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Societal Attitudes

Socio-cultural values of legislators, policy-makers, persons with mental health issues, their families and practitioners may also impact on the effectiveness of national implementation of international and regional human rights law (Patel et al. 2012). Stigmatisation, marginalisation and prejudice are commonplace, including in the language used in connection with persons suffering from mental health issues (Callard et al. 2012). Not only is this directed towards persons with mental health issues but also towards their families, carers and even mental health professionals (Becker and Kleinman 2013). The impact of such stigma may also cause health policy experts to place less emphasis on mental health care (Becker and Kleinman 2013).[1] Additionally, some groups of people with mental health issues may be more susceptible to discrimination than others. In Europe, for example, discrimination against ethnic minorities has been evidenced in terms of accessing and using mental health services (Kastrup 2010; Sashidharan 2001).

The enhanced role of the family in LMICs may militate against the realisation of individual rights. In these countries it is often generally accepted that families assume decision-making powers for individuals with mental health issues. In such situations, clinicians may therefore be more influenced by what they perceive to be the wishes of the family rather than those of the patient (Hanlon et al. 2010) and, as previously observed, may not conceptually make a distinction between the wishes and preference of family as a whole and those of the individual with mental health issues. An individual’s cultural beliefs concerning mental illness may also affect treatment assessment and decisions and potentially deny them the legal and human rights protection they require. For instance, if a patient believes that their condition is the result of demonic possession it may be very difficult for a psychiatrist to ascertain just how much this perception can be attributed to the condition itself or to how the patient personally perceives the symptoms of their illness (Bartlett 2010; Ayon-Rinde et al. 2004).

Nationally and globally mental health professionals may also collude to maintain the status quo rather than move forward, thus perpetuating a high level of institutionalisation of persons with mental health issues and underresourcing of care, support and treatment services that are most relevant to them (Patel et al. 2012). Whilst no dedicated research appears to have been conducted in relation to this, it is certainly arguable that factors such as the aforementioned cultural and societal attitudes towards mental health issues and human rights, political regimes, a lack of awareness and personal and professional self-interest may be motivating factors.

  • [1] Becker and Kleinman (2013) note that there are, however, indications that the Ministry of Health inChina and similar agencies in other countries are starting to promote the interests of persons with mentalhealth issues.
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