Health, Human Rights, and Advocacy Elective – Fall 2013
Mental health as a human right
On Thursday, November 14, Dr. Craig Katz spoke to us about his own experience in the field of global mental health. While he spoke about the critical role of mental health specialists following crises, he recalled a singular experience at one of the sites where he and his team came following an environmental disaster. Dr. Katz recalled that the teacher was grateful for their presence but asked, “Where were you before?” This question that drew attention to the absence of mental health care in a country already ravaged by civil war and terrorism even prior to the environmental catastrophe. According to Dr. Katz, this question caused him to challenge his own approach to global mental health, leading him to envision mental health care as a form of preventative medicine. This is an ideal that is not realized even in the United States, where there are over 500,000 mental health professionals (though even this number represents a gross shortage of mental health care professionals). Dr. Katz suggested that in order to implement this ideal, mental health care professionals could train community workers in mental health care – including screening and counseling techniques. His recommendations spurred a discussion among the students present as we considered different methods of implementing a preventative mental health care system.
Dr. Katz then posed two questions to the class as a whole: 1) Is mental health care a human right? 2) Is mental health a human right?
In my opinion, mental health (and, by necessity, mental health care) is not only a human right, but it is a societal necessity. The following statement is so easily taken for granted, so easily ignored, so easily forgotten: everyone deserves happiness – not only to be free of depression or of crippling psychiatric problems, but to be happy and fulfilled. Depression and other psychiatric illnesses originate from the same place as any other disease – partially genetic, partially environmental in source – yet they are absurdly stigmatized in most societies (show me a place where an individual’s depression is openly discussed and I’ll show you… forget it, I have other things to do). What can we do against this stigma, which has such devastating consequences for individuals and societies as a whole? Indeed, to separate “mental health” from overall health makes no sense to me whatsoever, when it has been proven that our mental state can have drastic effects on how our bodies function day-to-day and in the long-term (think psychological stress and heart disease, think depression/anxiety and IBS, think…the list goes on). In the end, it’s all about chemical interactions and molecular pathways, right?
And not only individuals, but complete societies suffer from these enormous gaps in mental health care.
For example, not a month goes by without another mass shooting in the United States, without violence between gangs or factions, without another terror attack in some area of the world, without rage (often justified) and the exploitation of that rage by leaders who are excellent at Exploitation of the Enraged. The exploitation of masses, of those seeking a target for their rage, for the suffering they or their loved ones have endured throughout a lifetime or generations. Rage may not be a symptom of a mental or emotional illness; rage may be a legitimate consequence of a world in which injustices multiply like drug-resistant diseases in poor or underserved areas. Yet rage without a clear target can be used, twisted, and manipulated. Yes, the rage has a much deeper source, located in structural inequities that have survived, unchallenged, for generations and generations. Yet we can see – particularly in the United States, where gang violence is virulent in certain places, where young people acquire firearms and decide to shoot at others indiscriminately – that we need more mental health care, and that this is, indeed, a social issue. We need (more) services for those traumatized by war or other forms of violence, we need services to be free of cost, we need preventative mental health care to become the norm.