The Human Rights Crisis We Ignore

At the heart of the American mental health crisis today lies the highly flawed, dangerous and unspoken assumption that people with mental disabilities are somehow less than human.
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A prisoner behind bars with hands cuffed
A prisoner behind bars with hands cuffed

As the world marked Human Rights Day, some 67 years since the United Nations General Assembly adopted the Universal Declaration of Human Rights, we currently face a global human rights crisis that few even recognize. It is the consequence of an affliction that can make its victims self-destruct.

It does not discriminate by country, class, culture or creed. It follows soldiers home from war. It stalks refugees long after they've reached safe harbor. It haunts the raped, the tortured and the wrongfully imprisoned. Still more, it grips millions of others spontaneously and indiscriminately, regardless of past traumas. Yet this human rights emergency is so shrouded in unwarranted shame and secrecy that it can often seem invisible.

For the hundreds of millions of people living with mental disorders around the world, however, it is all too real. According to the World Health Organization, the global burden of mental disorders is climbing, "with significant impacts on health and major social, human rights and economic consequences in all countries of the world." These conditions include clinical depression (a leading global cause of disability that affects roughly 350 million people worldwide), bipolar disorders, psychotic disorders, developmental disorders and dementia.

Living with one or more of these conditions can make you especially vulnerable to a wide range of human rights abuses, often disguised as treatment. For example, in parts of West Africa, as recently reported by The New York Times, there exist religious retreats for the mentally ill where patients are chained to trees and concrete blocks, forced to urinate, defecate and sleep in the same place--all while being encouraged to pray away chronic mental illnesses like schizophrenia.

Here in the United States, the condition of mental health care may well be strikingly different, but it is no less dire. We too face a human rights emergency, and we too have failed to treat it as such. Where some West Africans have reduced mental health to a spiritual issue, we have reduced it to a public health and safety issue. Until we acknowledge that mental health is also, and increasingly, a human rights issue, we will continue to fail tens of millions of Americans.

Unlike many living with serious mental illnesses in the U.S., I have been fortunate in that I have never been arrested, jailed or incarcerated. I have, however, been held in isolation, and it was torture--literally and legally by this bipolar lawyer's humble assessment. Isolation is a euphemism for solitary confinement, which is widely used in the U.S. as both treatment and punishment despite decades of research showing that it is ineffective--and even counterproductive--at both. Unfortunately, this parallel between treatment and punishment is only one of many.

The current American mental health and criminal justice systems have become so grossly intertwined that they are now nearly indistinguishable. Like the snakes of Medusa, they too have a reputation for transforming human beings--not into stone, but into the modern social equivalents: prisoners, indigents and corpses.

Jails now serve as our largest mental health facilities, and roughly a quarter of those shot dead by police this year appeared to have had a mental illness. According to information collected by the federal Department of Housing and Urban Development in January 2014, one in five homeless Americans had a serious mental illness.

Furthermore, despite the fact that the vast majority of those living with mental health conditions are not violent (and in fact, much more likely to be victims of violence than the general public), they are often portrayed and perceived as vicious mass murderers. Thus, calls for mental health reform tend to gain attention and momentum after mass shootings, for which many prefer to blame mental illness instead of guns.

Meanwhile, more than 100 Americans on average lose their lives every day to suicide, mostly by guns and many of them veterans. Moreover, suicide is on the rise and far more common than homicide, which is declining. In fact, suicide is undoubtedly the most common tragedy of mental illness and of gun violence. More than 90 percent of those who commit suicide have psychiatric symptoms, and more than half of all suicides are gun-related. Furthermore, some two-thirds of all gun fatalities are suicides, and according to a recent report by the Brady Center To Prevent Gun Violence, simply having a gun in the home makes suicide three times more likely.

Still, policymakers seem largely unmoved by these data on suicide, gun violence, homelessness, police brutality and mass incarceration. Rather, rare sensational instances of mass murders by "crazed" or "radicalized" gunmen seem far more likely to prompt their calls for mental health reform. As a result, mental health legislation tends to be framed as a means of protecting the public from the mentally ill, not as a genuine effort to help those of us living with mental health conditions.

Meet House Resolution 2646, known as the Helping Families in Mental Health Crisis Act and newly invigorated by the tragic San Bernardino shootings that left 14 people dead last week. The proposed legislation was originally drafted in response to the 2012 Sandy Hook Elementary School massacre and sponsored by Republican House Representative Tim Murphy of Pennsylvania. Apart from overlooking gun control as a crucial suicide prevention strategy, this bill relies heavily on coercion over cooperation in mental health care, reducing privacy rights for the mentally ill and potentially endangering community-based mental health services.

The bill's primary concern is clear: "helping families" of the mentally ill, not necessarily helping those experiencing mental illnesses. Granted, sometimes helping families helps the mentally ill, but sometimes it doesn't. Add embarrassingly high rates of child abuse and domestic violence to the mix, and we are left with a harsh, yet undeniable, reality: not all families have the best interests of their family members in mind.

The dismissive and patronizing "there-there-we-know-what's-best-for-you" attitude that underlies so many mental health policy discussions and decisions--whether among legislators or family members or healthcare providers--robs the mentally ill of their basic human dignity, contributing to a dangerous pattern of institutionalized disempowerment. The primary aim of mental health legislation should be to help those of us living with mental health conditions, not our families and not our highly unlikely murder victims.

At the heart of the American mental health crisis today lies the highly flawed, dangerous and unspoken assumption that people with mental disabilities are somehow less than human. As a result, we are often treated as though we are less deserving of consideration, even in the matters that affect us most, and ultimately less deserving of human rights than our neurotypical counterparts. This couldn't be further from the truth.

As people living with mental disorders, we have unique insights as to our own needs and care. More than that, we have unique insights period. Incalculable innovations have originated in the minds of the mentally odd, ill or disordered. Insomuch as our brains can transcend the arbitrary boundaries of human rationality, we are capable of extraordinary things.

So of course, it should go without saying that we are indeed fully human, perhaps even uniquely human, but unfortunately, it cannot. So on Human Rights Day, I say it: We are fully human; we are fully deserving of human rights, and yes, mental health is a human rights issue.