Americans’ healthcare has been threatened time and time again in 2017, and – unsurprisingly – mental health has been completely left out of this year’s proposed healthcare bills. Like all healthcare, treatment for mental illness is a human right. Worldwide, though, it receives little to none of the positive attention.
Firstly, mental health is rarely a topic in schools. Instead of learning the symptoms of bipolar disorder or what to do if we suspect that a friend has anorexia nervosa, we memorize Shakespeare’s sonnets and spend semesters rehashing the same pre-calculus lessons we did the year before. The lack of education about mental health perpetuates dangerous social stigma which permeates even our media. For example, the 2017 film “Split" takes split-personality disorder, an already misunderstood disease, and turns it into the basis of a character’s “evil" personality before he literally turns into a cannibalistic monster. The popular Netflix show “13 Reasons Why" also contributes to stigma by portraying suicide as a selfish act of revenge rather than a side effect of a mental illness and has promoted self-harm and suicide among viewers all around the world. When we think of people who have mental illnesses as “crazy" or “psycho" or we turn suicide into memes, we devalue those who struggle with suicidal ideation and diminish what they truly go through, which affects how society sees them by creating an environment that doesn’t take them seriously and even establishing another barrier to the acknowledgement and treatment of a mental disorder. It also isolates the mentally ill, preventing them from opening up and creating the support system they need.
Finally, this all translates to policy. In the U.S., the Affordable Care Act covers behavioral health treatment like psychotherapy and counseling as well as inpatient services, including substance abuse treatment. Insurers also can’t deny coverage due to pre-existing mental or behavioral health conditions. This care represents major improvements on America’s past: state-sponsored psychiatric facilities known for their neglect and physical and emotional abuse of inmates were shut down and banned in the 1960s due to their use of isolation, beating, withholding food and water, shock therapy, and lack of sanitation. Essentially, the hospitals focused on locking the mentally ill away, out of the public eye, rather than on their care.
While we have certainly improved, we still have work to do. We now struggle with criminalization of mental illness, especially addiction, with about half of all prison inmates suffering from some mental illness. In 2009, the U.S.’s recession budget cuts included axing 4.25 billion dollars from public mental health spending, the biggest cut since the end of legally required institutionalization in 1967 – which was followed by twice as many mentally ill being incarcerated one year later. Currently, there are more than three times as many seriously mentally ill people in jails and prisons than in hospitals. Similarly, mental illness is the 3rd leading cause of homelessness in America.
Globally, fewer than 28% of countries have a specific budget for mental health care, and many also face shortages of mental health workers. Mental health coverage is lacking in nearly every country and the treatment options that do exist are either limited in availability or are inhumane. Human rights workers found conditions in Central America and India even in the last five years that mirror the treatments documented in this photo project, Condemned, by Robin Hammond:
Many communities in developing countries view mental illness as a punishment from God or a possession and go to traditionalist faith healers to be treated. Even outside of institutions, the mentally ill are denied access to health and social services, housing, education, jobs, marriage, the right to have children, and more, which worsens their conditions and could trap them in the cycle of poverty.
The lack of mental healthcare around the world is not only a public health risk but also a violation of human rights, as Article 25 of the United Nations Declaration of Human Rights reminds us that “Everyone has the right to a standard of living adequate for the health and well-being of [themselves] and of [their] family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or other lack of livelihood in circumstances beyond [their] control."