HEALTH-RIGHTS: WHO Turns Spotlight on Mentally Disabled

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

MEXICO CITY, Apr 6 2001 (IPS) - If you are diagnosed with a mental disability in Hungary, your identity card is often taken away, making it difficult for you to indulge in such common activities as borrowing a book from a library.

And if you are a patient in one of the country’s mental health facilities, you may be “locked in cages for months at a time” because there is not enough staff to provide basic care.

Such forms of discrimination and harsh treatment, however, are also common beyond the borders of that central European country. Research done in over 15 countries across Europe and Latin America by Mental Disability Rights International (MDRI) reveals that children and adults with mental disabilities are often subjected to treatment that are equally “inhuman and degrading”.

“Throughout the world, people with mental disabilities face pervasive discrimination, abuse, neglect and segregation from society,” says Brittany Benowitz, a programme associate at MDRI, a Washington D.C.-based non-governmental organisation (NGO). “Children and adults with mental disabilities are routinely and arbitrarily detained in psychiatric facilities, orphanages and other closed institutions around the world.”

What is more, reveals the World Health Organisation (WHO), the combination of “gross human rights violations in mental hospitals” and the lack of efficient community-based health services tailored for mental health patients are “only some of the trials” faced by people with such health disabilities.

But the Geneva-based health body is determined to confront such an abusive trend by drawing global attention to this problem. Thus, it has chosen to focus on mental health for this year’s World Health Day, on Apr. 7.

In addition, the theme of World Health Day, ‘Stop Exclusion – Dare to Care’, also sums up the focus of a year-long campaign that will culminate in the World Health Report on mental health to be released later this year.

“An estimated 400 million people today suffer from mental or neurological disorders,” states the WHO. Of that number, an estimated 288 million people are affected by alcohol-related problems and some 60 million are afflicted with mental retardation.

In addition, reveals the WHO, there are over 40 million registered cases of epilepsy, some 20 million cases of dementia and close to 45 million with schizophrenia.

Nevertheless, it adds, few patients are diagnosed correctly and few receive treatment that is available to reduce suffering and the accompanying disability.

“Governments have been remiss in that they have not provided adequate means of treatment to their people,” said Dr. Gro Harlem Brundtland, director-general of the WHO, in a press release.

In India, for instance, the treatment rates for patients with schizophrenia and epilepsy are estimated at 20 percent in contrast with 80 percent treatment rates for the same disorders in industrialised countries. While in countries that make up sub-Saharan Africa, treatment rates for depression are estimated at around five percent.

According to public health experts, the stigma associated with mental disabilities and prevailing levels of discrimination have played a major part in keeping the mentally disabled from receiving proper care.

In many parts of the world, people with mental disabilities are often “hidden behind closed doors and become a family secret that no one wants to talk about or acknowledge”, says a WHO spokesperson. “People with epilepsy are still tied to trees or locked in rooms until they are willing to ‘behave’ themselves.”

What compounds their situation furthermore, adds Benowitz, is the difficulty they have attracting a sympathetic ear. “People with mental disabilities, due to their inability to speak for themselves and due to the fact that their words are discredited because of stigma, are among the most vulnerable people in the world.”

According to MDRI, the marginalisation of the mentally disabled is evident among those funding development programmes and human rights organisations, too. For instance, development programmes committed to assisting vulnerable populations “often fail to make their grants accessible to people with mental disabilities”.

And human rights organisations rarely call into question the abuse of people with mental disabilities, affirms Benowitz. “Major human rights groups whose mandates require oversight of places of detention exclude psychiatric facilities from their investigations.”

As a result, the plight of vulnerable groups such as Russian children with mental disabilities are ignored. These children, who are often deemed “uneducable” are placed in “lying down rooms” or left abandoned in their cribs with no human contact.

“In Mexico, we saw children and adults who became dependent on wheelchairs or lost their limbs due to the misuse of restraints, inadequate physical therapy and insufficient staff,” reveals Benowitz. “In some institutions, people are literally left to starve or freeze to death.”

However, Benowitz admits, there have been attempts to address such human rights abuses. Last April, for instance, the UN Commission on Human Rights declared that “any violation of the fundamental principle of equality or other negative differential treatment of persons with mental disabilities … is an infringement of the human rights of persons with disabilities”.

But, as the WHO observes, the world’s mentally disabled have still to benefit from such guarantees that protect their rights. “Rare is the family that is free from an encounter with mental disorders, yet almost universal are the shame and fear that prevent people from seeking care.”

In addition, says Dr. Michelle Frank, who handles human rights and mental health at the WHO, rights are also violated through the “involuntary admission” and “involuntary treatment” of the mentally disabled.