same or higher levels of severity as this time last year. 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. Due to a lack of resources, coordination, and training, both the TPKJM and the rapid response teams struggle to successfully rescue people from pasung. The . [62] Vikram Patel et al., The Lancet Commission on Global Mental Health and Sustainable Development, The Lancet 392 (10157), October 9, 2018, doi: 10.1016/S0140-6736(18)31612-X (accessed July 29, 2020); 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); Human Rights Watch, Living in Hell, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf, p. 35; [63] Human Rights Watch has found evidence of people with psychosocial or intellectual disabilities being shackled in Afghanistan, Argentina, Armenia, Bangladesh, Benin, Bolivia, Brazil, Brunei, Burkina Faso, Cambodia, Chile, China, Colombia, Cte d'Ivoire, Dominican Republic, Democratic Republic of Congo, East Timor, Ecuador, Egypt, El Salvador, Ethiopia, Ghana, Guatemala, Haiti, Honduras, India, Indonesia, Iraq, Israel, Japan, Jordan, Kenya, Laos, Liberia, Mexico, Morocco, Mozambique, Nicaragua, Nigeria, Oman, Pakistan, Palestine, Paraguay, Peru, Philippines, Russia, Saudi Arabia, Senegal, Sierra Leone, Somalia, South Africa, South Sudan, Sudan, Tajikistan, Tanzania, Thailand, Togo, Turkey, Uganda, Yemen, and Zimbabwe. I stay in a small room with seven men. [62], Human Rights Watch has found evidence of shackling across60 countries across Asia, Africa, Europe, the Middle East, and the Americas. The HRSA also runs several training programs to address the shortage of mental health professionals. (No. 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. For example, Delaware requires 15 more mental health providers to resolve its shortage, whereas Texas needs an additional 638. 90% of our funding comes from individual donors. James Ross, legal and policy director, provided legal review; and Babatunde Olugboji, deputy program director, provided programmatic review.

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