Psychological work in human rights is very important, says Gina Rodriguez, a Honduran masters-level clinical psychologist and human rights activist. On average, countries spend less than 2 percent of their health budgets on mental health. In 2010, Indonesias health ministry launched the Indonesia Free from Pasung, a program that aimed to eradicate the practice by 2014. Pennsylvania, New York and Minnesota ranked among the top. The report also draws on Human Rights Watchs extensive research on stigma, mental health, and discrimination that people with psychosocial disabilities face around the world, including in Australia, Brazil, Cameroon, Croatia, India, Iran, Kazakhstan, To be a young person in El Salvador, Guatemala or Honduras is extremely stressful, he says. Finally, we must ensure standards of care are consistent through continued adoption of evidence-based practices. 1366-1379. 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. ABSTRACT Objective To assess the need for decentralization of psychiatric services in El Salvador, based on country-specific evidence, and to generate baseline measures the government and researchers could use to monitor and measure future progress toward decentralization. From 2007 to 2019, El Salvador experienced some economic progress, with its poverty rate dropping from 39% to 22.3%. Two months ago, social protection officials tried to discharge me from the hospital and send me to my sisters house, but she refused. I want to look around outside, go to work, plant rice in the paddy fields. There are no statistics on the scale of shackling at a global level. [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. A World Health Organization (WHO) video describes it as a black dog that follows you everywhere, does not let you sleep or eat well. [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). Other ways to share [67] Thousands Of Mentally Ill People Chained Like Cattle For Years In Sheds In UP, Outlook, January 3, 2019, https://www.outlookindia.com/website/story/india-news-thousands-of-mentally-ill-people-chained-like-cattle-for-years-in-uttar-pradesh-sheds/322874 (accessed July 29 2020); Asian News International, Thousands of Psychiatric Patients Chained in Sheds in Uttar Pradesh's Badaun; SC Asks Govt to Provide Medical Aid, Firstpost, January 3, 2019, https://www.firstpost.com/india/thousands-of-psychiatric-patients-chained-in-sheds-in-uttar-pradeshs-badaun-sc-asks-govt-to-provide-medical-aid-5829361.html (accessed July 29 2020); Mentally challenged man, in chains for 14 yrs, rescued, The Indian Express, September 27, 2020 (accessed September 28, 2020). [23] 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, September 2020, https://doi.org/10.1111/hsc.12968 (accessed September 25, 2020), pp. 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. 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. Not only has the lack of access to primary health care services contributed to the deterioration of the health of patients with chronic diseases, resulting in more deaths, but both the ambulance system and hospitals are operating at full capacity. The offices of the first two are filled through popular elections; the president serves for five years and members of the legislature serve for three years. UNICEF is working with municipal governments and other authorities to develop and implement programs that support and protect vulnerable kids in El . Im only invited to spiritual events because my family thinks I have a spiritual problem, not a mental health condition, said Carlos, a 51-year-old man from Maputo, Mozambique. A/39/51 (1984), entered into force June 26, 1987; Convention on the Rights of the Child (CRC), adopted November 20, 1989, G.A. Travel restrictions have since been lifted but outpatient consultations at hospitals and health units remain suspended. Some families also use shackling as a way to prevent or control a certain behavior they find disruptive. [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. [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. It is typically an administrative process and does not contain any provisions for judicial oversight. The number of new jobs and the unemployment rate are regularly cited in the news, but theyre just part of the picture. In addition, even when there are services, they are often under-utilized or do not comply with human rights standards because of limited understanding and awareness of mental health. A number of factors fuel the shortage, including a greater awareness of mental health problems that has spurred people to seek treatment. [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. Covid-19 is an extreme threat to people with psychosocial disabilities who are shackled in homes or overcrowded institutions without proper access to sanitation, running water, soap, or even basic health care. 49) at 65, UN Doc. Despite being practiced around the world, shackling remains a largely invisible problem as it occurs behind closed doors, often shrouded in secrecy, and concealed even from neighbors due to shame and stigma. The Protocol of San Salvador has been ratified by Argentina, Bolivia, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, and Peru. Human Rights Watch researchers interviewed more than 350 people with psychosocial disabilities, including those who were shackled at the time of research or had been shackled at least once in their lives, and more than 430 family members, caregivers or staff working in institutions, psychiatrists, psychologists, nurses and other mental health professionals, faith healers, lawyers, government officials, representatives of local nongovernmental organizations (NGOs), including organizations of persons with disabilities, and disability rights advocates. MSF is also hearing worrying reports about the situation in some communities in San Salvador and Soyapango. In social care institutions, run by nongovernmental organizations (NGOs) or traditional or religious healing centers, families often use false pretenses to get relatives to enter an institution, or simply provide no explanation at all. For example, the Health Resource and Services Administration (HRSA) administers the National Health Service Corps, which provides loan repayment or scholarship for those providing health care services in underserved communities. MSF has launched health initiatives in San Salvador and Soyapango, focusing on socially vulnerable people whose access to health services has been affected by insecurity. [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. [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). We can tell by the physical signs on their bodies. [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. See the Shackling chapter for a more detailed description. Enable people with psychosocial disabilities to freely enter and leave at will, to refuse treatment, and to seek other services, and ensure that everyone in the camps is always fully aware of this. Provide counseling and other forms of support to people with psychosocial disabilities and their families. | Technical document. Just because it is painful, we cannot look away. 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. The desk research included online search, analyses of national mental laws and policies, and review of relevant literature and domestic and international news reports. Bo . pone.0162305 (accessed September 17, 2020), p.3; J. Edwards, Ghanas Mental Health Patients Confined to Prayer Camps. The Lancet 383: 9911 (2014), doi: 10.1016/s0140-6736(13)62717-8 (accessed September 17, 2020), pp. 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 Keep up with the latest data and most popular content. 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. 2200A (XXI), 21 U.N. GAOR Supp. [45] Human Rights Watch interview with Dr. Kafayah Ogunsola, psychiatrist, Lagos, September 26, 2018; Karoon, What is the state of mental health in Thailand?, post to Pacific Prime Thailand (blog),June 24, 2019, https://www.pacificprime.co.th/blog/state-of-mental-health-in-thailand/(accessed March 23, 2020); Melinda Benjamin, The Promotion of Mental Health Awareness in Cambodia, Borgen Magazine,August 1, 2019,https://www.borgenmagazine.com/mental-health-awareness-in-cambodia/(accessed March 19, 2020); Nivendra Uduman, Mental Health and Stigma in Sri Lanka, post to Ground Views (blog), February 19, 2018, https://groundviews.org/2018/02/19/mental-health-and-stigma-in-sri-lanka/ (accessed March 23, 2020); Mark Tilly,TV series to fight mental health stigma, Khmer Times, August 25, 2017,https://www.khmertimeskh.com/79742/tv-series-fight-mental-health-stigma/(accessed March 19, 2020); Human Rights Watch, We Are Also Dying of AIDS, 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, Southern African Institutefor Policy and Research,August 19, 2013, http://saipar.org/wp-content/uploads/2013/09/Allen-and-Green_Discrimination-and-Stigmitisation_Final-DraftCorrected.pdf (accessed April 2, 2020); Jane Chung,Disabled South Koreans Protect Inhumane Benefits System, Reuters, October25, 2012, https://www.reuters.com/article/us-korea-disabled/disabled-south-koreans-protest-inhumane-benefits-system-idUSBRE89O05X20121025 (accessed March 23, 2020); International Federation for Human Rights and Taiwan Association for Human Rights,The Hidden Face of Taiwan: Lessons learnt from the ICCPR/ICESCR review process,April2013,https://www.refworld.org/pdfid/51e799594.pdf(accessed March 23, 2020); M. Bari Qasem Saleh and A. Mohamed Makki,Mental Health in Yemen: Obstacles and Challenges, International Psychiatry,5.4(2008),https://www.cambridge.org/core/services/aop-cambridge-core/content/view/2F6080907180CF8B9BE1296B6C9D0360/S1749367600002277a.pdf/div-class-title-mental-health-in-yemen-obstacles-and-challenges-div.pdf(accessed March 18, 2020), pp. Some individuals in Hebron Prayer Camp, north of Accra, Ghana were denied food for up to seven days. 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. A special thank you to the Swedish Postcode Lottery; the Samuel Family Foundation; Tracy and Bruce Simpson; Cristina Sainz and Enrique Prez-Hernndez; Renaud and Marina de Planta; Kiran Chandaria; and Nadge and Christophe Hentsch for the financial support that made this research and report possible. [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. 14; Protocol of San Salvador, art. [43] Human Rights Watch, Like A Death Sentence, https://www.hrw.org/sites/default/files/reports/ghana1012webwcover.pdf; Treated Worse Than Animals, https://www.hrw.org/sites/default/files/report_pdf/india1214.pdf; Living in Hell: Abuses against People with Psychosocial Disabilities in Indonesia, March 2016, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf. CRPD/C/GC/1 (2014), http://daccess-ods.un.org/access.nsf/Get?Open&DS=CRPD/C/GC/1&Lang=E, para. 24-64; Treated Worse Than Animals: Abuses against Women and Girls with Psychosocial or Intellectual Disabilities in Institutions in India, December 2014, https://www.hrw.org/sites/default/files/report_pdf/india1214.pdf, p. 34; We Are Also Dying of AIDS: Barriers to HIV Services and Treatment for Persons with Disabilities in Zambia, July 2014, https://www.hrw.org/report/2014/07/15/we-are-also-dying-aids/barriers-hiv-services-and-treatment-persons-disabilities; Like A Death Sentence: Abuses against Persons with Mental Disabilities in Ghana, October 2012, https://www.hrw.org/sites/default/files/reports/ghana1012webwcover.pdf, pp. 12. The demand for mental health services is stronger than ever, with nearly six in 10 (56%) Americans seeking or wanting to seek mental health services either for themselves or for a loved one. CAB/LEG/67/3 rev. Authors Samuel V Nickels 1 , Mariely Campos Tomasino 2 , Nelson A Flamenco Arvaiza 2 , Cynthia A Hunter 3 Affiliations A combined federal, state, local view of how funds flow in and out. 1, Equal recognition before the law, U.N. Doc. 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 [63], In China, a six-part series by the government-controlled Global Times and Beijing News reported that people with mental health conditions were shackled or locked in cages across the country with approximately 100,000 cage people in the northern Hebei province alone, near Beijing. 2. Malaki went from playing football in the Nyarugusu camp in Tanzania to the 2019 Special Olympics World Games in Abu Dhabi, United Arab Emirates. Many think disability is a curse resulting from evil spirits. [146], International and regional human rights law expressly prohibits discrimination and requires parties to these conventions to take steps to eliminate all forms of discrimination against individuals, including persons with disabilities. 14(1)(b); CRPD Committee, Statement on article 14 of the Convention on the Rights of Persons with Disabilities, September 2014, http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=15183&LangID=E#sthash.ErjRRg0s.9wBvLiwR.dpuf (accessed August 12, 2020). [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. 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.