Unchain my Heart

Mental illness, from depression to schizophrenia, is a curse on those who suffer from it, as well as on their family and friends. And the provision of adequate care to the unfortunate people who live with this suffering is the responsibility of society—period.

The world map of disability is striking, particularly if you look at those red areas, and by that I mean the right column on the scale—from yellow to hemoglobin.

Mental illness worldwide—this graphic was published in PLOS Medicine by Ferrari and co-workers in 2013, and represents the YLD (Years Living with Disability) rate per 100,000 people.

Huge parts of South America, much of Africa and the Mid-East, and all of the ex-USSR. The exceptions are India and China, although in these broad assessments data quality can vary substantially from country to country.

Some mental disabilities, of which depression is a prime example, show well-established links to suicide rates—although most depressive people don’t kill themselves, two-thirds of suicides are committed by folks suffering from depression.

A recent study published by the Centers for Disease Control found that, for the period 1999-2016, the suicide rate has increased in all US states except Nevada—in some cases, particularly midwestern states, the rate has increased by fifty percent on average.

Anyone who travels widely quickly understands that the world is a very heterogeneous mix—for instance, what qualifies as underage sex in Europe and North America is very different from what you see in SE Asia.

Westerners, particularly those riding a high horse, are mostly unaware that one hundred-fifty years ago, the age of consent in the United States was… ten. In fact, the history of consent laws is an article in and of itself—we’ll leave it for another day.

What was acceptable in the West a century ago is reasonable in the East today—we see it in human rights, and in animal welfare. And unfortunately, we see it in mental health.

Ghana, which is colored blue in the YLD map, has one psychiatrist for every 1.2 million people—this statistic sounds so incredible, I dug in further. For a country of twenty-eight million, there should be twenty-three (and a third) shrinks—apparently there are eighteen.

The World Health Organization—undoubtedly another agency that Trump believes does the devil’s work—has calculated that developing countries spend only 0.5% of their health budget on mental health.

A mentally ill man shackled to a table in Java, Indonesia. The year is 2018, the picture was taken this month (courtesy Human Rights Watch.)

Ghana, like many other countries, had a practice of shackling mental patients, as a means of restraining them from normal activity, but has now banned the use of chains.

The lack of government facilities led to the development of ‘prayer camps’, where mentally ill folks are regularly chained, despite the ban. One such camp was recently visited by the BBC—staff proudly displayed the new facilities—when the reporter entered the housing units, a row of cages were the principal item of furniture.

And in each cage, a patient.

The BBC correspondent decided to try a cage for himself—he was unable to stand upright.

The video of the BBC report is horrifying, the suffering of the mentally ill in Ghana and many other countries is disgraceful.

Humans everywhere share a common trait—we have an old mind from an old world. We react to what happens on our street, our town, our region, pretty much in that order. We react to what happened yesterday, last month, last year, or the last decade in a similar way.

We think local, and we think now. This is why we elect xenophobes and re-elect politicians who only last year did us harm.

That’s why a mentally ill person kept in chains in some African nation is irrelevant when compared to Kayne West and Princess Eugenie.

The India Road, Atmos Fear, Clear Eyes, and Folk Tales For Future Dreamers. QR links for smartphones and tablets.

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