Recently, a 26-year old model committed suicide in Lahore, though there was nothing to prove it, some reports blamed her death on drug use. A young man took his own life in Peshawar and our media blamed it on ‘low college grades’. Their human rights to life, to dignity, to health – were all trivialised and bracketed under convenient excuses.
The relationship between mental health and human rights is three-fold. For one, human rights violations lead to a higher probability of mental health symptoms. Two, immoral approaches to mental health treatment, lack of acceptability and coercive practices can lead to a negative impact on human rights. And three, greater protection of human rights can mutually benefit greater protections granted to those suffering from mental health illnesses. Because those battling mental health may be unable to assert their human rights at a time when those rights are most vulnerable, it is not surprising that human rights approaches have become central to the narratives surrounding mental healthcare. Human rights set out universal, non-negotiable standards for all, and can therefore act as a powerful catalyst for change in narratives surrounding mental health.
The UN Human Rights Council (UNHRC) issued a resolution in 2016, calling for the recognition of the rights of people with a broad spectrum of mental illnesses, ranging from alcoholism and depression to schizophrenia and bipolar disorders. The resolution called on member states, including Pakistan, to work towards the implementation of the World Health Organisation’s Mental Health Action Plan (2013-2020), as adopted by the 66th Assembly. The plan aims to strengthen effective leadership and governance for mental health, provide comprehensive and responsive service provision, strengthen information systems, evidence and research base in this area, and most importantly, to implement strategies for the prevention of mental health illnesses. This is a testament to the global shift away from mental health being simply a ‘moral’ claim, to becoming an inalienable human right that countries are obligated to respect, defend and promote.
As a nation, we cannot claim to be advocates for human rights, yet continue to pick and choose the rights we want to protect
In Pakistan, mental health is still not seen as a basic right, and our international commitments have rarely acted as incentives to better our human rights portfolio. In terms of governmental priorities, mental health finds itself somewhere in between the ambits of health and social development; and mostly ends up falling through the cracks. The human right to good health is defined as the state of complete physical and mental well-being – yet the ‘mental’ aspect of the definition is routinely overlooked. Mental health has never enjoyed parity with physical health in terms of budgeting, education or practice, despite numerous reports indicating the correlation between mental health illnesses and poorer physical health. On the other hand, increased levels of mental well-being have been internationally acknowledged as a prerequisite for individuals to reach their full potential, which ultimately enables greater social development. In South Asia, mental well-being has been reportedly linked to greater life expectancy rates, increased employment rates and enhanced productivity. Despite this, Pakistan’s social development efforts have not tapped into mental health as a means to an end.
We must humanise mental health and realise that ‘good mental health’ means a lot more than the mere absence of a specific, scientifically-explained mental impairment. Rather, it means good emotional and social well-being, healthy and non-violent relationships between individuals and groups, and respect for the dignity of every individual. It means empowering those around us instead of playing on power asymmetries and stigmatisation. Human rights and human dignity are universal and indivisible, which include the right to be free from discrimination, stigma, prejudice, violence and social exclusion – all of which can be classified as’social symptoms’ that those with mental health illnesses face.
As a society, we are the epitome of double standards. We find ourselves on the streets to protest the silencing of journalists, yet we invoke fear to silence our wives and our daughters daily. We criticise the power hierarchies in our political and justice systems, yet we leave no opportunity to exercise the very same hierarchies on our domestic help. We partake in nation-wide uproars against child abuse, yet we suppress the stories of our own children for fear of being ostracised.
As a nation, we cannot claim to be advocates for human rights, yet continue to pick and choose the rights we want to protect. We cannot protect the right to exercise freedom of religion yet choose only one religion to defend. We cannot claim to shield the human rights of women but turn a blind eye when those rights are violated behind closed doors. We cannot deem the right to education as worthy of our attention yet find ways to justify child marriages. We cannot advocate for the right to health, yet choose to ignore the ‘mental’ half of the equation.
Defend one, defend all.
Daanika Kamal is a human rights lawyer and mental health advocate based in Islamabad. She tweets at @daanistan
Published in Daily Times, September 8th 2018.