Promoting the rights of people with mental disorders: solutions in countries
Mental health legislation can play a vital role in preventing violations and discrimination against people with mental disorders. Legislation can promote human rights and encourage the autonomy and liberty of people with mental disorders. It can also support access to quality mental health care and help people integrate into the community.
With WHO assistance, the Ghanaian Government has drafted a new mental health law. Ghana's previous law emphasized institutional care, which can lead to the serious mistreatment of people with mental disorders. The new law stresses access to in-patient and out-patient community care, and promotes voluntary admission and informed consent to treatment. Once adopted, Ghana's new law will fight discrimination and stigmatization, and help to protect the human rights of people living with mental disorders.
A mental health policy sets a vision and clear direction for improving mental health in a population. A well-articulated policy and action plan helps to reduce inefficiencies and fragmentation in the health care system.
Lesotho is developing a mental health policy and plan with the support of WHO. Lesotho's vision for 2020 is a high standard of mental health for all people, maintained through accessible services that uphold and protect the human rights of people with mental disorders. Specific objectives include a move towards a system of community-based care, integrating mental health services into general care, and a reduction in the number of people treated for mental disorders in institutions and correctional services. The national policy emphasizes the need to provide adequate mental health care and support to people with 'physical' disease including those living with HIV/AIDS.
In Mongolia, WHO is supporting the integration of mental health care into primary health care. Psychiatrists and general practitioners throughout the country have been trained to provide mental health care to people in the community.
Day-care centres have been established where people with mental disorders receive psychological, social and occupational rehabilitation. They are able to participate in meaningful and fulfilling work while receiving treatment.
'Gers' (a form of tent that is home to many Mongolians) are used for people with mental disorders as an alternative to living in a mental health institution. The gers provide sheltered accommodation as well as greater autonomy and freedom. People living in gers are engaged in day-to-day activities such as herding horses, milking cows, fuel gathering, gardening, carpentry, and embroidery.
On 28 October 2005, Namibia launched their first mental health policy. With the assistance of WHO, the government will be implementing this policy through the strategies and interventions identified within their five year action plan.
Namibia's policy provides a strong framework for the delivery of mental health services and articulates the roles and responsibilities of the different stakeholders involved in the promotion and protection of mental health. The key challenge in implementing the policy will be the need to change the attitudes of individuals, families, health professionals and the general public. Namibia plans to give people the knowledge needed to deal with mental and neurological conditions through training and education.
Other priority strategies include the integration of the mental health services with existing health services, and the development of a network of services and referral systems to help people with mental disorders access the treatment they need.
WHO is working with the Sri Lankan Government to establish high-quality community care. Specialized mental health day-care centres – located in communities – offer another way for people with mental disorders to access the care they need.
Projects to reintegrate people back into the community from psychiatric hospitals involve programmes of support which can include help to find employment. As a result, some people previously living in mental health institutions are now able to find jobs, save money and even buy a house and support their family. In this way, rehabilitation within the community can improve both the quality of life and future prospects not only for individual people but for their families as well. The ability to earn money and be seen as a useful member of society is extremely important.