On World Mind Matters Day (5th September 2016), we should all be playing a role in helping to fight for equal rights for all people with mental illness across the world. After all, we are all born free both in dignity and in rights, so why is it that individuals who go on to develop and experience mental illness are seen as a soft target for discrimination? This discrimination is damaging, derogatory, and demeaning, thereby making individuals with mental illness and their carers, second class citizens.
To mark this year's World Mind Matters Day, the World Psychiatric Association (WPA) published the Social Justice in Mental Illness report that revealed the results of a global survey of 193 United Nation Member States. The WPA team studied the countries' laws for discrimination in areas of employment, voting rights, funding, and other potential aspects of individual functioning.
Not entirely surprising, a vast number of UN member states prohibited marriage (37 per cent) and voting (36 per cent) for people with mental illness. In over half of countries, there was no explicit protection in laws against dismissal/termination/suspension of employment on grounds of health reasons including mental health problems. In nearly a quarter of countries, there are no laws preventing discrimination in the recruitment of people with mental health problems. As might be expected, there was a clear difference between high versus low income countries - dedicated mental health legislation was present in 77% of high income countries, compared with only 39% of low income countries. Definitions of mental illness varied thereby making them easy to mis-interpret.
In 2015, the UN recognized the promotion of mental health and well-being as a health priority within the global development agenda. The country's leaders committed to the prevention and treatment of non-communicable diseases, including behavioural, developmental and neurological disorders. However the UN still has a long way to go before this level of commitment trickles down to the people that really matter - those affected by mental illness.
For the UN goals to be met, there are some important steps that need to be taken before we can improve the care of people with mental illness and who can and should contribute actively to society.
The extent of the lack of protection against discrimination in so many countries, led the WPA to draft the Bill of Rights for Individuals with Mental Illness. In it ALL governments are urged to ensure that persons with mental illness/mental disability/mental health problems are not discriminated based on their mental health status, and are treated as full citizens enjoying all rights on an equal basis with others.
People with mental illness have the capacity to hold and exercise their rights and should, be treated on an equal basis with other citizens. The challenge for policy-makers, clinicians, and individuals with mental illness is now to fight discrimination using strategies similar to civil liberties, gender equality, sexual minority (LGBT) communities, which in many parts of the world have proven to be successful. Clinicians around the globe must work with patients, their carers, and their families, as well as relevant organizations representing these groups, to challenge discrimination; change laws; and ensure that these are applied equally. There is simply no explanation for continuing discrimination against individuals with mental illness, their families, and those who care for them, whether they are professional or lay carers.
The full report is published in the latest issue of International Review of Psychiatry (http://www.tandfonline.com/toc/iirp20/current)
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