by Eleanor J. Bader May 12, 2021 9:25 AM Expand A couple watches as workers bury the bodies of people who died from COVID-19 in El Salvador. 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. This report includes research and testimonies collected by 16 Human Rights Watch researchers in their own countries. In many healing centers, in countries such as Nigeria and Indonesia, men, women, and children were chained next to each other, leaving them no option to escape if they encountered abuse from staff or other chained individuals. A combined federal, state, local view of how funds flow in and out. More in This Topic Guide. I forgot him. If Dylan could get services from HCS, he could live at home. In its 2018 Concluding Observations the Human Rights Committee noted El Salvador's lack of legislation in this aspect. Out of the 110 countries on which we conducted research, we found cases of shackling of people with psychosocial disabilities across 60 countries. James, a man with a psychosocial disability who has been chained for several years in a Christian healing institution in Kenya, said: They cane us if we make a mistake. The Convention on the Rights of the Child states that under the convention, a child means every human being below the age of 18 years unless under the law applicable to the child, majority is attained earlier.[1], Disabled Persons Organizations (DPOs): Organizations in which persons with disabilities constitute the majority of members and the governing body and that work to promote self-representation, participation, equality, and integration of persons with disabilities.[2]. Poor communication with health care providers is often an issue. For the programs nationwide rollout, the Health Ministry trained 25,000 master trainers to train three to five staff members in every community health center across Indonesia. [104] Human Rights Watch visit to an NGO-run institution in Herat, Afghanistan (name and details withheld). Top photo: A young boy in El Salvador, where children face multiple threats to their safety and well-being including gang violence. One of their most surprising findings was that deported children did not experience greater psychological harm than a control group of Salvadoran children who remained in the country (El Salvador, in Childhood and Migration in Central and North America: Causes, Policies, Practices and Challenges, 2015). 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. [23] Consequently, instead of walking a short distance to a primary health center, families may have to give up a days work to travel to reach a psychiatric hospital. (London, October 6, 2020) Hundreds of thousands of people with mental health conditions are shackled around the world, Human Rights Watch said in a report released today. Platt also teaches classes in El Salvador to local clinical psychologists and psychology students on single session therapy, a solution-focused behavioral practice that aims to serve marginalized communities that may struggle to access psychological treatment because of isolation and limited resources. Nevertheless, Mexico needs at least 12,000 psychiatrists. [66] Human Rights Watch, Living in Hell, https://www.hrw.org/report/2016/03/20/living-hell/abuses-against-people-psychosocial-disabilities-indonesia, p. 35; Ministry of Health of Republic of Indonesia, Stop Stigma and Discrimination to People with Mental Disorder, October 10, 2014, http://www.depkes.go.id/article/view/201410270011/stop-stigma-dan-diskriminasi-terhadap-orang-dengan-gangguan-jiwa-odgj.html (accessed August 20, 2015); Marsel Rombe, Indonesian Mental Health Law Passed after Five Years, Jakarta Globe, July 13, 2014, http://jakartaglobe.beritasatu.com/news/indonesian-mental-health-law-passed-five-years (accessed August 19, 2015). An estimated 122 million Americans, or 37% of the population, lived in 5,833 mental health professional shortage areas as of March 31. Hannah Ritchie and Max Roser, Mental Health, Our World In Data, April 2018, https://ourworldindata.org/mental-health (accessed July 20, 2020); The World Bank, Mental Health, April 2, 2020, https://www.worldbank.org/en/topic/mental-health (accessed June 23, 2020); WHO, Mental disorders, https://www.who.int/news-room/fact-sheets/detail/mental-disorders, [12] WHO, Mental Health, https://www.who.int/news-room/facts-in-pictures/detail/mental-health. 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. In addition, as the state's . In some cases, families left fake phone numbers and addresses in order to abandon the relative, while in other cases they simply moved homes or failed to show up. CAB/LEG/24.9/49 (1990), entered into force November 29, 1999, art 14. [134] WHO, Building Back Better Sustainable Mental Health Care after Emergencies, https://apps.who.int/iris/bitstream/handle/10665/85377/9789241564571_eng.pdf?sequence=1, p. 73. 55. Mental healthcare is especially difficult due to lingering social stigmas and scarcity of services. Aisha, mother who chains her 18-year-old daughter with a psychosocial disability in the Gaza Strip told Human Rights Watch: Archbishop Danokech of the Holy Ghost Coptic Church of Africa in Kisumu, western Kenya, where over 60 men, women, and children with psychosocial disabilities are detained and most of whom are chained, told Human Rights Watch: We do not want them to wear clothes. Bobele, M., & Slive, A.In Hoyt, M.F., & Talmon, M. 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 Share this via WhatsApp 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. I am not free to walk about. 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, fasting, vigorous massages by traditional healers, Quranic recitation in the persons ear, singing Gospel hymns, and special baths. Many are held in overcrowded, filthy rooms, sheds, cages, or animal shelters and are forced to eat, sleep, urinate, and defecate in the same tiny area. In Gaza, where mental health services are scarce, Human Rights Watch found an 18-year-old woman chained by her family on a daily basis since she was 5 years old. [5]. 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. 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). [143] Standing unified with refugees at a time of crisis, sportanddev.org, September 21, 2020 (accessed September 28, 2020). 3, entered into force January 3, 1976, art. According to Indonesias 2018 Basic Health Survey (Riskesdas), 14 percent of people with serious mental health conditions have been shackled at least once in their lives and about 30 percent of them have been shackled within three months of the survey.[141]. Malakis story helped shape his community to be more inclusive and accepting. Malaki went from playing football in the Nyarugusu camp in Tanzania to the 2019 Special Olympics World Games in Abu Dhabi, United Arab Emirates. Res. But through this program, we are working to create a culture of prevention., Other psychologists have turned their attention to a frequently overlooked populationthose who have been deported from the United States, known as retornados.. "We're waiting for the equivalent of a heart attack- the suicides . And women and girls are not supported to manage their menstrual hygiene, for example through the provision of sanitary pads. In 15-minute interviews conducted while the Salvadoran immigration authorities processed migrants who had been deported from the United States for reentry into El Salvador, Gaborit and his colleagues assessed children and teens for depression, anxiety and somatization. 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. [111] People interviewed said there was too little food, sometimes only one meal a day. [101] 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. 12; CRC, art. Shackling: Traditionally defined as the practice of confining a persons arms or legs using a manacle or fetter to restrict their movement, historically used to confine slaves or prisoners. For example, in 2015 chaining was widespread in psychiatric as well as in mental health wards of general hospitals in Somaliland. The large majority of Americans (76%) also believe mental health is just as important as physical health. Although mental illness is widespread- 25% of adults in developed countries experience significant mental health problems each year- the treatment is outdated and lacking. Stigma and fear of contracting the disease are also delaying people from seeking medical care, sometimes with fatal consequences. The losses of productivity caused by poor mental health include but are not limited to the following: Negative job performance. Despite being commonly 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. Its heart-breaking that two of my cousins who have mental health conditions have been locked away together in a room for many years. [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. Mental Asylum, The Hindu, January 3, 2019, https://www.thehindu.com/news/national/sc-shocked-at-chaining-of-inmates-in-up-mental-asylum/article25901395.ece (accessed August 17, 2020). Child: The word child, boy, or girl in this report refers to someone under the age of 18. [81] UNHRC, Report of the Special Rapporteur on rights of persons with disabilities, Catalina Devandas-Aguilar, A/HRC/40/54, https://undocs.org/en/A/HRC/40/54, pp.6, 12. They dont want to socialize with me because my mental health condition brings shame on them. [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. 49) at 167, U.N. Doc. 16; ACRWC, art. [119] International Covenant on Civil and Political Rights (ICCPR), adopted December 16, 1966, G.A. [103] Colectivo Chuhcan A.C., Disability Rights International, EQUIS Justice for Women A.C., Information Group on Elected Reproduction (GIRE), Transversal, Action on the Rights of People with Disabilities A.C., and the Mexico Childrens Rights Network (REDIM), "Alternative Report by Mexican Civil Society Organizations Submitted to the Committee on the Rights of Persons with Disabilities: 2014-2019," 2019, https://www.driadvocacy.org/wp-content/uploads/Joint-Shadow-Report-CRPD-Jul2019-FINAL.pdf (accessed September 24, 2020), p. 19. ", "It is vital to improve coordination, increase the number of available beds [in health facilities] and ensure protective measures in hospitals to guarantee the safety of staff and patients, said Romero Pineda. His loving parents found him nonresponsive, with a heart rate near 200 beats per minute. [74] In Togo, prophets can lock up and chain up to 150 people in a single prayer camp. Table of Contents show. 2018 Oct 10;42:e172. [35] Office of the United Nations High Commissioner for Human Rights (OHCHR), Mental Health Is a Human Right, May 24, 2018, https://www.ohchr.org/EN/NewsEvents/Pages/MentalHealthIsAhumanright.aspx (accessed September 16, 2020); United for Global Mental Health, The Return of the Individual: Time to Invest in Mental Health, undated, https://gospeakyourmind.org/sites/default/files/2020-09/ROI_FullReport_0.pdf (accessed September 25, 2020). New Jersey and Massachusetts have the lowest proportions, at 0.4% and 4.0%, respectively. 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. [58] Human Rights Watch witnessed several people being shackled in a psychiatric hospital in northern Nigeria. 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. [146] American Convention on Human Rights (ACHR), adopted at the Inter-American Specialized Conference on Human Rights, San Jos, Costa Rica, 22 November 1966. In none of the hundreds of cases that Human Rights Watch documented were people with psychosocial disabilities allowed or given the opportunity to challenge their detention. If we want to save lives, save families and save futures we must reimagine our behavioral health system and take concrete steps to improving consumers ability to find the care they need, when they need it, and on their terms., Despite Strong Demand for Mental Health Services, Common Barriers Remain. 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. 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. Around the world, hundreds of thousands of men, women, and children with mental health conditions have been shackledchained or locked in confined spacesat least once in their lives. [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. Federal tax ID#: 13-3433452, Mdecins Sans Frontires 2022 [115] Human Rights Watch interview with Benjamin Ballal, survivor of shackling and secretary general for cultivation at Cultivation for Users Hope, Nairobi, February 15, 2020. Many people are afraid to leave their homes for fear of being judged for transmitting the disease or being taken away from family members if they are hospitalized. Despite being easy to diagnose, there is a lack of mental health experts to treat these illnesses in Mexico. In Juba and Malakal prisons, people with psychosocial disabilities were chained to the floor day and night or tied outside to tree naked, and soiled with their own excrement.[88]. The ACRWC has been ratified by Benin, Burkina Faso, Cte dIvoire, Egypt, Ethiopia, Ghana, Kenya, Liberia, Mozambique , Nigeria, Senegal, Sierra Leone, South Africa, Sudan, Tanzania, Togo, Uganda, and Zimbabwe. [76] Yulia Gorbunova, Held in Chains in Russia, commentary, Human Rights Watch Dispatch, August 8, 2017, https://www.hrw.org/news/2017/08/08/held-chains-russia. 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, Photo montage of people being shackled for weeks, months, and sometimes even years in Indonesia, Nigeria, Ghana, and Morocco. 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. Even though the healthcare system has many hospitals, clinics, and care centers, the quality of healthcare they provide is deemed inadequate. TRADEMARKS. [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. [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. support MSFs lifesaving care with a gift. If you get exhausted due to a lot of work, and so dont want to work anymore, you get caned.[124] In Nigeria, people in Islamic rehabilitation centers told Human Rights Watch that staff whipped them. Anna-Catherine Brigida reports from San Salvador about a group of ambulance workers on how they cope with the In some cases, the physical location of a mental health facility or residential care institution, next to a prison or tuberculosis sanitarium, can aggravate the stigma for mental health professionals as these locations are often perceived as being undesirable.[53]. He said that on one occasion in 2018 mental health professionals from the Dr. [131] Amit Anand Choudhary, Chaining Mentally Ill Patients Is Atrocious and Against Human Dignity: Supreme Court, Times of India, January 3, 2019, https://timesofindia.indiatimes.com/india/chaining-mentally-ill-patients-is-atrocious-and-against-human-dignity-sc/articleshow/67368856.cms (accessed August 16, 2020). 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. 66. 171, entered into force March 23, 1976; International Covenant on Economic, Social and Cultural Rights (ICESCR), adopted December 16, 1966, G.A. 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. Mental Health and Substance Use. Yet, there are very few mental health professionals, especially for the majority of the population who rely on the public health system. Feb 28, 2023. 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. Admitting patients to hospitals has also become more difficult. The . Progressively develop voluntary and accessible community-based support and services, including access to housing, education, employment, and mental health services, in consultation with people with lived experiences of mental health conditions and with the support of international donors and partners. The bill, in its current draft, provides the authorities with unfettered powers to arbitrarily strip people with mental health conditions of their civil liberties. 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. Engage spiritual and religious leaders to challenge discriminatory beliefs and practices related to psychosocial disabilities, and offer education opportunities on mental health and the rights and needs of people with psychosocial disabilities. This study of decentralization of mental health services in El Salvador supports the concerns of LAC mental health leaders and researchers that progress toward community mental health services has been slow and is far from being achieved. I want to move about, I have asked the baba [faith healer] to take them off, but he wont. [153], In its interpretation of the treaty provisions, the committee stated, At all times, including in crisis situations, the individual autonomy and capacity of persons with disabilities to make decisions must be respected.[154], The UN special rapporteur on torture has noted that shackling unequivocally amount(s) to torture even if committed by non-State actors under conditions in which the State knows or ought to know about them.[155], The core human rights treaties prohibit subjecting any person to torture or to cruel, inhuman, or degrading treatment or punishment, including non-consensual medical or scientific experimentation. [82] Mohammad Mahab, A Psychiatric Patient is Chained Inside a Mountain Hut in the Village of Sahalil, Al-Madina, December 20, 2013, https://www.al-madina.com/article/273714 (accessed September 16, 2020). There are currently no coordinated international or regional efforts to eradicate shackling. [9] WHO, Gender and Women's Mental Health, https://www.who.int/mental_health/prevention/genderwomen/en/. 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. [147] Non-discrimination is one of the cardinal principles on which the CRPD is grounded. [116] Human Rights Watch interview with Carlos [not his real name], man with a psychosocial disability, Maputo, November 20, 2019. In prayer camps in Ghana, administrators and pastors told Human Rights Watch that fasting was a key component of curing a psychosocial disability. In the U.S., mental health issues are far more common than many realize. Despite this strong demand and growing societal awareness of the importance of mental health in the U.S., the study revealed that the overwhelming majority of Americans (74%) do not believe such services are accessible for everyone, and about half (47%) believe options are limited. El Salvador 2020 Alejandra Sandoval/MSF. For example, Human Rights Watch research in Kenya found about 60 men, women, and children with real or perceived psychosocial disabilities chained, hidden from view, in the compound of the Coptic Church Mamboleo in Kisumu city in western Kenya. It made me sad [to chain him]. 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 Shelter is a major concern for people shackled outdoors at home, in prayer camps, or in open-air institutions. Human Rights Watch phone interview with Joshua Duncan, program manager, Mental Health Coalition of Sierra Leone, September 25, 2020. 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. The treaty further obligates governments to provide support as may be required to exercise their legal capacity. El Salvador is a republic with three branches of government: the Executive, the Legislature, and the Judiciary. [27] For example, there are 0.19 psychiatrists per 100,000 people in Kenya and 0.12 Some institutions are an extension of the faith healers house or situated at a secluded end of the compound. Physicians thought Bill Mitchell had dementia and could be a danger to himself or others, according to medical records. Individuals located in rural areas and of lower-income are less likely to say that mental health services are extremely accessible to them. [102] Disability Rights International, No Justice: Torture, Trafficking and Segregation in Mexico, July 22, 2015, https://www.driadvocacy.org/wp-content/uploads/Sin-Justicia-MexRep_21_Abr_english-1.pdf (accessed September 21, 2020). Findings of these visits, redacted to protect privacy rights, should be publicly reported. The ACHPR has been ratified by Benin, Burkina Faso, C, African Charter on the Rights and Welfare of the Child (ACRWC), OAU Doc. 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. 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.