World Mental Health Day 2015
Dignity and Mental Health
Article 1 of the Universal Declaration of Human Rights affirms that:
“All human beings are born equal in dignity and in rights.”
The Preamble of the UN Convention on the Rights of Persons with Disabilities states that:
“… discrimination against any person on the basis of disability is a violation of the inherent dignity and worth of the human person".
What is dignity?
Dignity refers to an individual’s inherent value and worth and is strongly linked to respect, recognition, self-worth and the possibility to make choices. Being able to live a life with dignity stems from the respect of basic human rights including:
- freedom from violence and abuse;
- freedom from discrimination;
- autonomy and self-determination;
- inclusion in community life; and
- participation in policy-making
"We, persons with mental health problems, are facing high levels of stigma and discrimination. When tagged as having a mental health problem, we experience social deprivation - losing our jobs, losing social prestige and becoming isolated from family and society." Matrika Devkota, Nepal
The dignity of many people with mental health conditions is not respected
- Frequently they are locked up in institutions where they are isolated from society and subject to inhumane and degrading treatment.
- Many are subjected to physical, sexual and emotional abuse and neglect in hospitals and prisons, but also in their communities.
- They are very often deprived of the right to make decisions for themselves. Many are systematically denied the right to make decisions about their mental health care and treatment, where they want to live, and their personal and financial affairs.
- They are denied access to general and mental health care. As a consequence they are more likely to die prematurely, compared with the general population.
- They are often deprived of access to education and employment opportunities. Stigma and misconceptions about mental health conditions means that people also face discrimination in employment and are denied opportunities to work and make a living. Children with mental health conditions are also frequently excluded from educational opportunities. This leads to marginalisation and exclusion from employment opportunities in later life.
- They are prevented from participating fully in society. They are denied the possibility to take part in public affairs, to vote or stand for public office. They are not given the opportunity to participate in decision-making processes on issues affecting them, such as mental health policy and legislative or service reform. In addition, access to recreational and cultural activities is often denied to people with mental health conditions.
“So it’s a double-edged sword when you’ve got mental health problems. You’re labelled. At home you’ve got a label, and you’re labelled in the system, so there’s not a great deal of dignity afforded to you.” Service User, United Kingdom
How can we promote the rights and dignity of people with mental health conditions?
In the health-care system we need to provide better support and care for people with mental health conditions by:
- providing community-based services, encompassing a recovery approach that inspires hope and supports people to achieve their goals and aspirations;
- respecting people’s autonomy, including their right to make their own decisions about their treatment and care; and
- ensuring access to good quality care which promotes human rights, is responsive to people’s needs, and respects their values, choices and preferences.
In the community we need to:
- support people with mental health conditions to participate in community life, and acknowledge the value of their contribution;
- respect their autonomy to make decisions for themselves, including about their living arrangements and personal and financial matters;
- ensure their access to employment, education, housing, social support and other opportunities; and
- include people in decision-making processes on issues affecting them, including policy, legislation and health service reform relating to mental health.
“My ward possessed the jail-like structures with the famous seclusion rooms where patients are left to lie on the ice-cold concrete floor covered with urine and faeces and without anything to use as covering. I lived in a very dirty place with overflowing toilets, broken doors and windows, torn uniforms and at times patients were left naked…" Sylvester Katontoka, Zambia
What is the World Health Organization doing to promote the dignity of people with mental health conditions?
Through the QualityRights protect, WHO is committed to ensuring that the dignity of people with mental health conditions is respected all around the world.
WHO QualityRights promotes dignity by:
- Advocating for political and social inclusion -working collaboratively with governments, health professionals, families and people with mental health conditions to ensure that the views of the latter are heard and listened to at policy, service and community levels.
- Promoting a recovery approach to mental health care -This means much more than merely treating or managing symptoms. It is about building the capacity of mental health workers to support people with mental health conditions to realise their hopes and dreams, to work, to enjoy family and friends, and to live a full and rewarding life in their community.
- Supporting human rights training and capacity building -QualityRights has developed training programmes to build the capacity of families and health-care professionals to understand and promote the rights of people with mental health conditions, and to change attitudes and practices towards them.
- Encouraging the creation and strengthening of peer support and civil society organizations -QualityRights is helping people with mental health conditions and families feel connected through mutually supportive relationships and empowering them to advocate for the rights and dignity of people with mental health conditions.