According to a Human Rights Watch (HRW) report, hundreds of thousands of people with mental illnesses are shackled and chained around the world.
The report, released to mark the World Mental Health Day on Saturday, said most people with mental health problems are held in overcrowded or filthy rooms, sheds, cages, or animal shelters and are often forced to eat, sleep, urinate and defecate in the same area.
Most of these patients are chained by their families or communities; or the institutions into which they are placed for long-term care, according to the report.
Shackling is a rudimentary form of physical restraint used to confine people with real or perceived psycho-social disabilities. It can be done by using chains, ropes or rags.
According to HRW, shackling is mostly practised in non-medical settings, by families, a faith healer, or non-medical staff, often in the absence of support or mental health services.
Shackled persons often suffer from post-traumatic stress, malnutrition, infections, nerve damage, muscular atrophy and cardiovascular problems.
HRW interviewed more than 350 people with psychosocial disabilities, including children, and 430 family members, mental health professionals, faith healers, government officials, and disability rights advocates in 110 countries for its report.
Of the 60 countries the report cites, 24 are in Africa. Forty-eight of them are developing nations, including some of the world’s poorest countries such as Liberia, Mozambique, Sierra Leone and Yemen.
Decades of conflicts in these countries have given rise to large numbers of people,ng from mental issues. But because their support systems and social safety nets are weak, their families often turn to cultural and religions institutions for help, the rights group said.
According to HRW, the lack of proper access to sanitation or even basic healthcare mean people who are shackled are also at greater risk of being infected with COVID-19.
According to the World Health Organisation (WHO), one in every five children globally suffers from mental illness.
According to the WHO suicide is the third leading cause of death among children aged between 15 and 19 globally. Health experts say poverty, sexual violence, forced migration, substance abuse and early pregnancy as causes for adolescent healthcare problems.
Shantha Barriga, director of disability rights at HRW said to Al Jazeera: “There are many taboos attached to mental health. It’s just not a priority for governments. They have overlooked the need to step up investment, housing and other support for people with psychosocial disabilities. We need a comprehensive approach. People with psychosocial disabilities deserve better.”
Shackling is particularly prevalent in West Africa. Huawei Ojeifo, who herself suffers from mental illness, is the founder and executive director of She Writes Women, a women-led movement in Nigeria.
“Nigerians are usually very religious, but at the same time there is a lot of ignorance about mental health. The media, music and film industries also need to sell the stories about mental health from a more informed and humanising perspective,” says Ojeifo, who is at the forefront of advocating for new legislation on mental health in her country.
HRW’s report says the governments should urgently ban shackling, reduce stigma around mental issues and develop quality, accessible and affordable community mental health services.
The report further says the governments should immediately order inspections and regular monitoring of state-run and private institutions and take appropriate action against abusive facilities.