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Living in Chains - Shackling of people with psychosocial disabilities worldwide

HUMAN RIGHTS WATCH
October 2020

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In order to show the scale and scope of shackling of people with real or perceived psychosocial disabilities worldwide, Human Rights Watch conducted a study of mental health legislation, relevant policies, and practices across 60 countries around the world.

This report includes research and testimonies collected by 16 Human Rights Watch researchers in their own countries. We worked closely with partner organizations to visit private homes and institutions in Afghanistan, Burkina Faso, Cambodia, Ghana, Indonesia, Kenya, Liberia, Mexico, Mozambique, Nigeria, Sierra Leone, Palestine, Russia, the selfdeclared independent state of Somaliland, South Sudan, and Yemen. Human Rights Watch researchers interviewed more than 350 people with psychosocial disabilities, including those who were shackled at the time of research or had been shackled at least once in their lives, and more than 430 family members, caregivers or staff working in institutions, psychiatrists, psychologists, nurses and other mental health professionals, faith healers, lawyers, government officials, representatives of local nongovernmental organizations (NGOs), including organizations of persons with disabilities, and disability rights advocates. The testimonies were collected between August 2018 and September 2020 through in-person and phone interviews.

Desk research and consultation with international disability experts was also undertaken

The impact of COVID-19 on disabled people in Northern Ireland

FITZSIMONS, Sean
O'NEILL, Emma
CRAWFORD, Alison
September 2020

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Key findings and recommendations are reported from an online survey published in April 2020 to gather the experiences of disabled people, their families and carers during the COVID-19 outbreak in Northern Ireland. The survey went live on April 1st 2020 and closed on April 30th 2020.  Over 400 survey responses were received, including over 1300 written statements. 

Key findings are reported in the areas of: social care; physical health; mental health and emotional wellbeing; carers; accessing food and medicine; accessing information; employment and training; social security benefits and community support

Interventions for anxiety in mainstream school-aged children with autism spectrum disorder (ASD)

HILLMAN, Kylie
DIX, Katherine
AHMAD, Kashfee
LIETZ, Petra
TREVITT, Jenny
ULJAREVIC, Mirko
VIVANTE, Giacomo
HEDLEY, Darren
May 2020

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Anxiety is a common problem in school-aged children with autism spectrum disorder (ASD). Cognitive behavioural therapy (CBT) and other psychosocial interventions have been developed as alternatives to pharmacological intervention to treat anxiety in students with ASD.

 

This Campbell systematic review examines the effects of interventions for reducing anxiety in school-aged children with autism spectrum disorder, compared to treatment-as-usual. The review summarises evidence from 24 studies using an experimental or quasi-experimental design.

 

Twenty-four studies, involving 931 school-aged children with ASD (without co-occurring intellectual disability) and clinical anxiety, are summarised in this review. The studies were experimental or quasi-experimental control-treatment trials, deemed to be of sufficient methodological quality and with reduced risk of bias. Studies spanned the period 2005 to 2018 and were mostly carried out in Australia, the UK and the USA.

Examined interventions ranged across clinical, school-based, or home-based settings, with group or individual treatment formats. Twenty-two of the studies used a CBT intervention. One study used peer-mediated theatre therapy and one study examined the benefits of Thai traditional massage for reducing anxiety. Most interventions involved parents/caregivers and were conducted face-to-face.

 

Campbell Systematic Reviews, Volume16, Issue2, June 2020, e1086

 
https://doi.org/10.1002/cl2.1086

 

Does the criminal justice system treat disabled people fairly? Inclusive justice: a system designed for all

EQUALITY AND HUMAN RIGHTS COMMISSION
April 2020

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The UK Equality and Human Rights Commission launched an inquiry to understand the experiences of disabled defendants and accused people in the criminal justice system. They looked at:

  • whether their needs are properly identified
  • the types of adjustments being made to accomodate their needs, and
  • whether they can fully participate in court processes and understand the charges they face.

Based on their findings, recommendations are made to UK Governments.

 

The use of video hearings was rapidly expanded in response to the coronavirus pandemic. In April 2020, interim findings from this inquiry were released to help mitigate the risks that this technology poses to disabled people in the criminal justice system.

Women and young persons with disabilities: Guidelines for providing rights-based and gender-responsive services to address gender-based violence and sexual and reproductive health and rights

HOLOBOFF RADFORD, Anastasia
et al
November 2018

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This publications aims to provide practical and concrete guidelines for making Gender-Based Violence (GBV) and Sexual and Reproductive Health and Rights (SRHR) services more inclusive of and accessible to women and young persons with disabilities and for targeting interventions to meet their disability-specific needs.
 
Critical services for all victims and survivors of GBV include health services (e.g. first-line support, sexual assault examination and care, mental health assessment and care), justice and policing services (e.g. assessment and investigation, perpetrator accountability and reparations, safety and protection, justice sector coordination), social services (e.g. crisis counselling; help lines; legal and rights information, advice, and representation; psychosocial support and counselling), and coordination at both the national and local level.

 

Fundamental SRHR services for women and young persons—with and without disabilities— include comprehensive sexuality education; information, goods, and services for the full range of modern contraceptive methods, including emergency contraception; maternal/newborn healthcare (including antenatal care, skilled attendance at delivery, emergency obstetric care, post-partum care, and newborn care); prevention, diagnosis, and treatment for sexual and reproductive health issues (e.g. sexually transmitted infections, including HIV, syphilis, and HPV, cancers of the reproductive system and breast cancer, and infertility); safe and accessible abortion, where it is not against the law; and post-abortion care to treat complications from unsafe abortion.

 

While the primary audience of these Guidelines is GBV and SRHR service providers and support staff, these Guidelines are also intended as a valuable resource for all stakeholders—including those in government, international organizations, and non-governmental organizations—involved in designing, developing, implementing, or advocating for GBV or SRHR services for women and young persons with disabilities. 

Greece: Refugees with Disabilities Overlooked, Underserved

HUMAN RIGHTS WATCH
January 2017

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Refugees, asylum seekers, and other migrants with disabilities are not properly identified and do not enjoy equal access to services in reception centres in Greece.  On the basis of research carried out in mainland Greece and on the Greek islands in October 2016 and January 2017, and follow-up phone interviews in December 2016 and January 2017, Human Rights Watch found that asylum seekers and refugees with disabilities are not properly identified in Greece, in part because of a rushed registration process and the need for better guidance for staff. Without an adequate understanding of the scale and needs, aid agencies cannot respond effectively. Problems with equal access to water and sanitation services, food distribution, shelter, and health care including mental health and psychosocial support are reported.

Living in hell : how people with mental health conditions in Indonesia are treated

HUMAN RIGHTS WATCH (HRW)
March 2016

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This report examines the abuses—including pasung—that persons with psychosocial disabilities face in the community, mental hospitals, and various other institutions in Indonesia, including stigma, arbitrary and prolonged detention, involuntary treatment, and physical and sexual violence. It also examines the government’s shortcomings in addressing these problems.

Based on research across the Indonesian islands of Java and Sumatra, Human Rights Watch documented 175 cases of persons with psychosocial disabilities in pasung or who were recently rescued from pasung. 

 

Treated worse than animals : abuses against women and girls with psychosocial or intellectual disabilities in institutions in India

SHARMA, Kriti
December 2014

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This in-depth, illustrated report on the abuses of female patients with psychosocial or intellectual disabilities at institutions in India found that patients experience widespread neglect and abuses of their rights, including denial of legal capacity, a lack of community-based support and services, verbal and physical violence as well as involuntary treatment and admission. It recommends that “India undertake urgent reforms to guarantee the legal capacity of people with psychosocial or intellectual disabilities and take steps to shift from institutional to community-based care and services for people with disabilities”, with specific recommendations for central and state government level, national and state commissions and international donors

 

Note: Easy-to-read version, summary and video also available

Women and girls with a disability in India

HUMAN RIGHTS WATCH (HRW)
December 2014

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This easy-to-read summary uses simple language and clear illustrations to succinctly present the key principles of the full report: “Treated worse than animals: abuses against women and girls with psychosocial or intellectual disabilities in institutions in India”. The report found that female patients with psychosocial or intellectual disabilities at institutions in India experience widespread neglect and abuses of their rights

 

Note: Full report, summary and video also available

Violence and abuse : what can I do? information for disabled or deaf women

SHAH, Sonali
BALDERSTON, Susie
WOODIN, Sarah
January 2014

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This leaflet presents information for disabled or Deaf women, or women who have an impairment or long-term health condition who have been a victim or survivor of violence. It presents information about rights and services in the UK that can help. It highlights barriers to accessing services or information, makes recommendations and presents what works based upon project results.

Like a death sentence : abuses against persons with mental disabilities in Ghana

HUMAN RIGHTS WATCH
2012

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"Focusing on the southern parts of the country, this report examines the experiences of persons with mental disabilities in Ghana in the three main environments in which they receive care: the broader community, the country’s three public psychiatric hospitals, and residential prayer camps...Human Rights Watch found that persons with mental disabilities in Ghana often experience a range of human rights abuses in the prayer camps and hospitals that Human Rights Watch researchers visited. These patients are ostensibly sent to these institutions by their family members, police, or their communities for help. Abuses are taking place despite the fact that Ghana has ratified a number of international human rights treaties, including the Convention on the Rights of Persons with Disabilities (CRPD), which was ratified in July 2012. These abuses include denial of food and medicine, inadequate shelter, involuntary medical treatment, and physical abuse amounting to cruel, inhuman, and degrading treatment"
The report is available in pdf, easy to read and html formats

The right to political participation of persons with mental health problems and persons with intellectual disabilities

EUROPEAN UNION AGENCY FOR FUNDAMENTAL RIGHTS (FRA)
November 2010

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This report provides the first results from a legal study carried out by the European Union Agency for Fundamental Rights (FRA) in the context of its project on the "Fundamental rights of persons with intellectual disabilities and persons with mental health problems." It begins with an analysis of the key international and European principles relating to the right to political participation. The situation in EU Member States is summarised and compared in Section 2. The report then presents the legal situation in the EU Member States and concludes with some possible ways forward
Note: This report is also available in easy read format

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