On World Mind Matters Day 2016, a global survey funded by the World Psychiatric Association (WPA), of laws and policies in 193 United Nations (UN) member states reveals the level of discrimination faced by people with mental illness in the areas of marriage, voting rights employment and right to contract. The results were published as the ‘Social Justice for People with Mental Illness’ report in the International Review of Psychiatry in August 2016 and include these findings:
The findings have led the WPA to create a Bill of Rights for Individuals with Mental Illness which urges ALL governments to ensure that persons with mental illness/mental disability/mental health problems are not discriminated against based on their mental health status, and are treated as full citizens enjoying all rights on an equal basis with others.
“Those with mental illness/mental disability/mental health problems have the capacity to hold rights and exercise their rights and should, be treated on an equal basis with other citizens. The challenge for policy-makers, clinicians, and individuals with mental illness is to fight discrimination using strategies similar to civil liberties, gender equality, sexual minority (LGBT) communities, which in many parts of the world have proven to be useful.”
Here, Professor Dinesh Bhugra CBE President of the World Psychiatric Association explains why this is important:
Mental health gives us the opportunity to 
function well, look after others and enjoy life. Often mental health and physical health are seen as completely different and in isolation from each other whereas the truth is that one affects the other. We know that if a person with diabetes gets depressed then both depression and diabetes are difficult to treat. Mental health has several aspects to it including mood, thoughts and behaviour. Different cultures add a further dimension of spirituality to mental health.
Why is mental health important? At a global level we know that mental ill health causes a tremendous amount of burden which is much greater than that caused by heart disease and cancers. Mental ill health often remains undiagnosed and affects individual functioning at work and at home creating further tensions. Cultures frame our view of the world and create our thinking processes and the way we express and deal with distress.
When an individual says: ‘I feel gutted’ they are expressing distress similar to what a Punjabi woman says: ‘my heart is sinking’. Childhood experiences combined with experiences of bad parenting can cause problems in adulthood. Over half the mental illnesses in adulthood start below the age of 15 and three-quarters start below the age of 24. Thus preventive strategies have to focus on the vulnerable age groups.
‘Wellbeing’ is a difficult concept to define as it has different meanings at personal, cultural and global levels. Personal wellbeing has become ever more important as longevity, conflict, insecurity and environmental issues increase, and social and technological changes impact on our individual and collective lives.
Prejudice, stigma and discrimination against mental illness delay help-seeking. There is considerable research evidence to suggest that early recognition and early interventions will get people back to normal sooner. There are different types of mental ill-health or mental illness caused often by a mixture of biological vulnerability, social and psychological causative factors. Social determinants of health include poverty, overcrowding and unemployment.
Stigma against mental illness is caused by lack of knowledge and often improved knowledge may lead to changes in attitudes and behaviours making these more positive and accepting. In small cohesive communities whether they are related to residential settings or work-place it may be easier to reduce stigma and deal with prejudice. Three years ago when 23 members of Parliament stood up in the House of Commons and talked about their personal experiences of mental ill health, that turning point really changed the nature of debate on mental health.
Mental health is everyone’s business and we all need to take responsibility for our own mental health and those in our immediate circle-whether these are professional or personal circles.
Mental ill health and major psychiatric disorders are eminently treatable and many conditions have cure rates of 90-98%. It is important that we understand the concepts of wellbeing. We must support family members and friends as well as colleagues who may be stressed and developing mental illness so that they are able to lead fulfilling and functioning lives and can contribute fully to their community and society.
Professor Dinesh Bhugra CBE is President of the World Psychiatric Association (2014-2017) and President of the Mental Health Foundation in the UK. He is the recipient of over 10 honorary degrees. His research interests are in cultural psychiatry, sexual dysfunction and service development. He has authored/co-authored over 350 scientific papers, chapters and 30 books and is the Editor of the International Journal of Social Psychiatry, International Review of Psychiatry and International Journal of Culture and Mental Health. Previously he was the Dean (2003-2008) and President (2008-2011) of the Royal College of Psychiatrists where he led on major policy initiatives on psychiatry’s contract with society and the role of the psychiatrist.
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