Wendel Abel

"All persons with a mental illness, or who are being treated as such persons, shall be treated with humanity and respect for the inherent dignity of the human person... There shall be no discrimination on the grounds of mental illness." The UN,1991.

Stigma and discrimination

Persons living with mental disorders have been discriminated against and stigmatised for centuries. For centuries, mentally ill persons were locked away in mental hospitals, had all their human rights taken away for a lifetime, treated in conditions far from human and referred to by names such as lunatics, mad men and mad women.

Unfortunately, in the Caribbean, many of these practices still prevail. In many communities persons are abused physically, emotionally, verbally and sexually because of their mental illness. Equally unfortunate is that in many countries in the region the only place for treatment is a mental hospital which functions as a large human warehouse. That persons are admitted involuntarily to these facilities without regard to their human rights is an indictment on any modern, civilised society.

Where are we in Jamaica?

Jamaica has ratified several regional and international conventions protecting the fundamental civil, political, economic and cultural rights of mentally ill persons. Its mental health legislation has been revised several times and there has been a major shift in policy and practice.

Concerted efforts are being made to lift the veil of silence, stigma and discrimination against mentally ill persons.

There is reasonable access to care and mentally ill persons are better integrated into society as the majority of persons living with mental illness are treated at the community level.

Persons living with mental illness may defend their rights and interests by taking petitions to regional and international bodies or to the local courts. We have had several instances in which individuals have challenged the state for violation of their human rights and have been successful.

Consumer movements such as the Committee for the Upliftment of the Mentally Ill, MENSANA and various human rights bodies have, over the years, championed the cause of mentally ill persons.

Weighed in the balance, found wanting

Despite the strides which we have made in mental health care in Jamaica, there is still a lot to be done. There are a number of issues that need to be addressed to further safeguard the rights of persons with mental illness.

The confinement of persons in large institutions, where they are held involuntarily for an indefinite period of time, may be unjustified especially when treatment in a less restrictive setting within the community may be an alternative.

In Jamaica, the law requires that a body be appointed to review the treatment of mentally ill persons in regard to involuntary admissions and treatment. This body either has never been appointed or where it has been, has never functioned.

Also, much more needs to be done for persons diagnosed or suspected of having a mental disorder who are serving imprisonment for criminal offences or for persons detained. Many of the facilities caring for such individuals offer a quality of care which is far from optimal.

Greater attention must be paid to the needs of children and adolescents. Services are limited for this group making access to quality care difficult. We do not have any specialised inpatient facility to adequately provide care for children and adolescents with mental health problems.

Recently the Ministry of Health in collaboration with the Pan American Health Organisation and the University of the West Indies hosted a conference on human rights and the mentally ill. It is hoped that we will be able to move this agenda forward.