Global Health Watch report says putting people with mental illness in prison a human rights issue

From The Independent online in South Africa:

The criminalisation and incarceration of people with mental illness is a human rights issue in need of urgent attention in countries around the world, particularly in Africa and Asia. This opinion is expressed in Global Health Watch 2, which was launched in Cape Town last week. It is an alternative world health report and one of its chapters takes a critical look at prisons and mental health.

More than 100 authors, including activists and scientists, voice the need for radical change in global approaches to climate change, poverty, inequality and health. The authors criticise the impact of a "divisive and destructive" form of globalisation, the rise of a "harmful" neoliberal doctrine, multinational corporations' growth in power and wealth, the threat of global warming and the erosion of multilateralism.

They warn that "people with mental illnesses often end up being misdirected towards prison instead of appropriate mental health care or support services.

"A significant proportion of prisoners suffer from mental illness, making prisons the new mental health asylums of our time. Humiliation and sexual abuse by prison guards and other prisoners pose a further threat to their physical and mental well being."

The report says a review of surveys from 12 different countries estimated the prevalence of psychiatric disorders in a total population of 22 790 prisoners. It found that among male prisoners included in the review, 3,7 percent had a psychotic illness, 10 percent major depression and 65 percent a personality disorder. A

Among female prisoners surveyed, 4 percent had a psychotic illness, 12 percent major depression and 42 percent a personality disorder. Prisons in the US now imprison three times more adults with serious mental health disorders than the general population.

In 2005, it was estimated that 50 percent of prison inmates in the world had a mental health problem - over one million people. The report said around half the prisoners with mental health problems were imprisoned for non-violent offences.

Prison mental health services were frequently short of funding, resources and adequately trained medical personnel. In many areas prison mental health services were non-existent, with prison staff often receiving little or no raining in managing prisoners with mental health problems. Common practices such as solitary confinement only served to further fuel mental illness.

Many have ended up in prison because "community mental health systems are in a shambles - fragmented, under-funded and unable to serve the poor, the homeless and those who are substance-addicted as well as mentally ill".

The report said the World Health Organisation (WHO) estimated that 13 percent of the worldwide burden of disease was due to mental health problems, yet 40 percent of countries did not have mental health policies.

Each year nearly a million people took their own lives.

"Incidents of suicide are widely under-reported because it is considered a sin in many religions, a taboo in many societies and a crime in others."

Thirty-three countries with a combined population of two billion people invest less than 1 percent of their total health budget on mental health.

The report said there was a need to improve the availability and quality of mental health care worldwide.

"There is also a need for more thoughtful analysis of the programmes of the key global institutions such as the WHO and the World Bank."