E/C 12/2000/4, 2000, https://undocs.org/E/C.12/2000/4 (accessed September 23, 2020), paras. The trained staff in turn educate additional health center staff about the program and mental health. Media@TheNationalCouncil.org In Mexico, for example, children with psychosocial disabilities in one institution were fully wrapped in bandages, duct tape or clothing, like mummies. 8; UN Office of the High Commissioner for Human Rights/WHO, Fact Sheet No. The Health Resources and Services Administration tracks health professional shortage areas, which are geographic areas, population groups, or health care facilities designated as having a shortage of health providers. [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. In Russia, residents with psychosocial disabilities were being chained by their wrists or ankles to beds, radiators, and other objects in the Trubchevsk Psycho-Neurological Institution near Briansk, located southwest of Moscow. 7; CRC, art. 58. In Mexico, Felipe Orozco, a 41-year-old man, told Human Rights Watch he had been hospitalized five times because he had a mental health condition. [146] American Convention on Human Rights (ACHR), adopted at the Inter-American Specialized Conference on Human Rights, San Jos, Costa Rica, 22 November 1966. [99] Human Rights Watch interview with Archbishop Danokech, Archbishop at the Holy Ghost Coptic Church of Africa, Kisumu, Kenya, February 18, 2020. Nearly 1 in 5 Americans has some type of mental health condition. 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. See also, Beijing Declaration and Platform for Action, Fourth World Conference on Women, September 15, 1995, A/CONF.177/20 (1995), art. 19. For example, in 2017 India passed a landmark mental health care bill that explicitly prohibited people with mental health conditions from being chained in any manner or form whatsoever.[129] While the provision has proven challenging to implement, it enabled a lawyer to challenge in court cases of people shackled in homes and faith-based institutions in the state of Uttar Pradesh, India. International human rights law guarantees to persons with disabilities the right to liberty on an equal basis with others. CAB/LEG/24.9/49 (1990), entered into force November 29, 1999, art 14. As a result, the person can be shackled for years or even decades. [6] In some countries, these centers are called prayer camps. And when natural disasters such as hurricanes strike, aid is not available to help residents recover. 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. [49], A volunteer from an organization providing services to people with disabilities in Cameroon said: People in Cameroon have negative perceptions about disability. Amid such far-reaching and systemic challenges, many have fought to defend Central Americans right to migrate, but Lykes says its also time to start considering another inalienable rightthe right to remain. Faith healers in Ghana, Indonesia, Kenya, and Nigeria reported sharing the little food available among all the residents, especially because some families did not provide food for their relatives, and prayer camps and institutions said they did not have the resources to buy enough food for everyone. This is critical to help attract new providers into the field and more must be done to train and retain providers to help ensure people can get help when they need it. Mental Health Services Help Health Workers Improve HIV Services in Central America . It is typically an administrative process and does not contain any provisions for judicial oversight. MSF has continued to operate non-COVID-19 healthcare activities in the two most populated cities, Soyapango and San Salvador, which are now epicenters of the outbreak. 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. 90% of our funding comes from individual donors. People with psychosocial disabilities face pervasive stigma and bias and are among the most marginalized, enduring stigma and discrimination in every sphere of lifepersonal, professional and public. [35] Mental health is not just a human right but a public good that is key to achieving the United Nations Sustainable Development Goals (SDG). 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). The Census Bureau reported that 30% of American adults had symptoms consistent with an anxiety or depression diagnosis as of May 24. [61] Human Rights Watch, Like a Death Sentence, https://www.hrw.org/report/2012/10/02/death-sentence/abuses-against-persons-mental-disabilities-ghana; Chained Like Prisoners," https://www.hrw.org/report/2015/10/25/chained-prisoners/abuses-against-people-psychosocial-disabilities-somaliland; Living in Hell, https://www.hrw.org/report/2016/03/20/living-hell/abuses-against-people-psychosocial-disabilities-indonesia; "Nigeria: People With Mental Health Conditions Chained, Abused," Human Rights Watch news release, https://www.hrw.org/news/2019/11/11/nigeria-people-mental-health-conditions-chained-abused. People with psychosocial disabilities, including children, who are shackled in homes or institutions are routinely forced to take medication or subjected to alternative treatments such as concoctions of magical herbs, vigorous massages by traditional healers, Quranic recitation in the persons ear, and special baths. They have scars.[77] Esther, 37, a woman with a psychosocial disability who lived with her parents in a rural community in Apodaca, Nuevo Len, in northeastern Mexico, was shackled from the time she was a young girl. [58] Human Rights Watch witnessed several people being shackled in a psychiatric hospital in northern Nigeria. [11] Estimates that include people with conditions related to substance could be as high as 970 million or 13 percent of the global population. Texas, Wisconsin and Georgia ranked among the lowest in terms of lacking adequate number of providers, facilities and funding to support the states populations. For example, in Yemen, Amnesty International documented cases of people with psychosocial disabilities who were unable to flee from violence because they were chained. [119] International Covenant on Civil and Political Rights (ICCPR), adopted December 16, 1966, G.A. 5, 21 I.L.M. Psychological work in human rights is very important, says Gina Rodriguez, a Honduran masters-level clinical psychologist and human rights activist. In one case, a man with a psychosocial disability spent 37 years chained in a dark, sweltering cave in the mountains in Wadi Al-Sabab, Saudi Arabia. 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. 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). The HRSA also runs several training programs to address the shortage of mental health professionals. Two-thirds of shortage areas are in rural or partially rural parts of the country. The desk research included online search, analyses of national mental laws and policies, and review of relevant literature and domestic and international news reports. According to WHO, over 10 million children under the age of five who. may well amount to torture.[161], The CRPD and the African Charter both explicitly prohibit all forms of exploitation, violence, and abuse. The government identifies shortage areas so it can address them with proper resources. People are shackled in locations that are out of sight and out of the way for families: in backyards, outhouses, sheds, or animal shelters. The nature of shackling means that people live in very restrictive conditions that reduce their ability to stand or move at all. [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. [124] Human Rights Watch interview with James [not his real name], man with a psychosocial disability, Kenya, February 2020 (name and details withheld). Key findings include: Seven out of 10 (71%) of students are experiencing mental health issues such as stress, anxiety and/or depression. There are currently no coordinated international or regional efforts to eradicate shackling. 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. Students in UVGs masters program in psychological counseling and mental health, which Cbar Cataln directs, also conduct preventive workshops in agrarian communities in western Guatemala. [31] ngela Carbonell, Jos Javier Navarro Prez, Maria Vicenta Mestre, "Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review," Health and Social Care in the Community vol.28:5, https://doi.org/10.1111/hsc.12968, pp. In certain cases, people with disabilities and their family members are identified with pseudonyms and identifying information, such as location or date of interview, has been withheld in order to respect confidentiality and protect them from reprisals from family or staff in institutions. Since the program involves home visits, it becomes easier for community health workers to detect cases of shackling and facilitate the release of shackled people. We advocate for policies to ensure equitable access to high-quality services. Travel restrictions have since been lifted but outpatient consultations at hospitals and health units remain suspended. Its very challenging to navigate domains where we may be told we dont belong, he says. Learn how you can support MSFs lifesaving care with a gift. 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 . 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. Res. [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. If Dylan could get services from HCS, he could live at home. [27] For example, there are 0.19 psychiatrists per 100,000 people in Kenya and 0.12 171, entered into force March 23, 1976; International Covenant on Economic, Social and Cultural Rights (ICESCR), adopted December 16, 1966, G.A. [29] Human Rights Watch research in over 25 countries around the world has found that people with mental health conditions can face a range of abuses including arbitrary detention, involuntary treatment, including electroconvulsive therapy, forced seclusion as well as physical and sexual violence in psychiatric hospitals. 14, 2019). In its 2018 Concluding Observations the Human Rights Committee noted El Salvador's lack of legislation in this aspect. [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. 69 (1988), signed November 17, 1988. Please give now to support our work, Share this via Facebook Pixabay. [109] "Indonesia: Shackling Reduced, But Persists," Human Rights Watch news release, October 2, 2018, https://www.hrw.org/news/2018/10/02/indonesia-shackling-reduced-persists. A central issue is the lack of mental health care professionals. Help us! The group also administers APAs ACT Raising Safe Kids Program to teach parents and caregivers how to create healthy and nurturing environments for young children. [130] In 2019, the Supreme Court of India directed the government to take immediate action, stating that keeping people with mental health conditions handcuffed or chained is in violation of their human rights.[131] In 2017, Dr. Akwasi Osei, CEO of the Mental Health Authority in Ghana, announced the government would enforce the 2012 Mental Health Act provision that people with psychosocial disabilities shall not be subjected to torture, cruelty, forced labor and any other inhuman treatment, including shackling.[132]. Traditional or religious healers: Traditional healers administer therapies based on theories, beliefs, and experiences indigenous to different cultures including ritual and herbal methods of treatment. [11] In countries in crisis or conflict, up to 22 percent or 1 in 5 people have a mental health condition. [13] Every 40 seconds, someone dies by suicide. During house visits, the community health worker collects data, educates the family about mental health, provides counseling, and helps them get a national health insurance card for free or subsidized health services. 46) at 193, U.N. Doc. 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 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. Accessibility means that health services should be affordable, situated within easy physical reach, and be offered to everyone without discrimination. [9] WHO, Gender and Women's Mental Health, https://www.who.int/mental_health/prevention/genderwomen/en/. In 2006, the WHO launched the Chain-Free Initiative in Somalia and Afghanistan. We dont know if hes dead or alive.[108] While Covid-19 has exposed the importance of psychological wellbeing and the need for connection and support within communities, it has exacerbated the risk to people with psychosocial disabilities. [14] Yet, psychosocial disabilities draw only limited government attention. Photo montage of people being shackled for weeks, months, and sometimes even years in Indonesia, Nigeria, Ghana, and Morocco. Findings of these visits, redacted to protect privacy rights, should be publicly reported. In the 2018-2019 academic year, 4,104 people completed behavioral health training programs funded by the HRSA. The study offers a comprehensive analysis of the state of mental health care in the U.S. Most mental health professions require at least a bachelors degree, except for psychiatric nurses, and many require additional post-graduate education and certification. 1366-1379. The stigma attached to psychosocial disabilities extends to the mental health profession, which often discourages doctors from specializing in psychiatry and causes many general physicians and other health care workers to resist mental health training. A/810 at 71 (1948), art. Overt commitment by political leaders and building capacity of existing health workers were critical to the success of the chain-free initiative When asked if they would be open to using it, almost half, or 45%, of Americans who have not already tried telehealth services said they would be open to the idea of trying a service to address a current or future mental health need. Priority Ambulance (011-503-2264-7911) is the only private ambulance service with a fleet of vehicles in San Salvador that has trained personnel and medical equipment to manage emergencies. eCollection 2018. [86] Civil Society Organizations Call for the Draft Law on Public Order to be Immediately Discarded, joint statement, August 13, 2020, https://www.hrw.org/news/2020/08/13/civil-society-organizations-call-draft-law-public-order-be-immediately-discarded. Res. Im never invited to happy occasions, weddings or birthdays with my family. The cost of mental health. Some families also use shackling as a way to prevent or control a certain behavior they find disruptive. I want to look around outside, go to work, plant rice in the paddy fields. Help us continue to fight human rights abuses. (No. Establish independent and confidential complaints systems that receive and investigate complaints, including ill-treatment of persons with psychosocial disabilities in institutions. Once the person is committed to an institution, they have no right to appeal or leave until the institution discharges them. [75] Human Rights Watch phone interview with Pascal Douti, Association Vie Libre, September 3, 2019; Benedict Carey, The Chains of Mental Illness in West Africa, New York Times, October 11, 2015, https://www.nytimes.com/2015/10/12/health/the-chains-of-mental-illness-in-west-africa.html (accessed July 30, 2020). Islamic faith healers often use Quranic recitations or herbal medicine, including the burning of herbs, as a treatment method. However, implementation has depended on the provincial governors issuing a decree and deploying adequate resources. 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. Personal hygiene is a serious problem since people who are chained often do not have access to a toilet. 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 Depression is the most common mental illness in the world. [8] Women, given the high incidence of sexual violence they suffer, are also disproportionately affected by Post-Traumatic Stress Disorder (PTSD).[9]. 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. Mental healthcare in the Philippines faces continued challenges including underinvestment, lack of mental health professionals and underdeveloped community mental health services. (No.16) at 52, U.N. Doc. An additional 6,398 mental health providers are needed to fill the gaps. The ACRWC has been ratified by Benin, Burkina Faso, C. American Convention on Human Rights (ACHR), adopted at the Inter-American Specialized Conference on Human Rights, San Jos, Costa Rica, 22 November 1966. [128] Human Rights Watch interview with Tina Mensah, Ghanas deputy health minister, Accra, November 8, 2019. [147] ICESCR, art. 58-60; Once You Enter, You Never Leave: Deinstitutionalization of Persons with Intellectual or Mental Disabilities in Croatia, September 2010, https://www.hrw.org/report/2010/09/23/once-you-enter-you-never-leave/deinstitutionalization-persons-intellectual-or. Locking them in a confined space such as a room outside or within a house, shed, hut, cage, or animal shelter (including chicken coops, pig pens, or goat sheds). Undertake community support programs and independent and supported living arrangements for people with psychosocial disabilities, particularly those who have been freed from shackling. The announcement was made via a DOD press release. The Cohen Veterans Network (CVN) is a 501(c)(3) national not-for-profit philanthropic organization for post-9/11 veterans and their families. Those workshops address teen marriage and pregnancy, suicidality, behavioral problems and drug and alcohol misuse in an effort to improve educational and professional outcomes for rural populations. 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. The COVID-19 pandemic has only made the situation more complex. [66], In India, in January 2019, the media reported that thousands of people with mental health conditions were chained like cattle, their feet tied with iron chains and padlocked for days, months and years, in the state of Uttar Pradesh. Based on the analysis of third-party data, states are struggling to keep up with demand due to lack of funding and facilities, and, to a lesser extent, providers. Cohen Veterans Network and National Council for Mental Wellbeing partnered with Ketchum Analytics who conducted an online survey among 5,000 Americans, representative of the U.S. population based on age, gender, region, household income and race/ethnicity. [12] The World Health Organization (WHO) reports that one in five of the worlds children and adolescents have a mental health condition. I was taken to a traditional healing center where they cut my wrists to introduce medicine and another one where a witch doctor made me take baths with chicken blood. My family believed her mental health condition would stigmatize the whole family. Published on Wed, June 9, 2021 12:03PM PDT | Updated Wed, July 14, 2021 2:54PM PDT. If the family does not come to pick up the relative or abandons them at the institution, the person can end up spending many years or even the rest of their life shackled in the social care institution or healing center. People with mental health conditions can also be arbitrarily detained and chained in state-run social care institutions and psychiatric hospitals. About 80 percent of people with disabilities, including people with psychosocial disabilities, live in middle or low-income countries where it is often challenging to access healthcare, particularly mental health care. While many countries are increasingly starting to pay attention to the issue of mental health, the practice of shackling remains largely invisible. A/6316 (1966), 999 U.N.T.S. 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. Just because it is painful, we cannot look away. Child: The word child, boy, or girl in this report refers to someone under the age of 18. [71], In Guatemala, Disability Rights International in a 2018 report found hundreds of children with psychosocial or intellectual disabilities tied to furniture or locked in cages in orphanages and institutions. Retornados often struggle to find work, become targets of gangs who assume they have money, and have problems with addiction and suicidality, Garca Rivera says. In state-run or private institutions, as well as traditional or religious healing centers, they are often forced to fast, take medications or herbal concoctions, and face physical and sexual violence. [72] Disability Rights International, Still in Harms Way - International Voluntourism, Segregation and Abuse of Children in Guatemala, July 16, 2018, https://www.driadvocacy.org/wp-content/uploads/Still-in-Harms-Way-2018.pdf (accessed August 1, 2020), p. V. [73] Moroccan Minister of Health to Close Bouya Omar Shrine, Morocco World News, April 16, 2015, https://www.moroccoworldnews.com/2015/04/156319/moroccan-minister-of-health-to-close-bouya-omar-shrine/ (accessed April 1, 2020). [68] Daniel Arias et al., Prayer Camps and Biomedical Care in Ghana: Is Collaboration in Mental Health Care Possible? PLoS ONE 11(9), September 12, 2016, doi:10.1371/journal. Gaborit stresses that psychologists must assemble professionally and partner with nongovernmental organizations such as IJM, UNICEF and local groups to achieve a greater collective impact. In one case, a person died while tied up and locked in one of the bathrooms, which was used as an isolation room. [17], While one in ten people have a mental health condition, access to services is scarce. Human Rights Watch phone interview with Pascal Douti, September 3, 2019. [119] The United Nations special rapporteur on torture has noted that involuntary treatment and other psychiatric interventions in health-care facilities can be forms of torture and ill-treatment. In many institutions in Indonesia, people with psychosocial disabilities were fed meals devoid of proper nutrition such as instant noodles for most meals.[113]. [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. Others, inspired by the mission of liberation psychology, have launched or joined human rights organizations to more directly address systemic issues such as gender-based violence, public corruption and income inequality. It was like my mind had gone blank on account of the fright, she said. 18 (4) and 28; ACHR, art. 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. [42] Human Rights Watch, Disability Is Not Weakness: Discrimination and Barriers Facing Women and Girls with Disabilities in Afghanistan, April 2020, https://www.hrw.org/report/2020/04/28/disability-not-weakness/discrimination-and-barriers-facing-women-and-girls. 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). In the worst of cases, depression can lead to suicide - an estimated 63,000 people kill themselves every year in the Americas. Clinical psychologists usually need a Doctor of Philosophy in psychology (PhD) or a Doctor of Psychology (PsyD) degree. While the conditions of confinement may vary based on the method of shackling, location, and country, one thing remains the same: people who are shackled are forced to live in extremely unsanitary and degrading conditions. Although mental illness is widespread- 25% of adults in developed countries experience significant mental health problems each year- the treatment is outdated and lacking. Ensure shackling is not practiced by the organizations representatives or at holy sites. [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). In one center in northern Nigeria, Human Rights Watch found a dozen people who showed researchers scars on their arms, chests, and backs that they said were from floggings by staff. [133] Of these, 1,355 had been chained in Habeb hospital in Mogadishu, the capital, and 417 in the surrounding community. Persons with disabilities are systematically placed into institutions and psychiatric facilities, or detained at home and other community settings, based on the existence or presumption of having an impairment.[166]. Tony Evers declared this as the "year of mental health" in his budget address last month, one psychotherapist says the budget leaves an important component - mental health 74(e). In Guatemala, for instance, rising temperatures and long droughts are reducing returns from coffee, corn and sugarcane farms. Adults Who Needed Substance Use and Mental Health Care Did Not Get Treatment, National Council will Honor Five Distinguished Recipients with Awards of Excellence During NatCon22, Statement from National Council for Mental Wellbeing President and CEO Chuck Ingoglia on the Senate Finance Committees Hearing on February 8. [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. Along with hundreds of thousands of others, these Central Americans are migrating north this year seeking asylum, employment and family reunification. [7] Christian faith healers typically use prayer, religious counseling, fasting, and spiritual healing as treatment methods. In Somalia, Islamic faith healers are called sheikhs, an honorific title given to an Islamic scholar or elder. 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. Individuals located in rural areas and of lower-income are less likely to say that mental health services are extremely accessible to them.
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