lack of mental health services in el salvador lack of mental health services in el salvador

Malakis story helped shape his community to be more inclusive and accepting. [144] International Covenant on Civil and Political Rights (ICCPR), adopted December 16, 1966, G.A. 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. Typically, people in these centers have been placed there by their families or by local police, some forcibly. [123] Human Rights Watch interview with Halima Gani, woman with a psychosocial disability, Kano, Nigeria, September 23, 2019. 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. A/6316 (1966), 999 U.N.T.S. As part of the project, WHO developed a toolkit with practical information and resources for countries to assess and improve the quality of and human rights standards in mental health services. Single session therapy has a lot of potential because its focused on giving the most help we can in the shortest amount of time, he says. (No. [101] Most cages are so narrow that the men cannot even stretch out their arms. [29] WHO, Mental Health, https://www.who.int/news-room/facts-in-pictures/detail/mental-health. Human Rights Watch visit to Holy Ghost Coptic Church of Africa, Kisumu, February 18, 2020. [177], The CRPD further provides that health information be accessible to persons with disabilities and that the delivery of health services not discriminate on the basis of disability. [119] International Covenant on Civil and Political Rights (ICCPR), adopted December 16, 1966, G.A. In a privately-run social care institution in Russia, staff regularly brought people with psychosocial disabilities to the dining hall chained to each other and forced them to eat in handcuffs. 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). Lt. Gov. Coleman promotes administration's Education First Plan [147] Non-discrimination is one of the cardinal principles on which the CRPD is grounded. [28] WHO, Mental Health ATLAS 2017 Member State Profile: Kenya, 2018, https://www.who.int/mental_health/evidence/atlas/profiles-2017/KEN.pdf?ua=1 (accessed June 22, 2020); Mohan Isaac et al., Postgraduate training in psychiatry in Asia, Current Opinion in Psychiatry, vol. The rate of mental health workers in low-income countries is fewer than 2 per 100,000 people, compared with over 70 in high-income countries. hospital bed.[60]. [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. 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. 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 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. Human Rights Watch research found that in institutions and healing centers visited, people with psychosocial disabilities often live in severely overcrowded and unhygienic conditions. It was like my mind had gone blank on account of the fright, she said. I have to go to the toilet in a bucket. In situation of conflict or crises, and more recently during the Covid-19 pandemic, people who are shackled are at greater risk because they are unable to leave or flee. But Garca Rivera says that in light of the crisis in Central America, psychologists must do more than conduct research, provide clinical services and design community interventions. [109] When his community went into lockdown and Sodikin lost access to community-based mental health services, his family was unable to support him and locked him in a room. Res. In Indonesia, 57,000 people with mental health conditions have been in pasung (shackles) at least once in their lives. Black Men & Mental Health: Stigma & Challenges Talkspace Photo montage of people being shackled for weeks, months, and sometimes even years in Indonesia, Nigeria, Ghana, and Morocco. To date, about 20 out of Indonesias 34 provincesincluding Central Java, West Nusa Tenggara, East Java, Jambi, Yogyakarta, and Acehhave a functional pasung-free initiative. There are no statistics on the scale of shackling at a global level. The Black community, in particular, is affected by mental health, often due to: Lack of health insurance. The term psychosocial disability describes conditions commonly referred toparticularly by mental health professionals and mediaas mental illness or mental disorders. The Convention on the Rights of Persons with Disabilities recognizes that disability is an evolving concept and that it results from the interaction between people with impairments and social, cultural, attitudinal, and environmental barriers that prevent their full and effective participation in society on an equal basis with others. It is typically an administrative process and does not contain any provisions for judicial oversight. [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. 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. 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. [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). Gangs often threaten teens or adults with rape or murder, forcing entire families to flee their homes (World Report 2019, Human Rights Watch). [127] Human Rights Watch, Living in Hell, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf; 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. [67], In countries where people believe mental health is a spiritual issue and robust mental health services are lacking, private institutions and faith-healing facilities flourish. A young woman raised by her grandmother in Honduras leaves to reunite with her parents after more than a decade. Help us! [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. [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. I was fearful that someone would attack me during the nights, without being able to defend myself because of being shackled.[89], People end up living shackled in institutions for long periods because their relatives do not take them home and the institution has nowhere to send them. 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. Stigma and fear of contracting the disease are also delaying people from seeking medical care, sometimes with fatal consequences. CAB/LEG/24.9/49 (1990), entered into force November 29, 1999, art 14. 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. [138] Human Rights Watch phone interview with Joshua Duncan, program manager, Mental Health Coalition of Sierra Leone, September 25, 2020. [20] In low-income countries, government mental health spending decreases to less than 1 percent of health budgets with less than US $0.25 spent annually per person on mental health, compared to $80 in high income countries. The Protocol of San Salvador has been ratified by Argentina, Bolivia, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, and Peru. 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. 58. El Salvador's own 2015 National Survey on Non-communicable Diseases (NCDs) in the Adult Population -which the World Bank helped fund- revealed high levels of factors that can trigger non-communicable diseases, such as sedentary lifestyles, at-risk drinking, smoking, poor nutritional choices on salt, sugar or highly processed foods. Depression is the most common mental illness in the world. 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. The World Health Organization's new Mental Health Atlas paints a disappointing picture of a worldwide failure to provide people with the mental health services they need, at a time when the COVID-19 pandemic is highlighting a growing need for mental health support.The latest edition of the Atlas, which includes data from 171 countries, provides a clear indication that the increased attention . [24] Human Rights Watch, Living in Hell: Abuses against People with Psychosocial Disabilities in Indonesia, March 2016, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf, pp. [55] In some countries, Human Rights Watch also found evidence of people with intellectual disabilities being shackled. [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. 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. It doesnt feel right; it makes me sad. (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. [40] Human Rights Watch interview with Ridha, family member, September 2020 (full name and details withheld). While mental illness, including addictions, has become more top of mind for the media and Canadians in general over the past few years, it's fair to say that most people still don't have a true understanding of just how big, onerous, and potentially damaging the crisis really ison both a societal and personal level. 49) at 167, U.N. Doc. [16] WHO, Gender and Women's Mental Health, https://www.who.int/mental_health/prevention/genderwomen/en/. Support for Central Americans. In 2010, Indonesias health ministry launched the Indonesia Free from Pasung, a program that aimed to eradicate the practice by 2014. [45]In urban as well as rural areas in numerous countries there is a widespread belief that mental health conditions are the result of a variety of factors, including witchcraft, black magic, a curse, past sins, or possession by evil spirits or the devil. Media@TheNationalCouncil.org In many of the countries where Human Rights Watch conducted research for this report, there is a widespread belief that mental health conditions are the result of possession by evil spirits or the devil, or the consequence of some form of sin, displaying immoral behavior, orfor those whose families are adherents of certain religionshaving a lack of faith. [175] Availability refers to the presence of functioning healthcare facilities, trained personnel, as well as adequate supply of medication. 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. 25, 27, 52; I Needed Help, Instead I Was Punished: Abuse and Neglect of Prisoners with Disabilities in Australia, February 2018, https://www.hrw.org/report/2018/02/06/i-needed-help-instead-i-was-punished/abuse-and-neglect-prisoners-disabilities; Living in Hell: Abuses against People with Psychosocial Disabilities in Indonesia, March 2016, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf, pp. This report includes research and testimonies collected by 16 Human Rights Watch researchers in their own countries. 1, Equal recognition before the law, U.N. Doc. [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]. Victor, a patient from Soyapango, told MSF that his grandfather has chronic health problems and has to have his catheter changed every few months. CRPD/C/GC/1 (2014), http://daccess-ods.un.org/access.nsf/Get?Open&DS=CRPD/C/GC/1&Lang=E, para. A World Health Organization (WHO) video describes it as a black dog that follows you everywhere, does not let you sleep or eat well. Families or staff in institutions often make the person who is shackled stay naked, dress in very scant clothing, or wear an adult diaper, so it is easier for them to keep the person clean and they do not have to regularly wash soiled clothing. Traditional or spiritual healing centers are also considered types of rudimentary institutions. Target support toward community-based support and services, including mental health services. 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. 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). Of the 61 countries considered in this report, 56 are party to ICCPR, 57 are party to ICESCR, 59 are party to CEDAW, 55 are party to CAT, 61 are party to CRC, and 59 are party to CRPD. Mental health professionals' skills comprise a potentially robust . 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. [32], The cost of neglecting mental health is significant; the global economy loses roughly $2.5 to $8.5 trillion per year as a result of reduced economic productivity. Conduct public information campaigns to raise awareness about mental health conditions and the rights of people with disabilities, especially among alternative mental health service providers and the broader community, in partnership with people with lived experiences of mental health conditions, faith leaders, and media. Travel restrictions have since been lifted but outpatient consultations at hospitals and health units remain suspended. 2200A (XXI), 21 U.N. GAOR Supp. 16) at 52, U.N. Doc. [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. Portland students sat down with U.S. Department of Health and Human Services Secretary Xavier Becerra at Faubion K-8 in Northeast Portland Monday to discuss youth mental health. 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]. [111] People interviewed said there was too little food, sometimes only one meal a day. Instead, many turned to unreliable resources for information, including Facebook, YouTube and Twitter. [74] In Togo, prophets can lock up and chain up to 150 people in a single prayer camp. In 2020, among the 14.2 million adults with SMI, 9.1 million (64.5%) received mental health treatment in the past year. COVID-19 presents a serious threat to both physical and mental health, but policymakers in Indonesia have so far mostly . Malaki went from playing football in the Nyarugusu camp in Tanzania to the 2019 Special Olympics World Games in Abu Dhabi, United Arab Emirates. 37; CRPD, art. Since then Ive been living on the streets. This is in part due to a lack of government support and monitoring. While Gov. Due to these perceptions, people dont want to help or mingle with persons with disabilities.[50], Ying, a young woman from Goungdong province, in southern China, said: All through my childhood, my aunt was locked in a wooden shed and I was forbidden to have contact with her. The government identifies shortage areas so it can address them with proper resources. 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. [126] In healing centers in countries such as Nigeria and Indonesia, men and women are chained next to each other, leaving women no option to run away if they encounter abuse.[127]. 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, 40, entered into force November 25, 2005. We are seeing an increase in the number of people dying in their homes before our ambulance services arrive, said Luis Romero Pineda, MSF project coordinator in El Salvador. Human Rights Watch calls on the international community and national governments to ban shackling, adopt measures to reduce stigma against people with psychosocial disabilities, and develop adequate, voluntary, and community-based mental health services.