Mental Health Perceptions and Human Rights in Post-conflict Northern Uganda [1]

 

Kamila Krygier

Department of Sociology and Social Policy, Lingnan University, Hong Kong

 

Abstract

People with mental health problems constitute a particularly vulnerable group, whose rights have been and still are abused and violated all over the world. The challenges are amplified in post-conflict regions of developing countries, where the prevalence of mental illness has been found to increase drastically. The present study takes the example of northern Uganda to examine the extent to which international human rights law is reflected in the daily lives of the rural communities.

The findings indicate that service provision is inadequate in terms of quality and accessibility. There is widespread discrimination against and abuse of people with mental health problems and little is done by the government to combat the common prejudices, raise awareness or assist the families with mentally ill relatives—all state obligations under the human rights treaties ratified by Uganda. Finally, it is argued that the existing international law itself is inadequate to cater for the unique situation of people with mental ill-health.

 

Background

Introduction

The field of mental health and mental illness has always been and still is a realm of serious and often disastrous human rights violations (Porter 2002: 4-9). Although the right to health, which explicitly refers to physical as well as mental health, is part of the International Covenant on Economic, Social and Cultural Rights (UN 1966), one of the earliest human rights documents, most countries, including those in the North championing these rights, have been equally complicit in abusing and violating them. It is important to note, however, that over the last centuries, and particularly decades, there has been considerable improvement with regard to the human rights situation of people with mental ill-health. In many countries new legal documents safeguarding the rights of people living with mental illness replaced the old ones, which frequently used abusive language and provided opportunities for mistreatment rather than legal protection (Lawton-Smith & McCulloch 2013: 1-10). Furthermore, new international human rights documents have been developed which are supposed to address this group more specifically, such as the Convention on the Rights of People with Disabilities (UN 2006) or the Guidelines for the Promotion of Human Rights of Persons with Mental Disorders (WHO 1996).

Despite the above-mentioned positive developments, the situation of people with mental health problems is still rather dismal in most parts of the world. In particular, poor or developing countries struggle to provide adequate or sometimes, in fact, any care at all (Kohn et al. 2004: 858-866; Read, Adiibokah & Nyame 2009). A post-conflict setting aggravates the existing challenges. In some countries, where service provision existed previously, the infrastructure got destroyed during the conflict and in places where mostly the community cared for the mentally ill, the destruction of the social fabric leaves this group more vulnerable than ever (Sayon 2011; UN Peacebuilding Programme 2011: 4). Moreover, mental health rarely appears to be an immediate need as the inadequate provision of this type of care does not seem as serious or life-threatening. At the same time it is known that mental disorders, in particular post-traumatic stress disorder (PTSD) and depression, increase considerably as a result of violent conflicts (de Jong et al. 2001: 555).

Uganda provides an example for most of the described challenges. It is a developing country with a long history of violent conflicts. Various studies have found an extremely high prevalence of PTSD and depression within the population of northern Uganda most affected by conflict (Vinck et al. 2007: 543; Roberts et al. 2008). >> View Full Text (PDF)

 


[1]This article is based on research carried out in 2014 by the author and members of staff of the Research Department of John Paul II Justice and Peace Centre, Kampala, Uganda.