Speaker: 'Psychiatrists need to be aware' of bill of rights for people with mental illness

Stigma against individuals with mental illness is common, making an emphasis on social justice and human rights for this segment of the population important, according to a presenter at the American Psychiatric Association annual meeting.

Study results presented at the meeting suggested many countries throughout the world are not upholding certain protections for individuals with mental illness that they agreed to when signing onto the United Nations Convention on the Rights of Persons with Disabilities.

“Particularly in these times of COVID-19, the discrimination against people with mental illnesses is increasing, especially when people with mental illnesses and physical ill health are more vulnerable to psychiatric problems, such as feeling trapped, feeling lonely, feeling isolated,” Dinesh Bhugra, MD, professor of mental health and diversity at the Institute of Psychiatry at King's College London, said during a presentation. “It’s not any news that illnesses can have social origins, and quite often, when we treat patients, we send them back to the conditions where they live, work, play and age, without realizing that we are making life difficult for them.”

Social factors that may influence the development of mental illnesses include age, gender, ethnicity/migrant status, religious affiliations, early childhood adverse experiences, education, insecure employment/unemployment and poverty, according to Bhugra. Structural factors that affect mental illness development include systems of governance, economic policies, social welfare, employment and health and education policies. Bhugra noted the role of social justice and a human rights framework in improving therapeutic engagement and resources for these individuals.

Bhugra and colleagues commissioned the Centre for Mental Health in Pune, India, to conduct a survey of the laws of 193 countries that signed onto the Convention on the Rights of Persons with Disabilities in 2007 to evaluate discrimination in social, personal, political and economic fields. Specifically, the researchers assessed the rights to vote, to inherit property and to make a will, to employment and to marriage for individuals with mental illness.

Results showed only 11% of the countries assessed had no restriction on voting among those with mental illness, and these individuals were prohibited from voting in 36% of these countries. Unemployment rates ranged from 70% to 90% for individuals with mental illness in these countries, with 29% of the countries assessed having issues with work-related discrimination. A total of 37% of the countries do not allow those with mental illness to get married and 12% allow divorce on the grounds of mental illness of the spouse. A total of 29% do not allow these individuals to inherit property and 43% do not allow them to make a will.

“Psychiatrists need to be aware that we created a bill of rights for people with mental illness, reiterating that people with mental illness have the capacity to have those rights,” Bhugra said. “We have a moral and ethical obligation to push for equality and human rights of people with mental illnesses. We must push that for every policy that every government around the world puts forward, they should do an impact assessment on the mental health of those populations.”

Reference:

Bhugra D. Social justice and human rights for individuals with mental illness. Presented at: American Psychiatric Association Annual Meeting; May 1-3, 2021 (virtual meeting).