Some institutions are an extension of the faith healers house or situated at a secluded end of the compound. 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. Specifically, younger Americans need more information on how and where to access care. Two months ago, social protection officials tried to discharge me from the hospital and send me to my sisters house, but she refused. 31, The Right to Health, http://www.ohchr.org/Documents/Publications/Factsheet31.pdf (accessed September 22, 2020), pp. An estimated 122 million Americans, or 37% of the population, lived in 5,833 mental health professional shortage areas as of March 31. In Yemen, Human Rights Watch documented the case of a woman with a perceived mental health condition who was chained to a door handle so she would not wander outside. Provide training to broader membership, including at grassroots levels, about the rights of people with psychosocial disabilities. UNHRC, Follow up report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment on his follow-up visit to the Republic of Ghana, Session 31, A/HRC/31/57/Add.2, February 25, 2015, People with Mental Health Conditions Living in Chains, https://www.hrw.org/report/2020/06/04/better-make-yourself-invisible/family-violence-against-people-disabilities-mexico, https://www.hrw.org/news/2019/11/11/nigeria-people-mental-health-conditions-chained-abused, https://www.hrw.org/sites/default/files/report_pdf/kazakhstan0319_web3.pdf, https://www.hrw.org/sites/default/files/report_pdf/iran0618_web_1.pdf, https://www.hrw.org/sites/default/files/report_pdf/somaliland1015_forupload_0.pdf, https://www.hrw.org/sites/default/files/report_pdf/india1214.pdf, https://www.globaltimes.cn/content/928917.shtml, http://www.bjnews.com.cn/feature/2013/07/11/272800.html, https://www.scmp.com/news/china/society/article/2021288/mentally-ill-chinese-girl-8-roped-tree-outside-grandparents, https://www.hrw.org/report/2012/10/02/death-sentence/abuses-against-persons-mental-disabilities-ghana, https://www.pih.org/article/celebrating-new-possibilities-sierra-leones-only-psychiatric-hospital, https://undocs.org/en/A/HRC/31/57/Add.2,para. Clinical psychologists usually need a Doctor of Philosophy in psychology (PhD) or a Doctor of Psychology (PsyD) degree. Lack of or poor communications with coworkers. For example, ECAP, a Guatemalan organization whose name translates to the Community Studies and Psychosocial Action Team, works primarily with indigenous women and children to seek gender equity and restorative justice for past crimes. Target support toward community-based support and services, including mental health services. 202-621-1631. For example, Ghana has several hundred prayer camps, but precise numbers are difficult to come by since they are not state-regulated. PDF Profile El Salvador April 2008 - PAHO El Salvador: Deaths increase as health system collapses Share this via WhatsApp [10] Human Rights Watch interview with Carlos [not his real name], man with a psychosocial disability, Maputo, November 20, 2019. lack of mental health services in el salvador - Lindon CPA's None of my relatives want anything to do with me. In China, about 100,000 people are shackled or locked in cages in Hebei province alone, near Beijing. 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 I eat here once a day. [15] Discrimination, gender-based violence, socioeconomic disadvantage, income inequality, subordinate social status and the pressure of multiple roles are among the most cited at-risk factors that contribute to poor mental health among women. [65], In Indonesia, according to government data, 57,000 people with mental health conditions have been in pasung (shackled) at least once in their lives with approximately 15,000 still living in chains as of November 2019. 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. Ukraine: MSF teams treating patients after missile attack on residenti Bangladesh: New cuts to food rations will have dire health impacts on Somalia and Somaliland: Indiscriminate fighting affects medical care i Mdecins Sans Frontires 2023 [144] The CRPD has been ratified by 181 countries around the world. [129] The Mental Healthcare Act, 2017, https://www.prsindia.org/uploads/media/Mental%20Health/Mental%20Healthcare%20Act,%202017.pdf (accessed September 22, 2020), art. In El Salvador, for instance, an underfunded and corrupt police force, unable to maintain public safety, has helped spur the formation of gangs as de facto authorities across most of the country (Life Under Gang Rule in El Salvador, International Crisis Group, 2018). 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). The ACHR has been ratified by Argentina, Bolivia, Chile, Colombia, the Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, and Peru; Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights (Protocol of San Salvador), O.A.S. In 2019, this happened to [our teams] 11 times from January to June. Instead, many turned to unreliable resources for information, including Facebook, YouTube and Twitter. E/C 12/2000/4, 2000, https://undocs.org/E/C.12/2000/4 (accessed September 23, 2020), paras. Comprehensively investigate state and private institutions in which people with mental health conditions live, with the goal of stopping chaining and ending other abuses. [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. Help us! 48, 51; I Am Equally Human: Discrimination and Lack of Accessibility for People with Disabilities in Iran, June 2018, https://www.hrw.org/sites/default/files/report_pdf/iran0618_web_1.pdf, pp. People end up living shackled in institutions for long periods because their relatives do not come to take them home and the institution has nowhere to send them. 10, 13. 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 The government identifies shortage areas so it can address them with proper resources. "We took him to a hospital in San Salvador where he was asked to go to one in Soyapango, and from there to another, said Victor. and Zambia. In Mexico, for example, children with psychosocial disabilities in one institution were fully wrapped in bandages, duct tape or clothing, like mummies. I want to look around outside, go to work, plant rice in the paddy fields. 2(1); CEDAW, art. Gangs often threaten teens or adults with rape or murder, forcing entire families to flee their homes (World Report 2019, Human Rights Watch). Individuals were either crowded in the few spots where there was shade or baked in the sun. In 2020, among the 14.2 million adults with SMI, 9.1 million (64.5%) received mental health treatment in the past year. Two-thirds of shortage areas are in rural or partially rural parts of the country. Roxanna Alizadeh, Elise Fabre, Alexis Kallen, and Liam Turnbull, interns in the Disability Rights Division, provided important research support. 15; CAT; ACHPR, art.5; ACHR, art. [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. 108(e); United Nations Educational, Scientific, and Cultural Organization (UNESCO), Universal Declaration on Bioethics and Human Rights, adopted October 2005, SHS/EST/05/CONF.204/3 REV, arts. For example, in Yemen, Amnesty International documented cases of people with psychosocial disabilities who were unable to flee from violence because they were chained. [21] WHO, Mental Health in the Western Pacific, undated, https://www.who.int/westernpacific/health-topics/mental-health (accessed June 17, 2020). In Guatemala, hundreds of children with psychosocial or intellectual disabilities were tied to furniture or locked in cages in orphanages and institutions. A number have also signed the African Charter on the Rights and Welfare of the Child (ACRWC). In an effort to make the Northern Triangle safer and more humane for the millions of people who live there, psychologists are providing psychosocial support for trauma survivors, designing and delivering preventive community workshops and studying what drives residents to migrate north. These individuals are skewing younger and are more likely to be of lower income and have a military background. [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. Shackling is a rudimentary form of physical restraint used to confine people with real or perceived psychosocial disabilities. [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. 37. One mother in Bali, Indonesia shared why she chained her son with a mental health condition for over 10 years: Due to prevalent stigma and inadequate support services, families often struggle to cope with the demands of caring for a relative with a psychosocial disability and feel they have no choice but to shackle them. Institutions: Refers to state-run (unless specified otherwise) psychiatric hospitals, government social care or nongovernmental organization-run residential facilities. Res. Res. Poor communication with health care providers is often an issue. [98] Human Rights Watch interview with Aisha [not her real name], family member, Gaza, February 15, 2020. [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. [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. 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. The bill, in its current draft, provides the authorities with unfettered powers to arbitrarily strip people with mental health conditions of their civil liberties. 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? [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. It is comprised of a two-pronged research project that includes an online survey of 5,000 American adults, and a robust analysis of third-party data measuring patients access to mental health services in terms of four pillars providers, facilities, funding and perceived satisfaction among patients. Because we currently lack the needed resources many of our. The lack of constitutional guarantees or specific protection mechanisms for LGBTI people in El Salvador has fostered systematic and institutionalized violence and discrimination against them. The exchange, co-founded by clinical psychologist Leticia Gonzalez Pileski, PsyD, and Jason Platt, PhD, a counseling psychologist based in Mexico City, holds one-day conferences where students discuss their work in liberation psychology and organizes trips to war-torn areas of El Salvador to help survivors preserve cultural memory about the violence they endured. In Guatemala, we tend to be reactive, she says. 2. Shelter was a major concern for people shackled outdoors without a roof over their heads, protection from the sun or rain, and with constant exposure to mosquitoes and pests. 14; Protocol of San Salvador, art. Many spiritual healing centers that Human Rights Watch visited were located in open fields or forests; some operated out of structures that were half-built and offered only a rooftop for shelter. Of the 60 countries where Human Rights Watch found evidence of shackling, only a handful have laws, policies or strategies in place that explicitly ban or aim to end shackling of people with mental health conditions. 171, entered into force March 23, 1976; International Covenant on Economic, Social and Cultural Rights (ICESCR), adopted December 16, 1966, G.A. [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. Mexico ignores mental health - El Universal 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. 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. 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. [5] World Network of Users and Survivors of Psychiatry, Implementation Manual for the United Nations Convention on the Rights of Persons with Disabilities, February 2008, http://www.wnusp.rafus.dk/documents/WNUSP_CRPD_Manual.doc (accessed December 20, 2015), p. 9. Wyoming and Utah have the largest proportion of population living in mental health shortage areas, at 96.4% and 83.3%, respectively. Of all sectors of health care, mental health is best equipped to stand against racism. [138] Until 2018, people with mental health conditions being admitted to the psychiatric hospital were asked to pay for a padlock and chain prior to admission. [55] Shackling is also used in church-affiliated prayer camps, traditional or religious healing centers as well as in state-run or private social care institutions as a form of restraint, punishment, or treatment.[56]. [22] WHO, Mental health: massive scale-up of resources needed if global targets are to be met, June 6, 2018, https://www.who.int/mental_health/evidence/atlas/atlas_2017_web_note/en/ (accessed July 22, 2020). 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. 6. [52] This, in part, contributes to the acute shortage of mental health professionals. 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. 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. [69] In 2019, large prayer camps such as Mount Horeb detained dozens of people in chains. [14] "Suicide: One Person Dies Every 40 Seconds," WHO news release, September 9, 2019, https://www.who.int/news-room/detail/09-09-2019-suicide-one-person-dies-every-40-seconds (accessed September 22, 2020). [65] Viola Zhou, Mentally ill Chinese Girl, 8, Roped to Tree Outside by Grandparents for Nearly Six Years, South China Morning Post, September 21, 2016, https://www.scmp.com/news/china/society/article/2021288/mentally-ill-chinese-girl-8-roped-tree-outside-grandparents (accessed July 28, 2020). [49] Human Rights Watch interview with Benjamin Ballal, survivor of shackling and secretary general for cultivation at Cultivation for Users Hope, Nairobi, February 15, 2020. Budget allocations for mental health care are barely 1% of the total health care budgets; and the psychiatric hospitals located in the national capitals consume at least 90% of those funds. Even in Guatemala, which has about 7,700 mental health professionals and 16 million people, rural areas are vastly underserved (Healthcare Access and Conditions in Guatemala, Honduras and El Salvador, Centers for Disease Control and Prevention, 2017).
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