We must protect the rights of mental health patients

Illustration: Kazi Tahsin Agaz Apurbo

Mental health problems affect our moods, emotions and behaviour, impacting our ability to perform daily activities. Issues such as depression, anxiety and attention deficit hyperactivity disorder (ADHD) can stem from our genetics, brain chemistry, traumas and experience of abuse. Unfortunately, in many countries including Bangladesh, mental health problems are stigmatised, and those who suffer from them are looked down upon, discriminated against and often denied treatment.

In Bangladesh, according to a World Health Organization survey in 2019, the prevalence of mental disorders is 16.8 percent among adults aged 18-99 years and 13.6 percent among children aged 7-17 years. The study also indicated that 92.3 percent of adults and 94.5 percent of children diagnosed with mental disorders do not get proper treatment for their condition, which means, among other things, the authorities are paying little attention to raising awareness of mental health issues and how they affect citizen's lives.

The social stigma attached to mental health, and the disparity in treatment of different socio-economic groups, mean that human rights are also being violated. This matter was highlighted by the United Nations in 2005, when the UN Human Rights Committee recommended the Bangladesh government to develop separate policies to protect the human rights of people with mental health issues in the country. These policies have been under development for the past 15 years with the support of courts and various international organisations trying to consolidate efforts to create an enabling environment for mental health to flourish.

Right to life

Bangladesh Constitution provides that the state shall direct its policy towards securing citizens' right to life, living and livelihood, as set out in Article 32 of the constitution. This right was also affirmed in the case of Kalam and others vs. Bangladesh and others, where the court held that slum-dwellers had equal rights in every sphere of life including food, shelter, healthcare and education. Similarly, in the case of Kalandiar Kabir vs. Bangladesh and others, a similar statement was made regarding people with mental illness where the court acknowledged that people with mental illness are continuously subjected to inhuman and degrading treatment, and that in some cases, it amounted to a clear violation of their right to life.

Protection against discrimination

Article 28(4) of the constitution provides that nothing shall prevent the state from making special provisions in favour of women or children and their rights. The legal requirement of equality in the eyes of the law was also considered in the case of BLAST and others v Bangladesh and others, in which a lawyer with mental illness was denied the opportunity of attending exams for the Public Service Commission. Many citizens from different occupations trying to sit for such exams are also often subjected to similar discrimination.

To address the mental health component of the scourge of discrimination, there should be, among other things, special educational services for people suffering from dyslexia, ADHD and other problems, so that they can get extra learning support and the same career opportunities as other citizens. It is challenging enough for young students who are struggling to juggle their studies with the stress of finding a job—the additional burden of having to deal with this kind of discrimination can be too much for them. Greater understanding and awareness of the right to education is also needed. There are organisations such as WHO and Unicef working on this issue through their platforms and various initiatives, but more such initiatives, especially from the government, are needed for wider impact.

Right to liberty and security

The right to liberty and security for people with mental illness has been guaranteed under Articles 31 and 32 of Bangladesh Constitution. One study shows that an average mental health patient spends 137 days detained in their cells/rooms. This is clearly a violation of a person's right to liberty, and goes against the International Bill of Human Rights. Not all people with mental health issues are violent. But a disproportionate number of them in Bangladesh are reportedly kept in chains or compelled to stay indoors. It is because people in general have not been sufficiently taught about mental health issues, and therefore, they harbour prejudices against those who suffer from them.

The fact that government-funded mental hospitals are failing to take care of patients with love, care and kindness is utterly disappointing. This reflects lack of concern from those in power. There are also very limited beds for patients, and most doctors have limited experience. In 2015, an article in The Guardian newspaper highlighted how people suffering from mental illnesses like schizophrenia and clinical depression in Bangladesh are locked or chained up so they can't harm themselves or others. In response, the then secretary of the cabinet division introduced the Mental Health Act 2018 to address these violations and bring hope for people who are struggling to get proper treatment, including provisions for health and rehabilitative services.

Right to health and medicine

Article 18(1) of the constitution says that the state shall regard raising the level of nutrition and improvement of public health as among its primary duties. The right to health and medicine thus forms the link between mental health problems and human rights, since people with mental health problems often struggle to get proper medication or treatment, especially because they lack the necessary means or support. The Mental Health Act 2018 sought to improve the overall condition of mental patients around the country, protecting their rights to property, ensuring caring services and rehabilitation. This act further aims to ensure that people of all classes have access to equal treatment. What we need to do now is ensure that it is properly and evenly executed.

To sum up, the human rights of people with mental illness are getting routinely violated in Bangladesh. The courts and the government will have to play a pioneering role in terms of addressing this issue. Equally importantly, as members of society, we too have a huge responsibility here: to use our respective platforms and raise awareness of mental health issues so that those suffering from them are treated with care and given all the support they need.

Tasfiah Rahman is studying law at the BPP University Law School.