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By Rosalynn Carter

This article was originally published by the LA Times Syndicate, Oct. 6, 1998.

Global Viewpoint

Atlanta - Fifty years ago, nations of the world joined together to issue a document designed to protect the basic rights of all citizens - the Universal Declaration of Human Rights. But today its promises remain unfulfilled for one group, those with mental illness. As World Mental Health Day is commemorated this month and the 50th anniversary of the declaration in December, it is important to recognize that although advances have been made to secure human rights in health care since the 1940s, in many ways the work is just beginning.

The Universal Declaration states, "everyone has the right to a standard of living adequate for the health and well-being of himself and family, including food, clothing, housing, medical care." Yet the human rights of those with mental illness are often severely compromised. Today most countries still lack legislation to protect the human rights of those who are mentally ill, and most national and regional health-care guidelines or plans do no include specific goals, standards or budgets for caring for them.

A landmark report - "World Mental Health: Problems and Priorities in Low-Income Countries," the result of two years' study by experts in more than 30 nations and issued by the Department of Social Medicine of Harvard University in 1995 - identified an unheralded crisis in world mental health and called for urgent action on local, national and international levels. The report cited human rights abuses as severe as patients in a psychiatric hospital being forced to sleep on floors slick with human waste; overuse of electroconvulsive therapy, sometimes administered in substandard conditions; and patients enduring inadequate care due to dramatic shortages of essential medications and health-care personnel. In 1990 alone, the report noted, 32 women in one state-run psychiatric institution in the Americas died of malnutrition.

In recent years, various countries have begun positive mental health initiatives - such as awareness campaigns about domestic violence and establishment of low-cost residential facilities for destitute elderly - but injustices continue. Even in the United States, mental-health services are insufficient. Mental illnesses still are not on par with physical illnesses in terms of insurance coverage and treatment systems.

The US should set an example for the rest of the world by eliminating the stigma of mental illness. We must fight against discrimination in employment and housing, and guarantee that patients are not deprived of legal rights, once they are diagnosed as mentally impaired. We must insure that involuntary hospitalization occurs only when absolutely necessary, that patients in these situations are not isolated or abused, and that they receive proper treatment. Access to quality mental health care administered by adequately trained staff in clean, safe facilities should be a standard - not a luxury afforded by only a few.

The importance of mental health to the progress and well-being of societies around the world continues to be minimized by individuals and governments alike. It is crucial that the extensive culturally and economically - be recognized and dealt with effectively. As a result, not only will those who suffer such conditions be helped, but the communities in which they live will prosper, as more of their citizens become productive and as independent as possible.