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This chapter’s purpose is to summarize and analyze current states of the rights of persons with disabilities and the nexus of these rights with mental health and psychosocial well-being, particularly focusing on the Convention on the Rights of Persons with Disabilities (CRPD) and the Sustainable Development Goals (SDGs). It describes the key rights in CRPD and analyzes the interrelationship between CRPD and SDGs. The chapter also presents the history of global efforts to protect and promote the rights of persons with disabilities as well as recent and current developments. Persons with disabilities, including persons with mental health conditions and psychosocial disabilities, have faced numerous barriers and violations of human rights for a long time. The adoption of CRPD, coupled with SDGs and other key global agreements, provides great momentum for realizing their rights. The chapter concludes that respecting diversity, eliminating social barriers (including attitudinal ones), being attentive to the silent majority and minorities and reaching out to unheard voices, enabling supportive environment where individuals support each other based on needs instead of their attributes, and establishing and incorporating indicators pertaining to mental health and well-being into the monitoring efforts of sustainable development, peace and security, and overall human rights together with mental health perspectives are critical.
This briefly reviews the literature on common perinatal mental disorders (CPMD) and describes the activities of the Perinatal Mental Health Project (PMHP) based at the University of Cape Town (UCT), South Africa. It summarizes the key lessons learnt over the 10 years regarding the integration of maternal mental health care within primary care settings. The aim of the PMHP training program is to prepare the service delivery environment to integrate maternal mental health care into routine practice. The PMHP's advocacy and communication program focuses on raising awareness among health officials, policy makers, and the public concerning the prevalence and impact of CPMDs, and on maternal mental health as a cross-cutting solution to several key health and development priorities. Maternal mental health interventions require screening, which is undertaken by maternity staff during routine antenatal care. Institutional stigma is, however, a major challenge to providing mental health services in the public sector.
This chapter focuses on the United Nations (UN), and its work related to mental health and psychological well-being, so that the mental health community can strengthen partnership with the UN as a key stakeholder in global mental health. In 2006, the UN General Assembly adopted the Convention on the Rights of Persons with Disabilities (CRPD) by consensus. The Convention on the Rights of the Child (CRC) recognizes the rights of children with regard to mental health. The convention states that child must have a standard of living adequate for the child's physical, mental, spiritual, moral, and social development. The Platform for Action (PFA) reaffirms that women have the right to enjoy the highest attainable standard of physical and mental health. An interagency mechanism on mental health and psychosocial well-being should be established to support integration of mental health into existing and emerging priorities of the UN policies and programs.
Although there is speculation that individuals living in the vicinity of nuclear disasters have persistent mental health deterioration due to psychological stress, few attempts have been made to examine this issue.
Aims
To determine whether having been in the vicinity of the Nagasaki atomic bomb explosion in the absence of substantial exposure to radiation affected the mental health of local inhabitants more than half a century later.
Method
Participants were randomly recruited from individuals who lived in the vicinity of the atomic bomb explosion in uncontaminated suburbs of Nagasaki. This sample (n = 347) was stratified by gender, age, perception of the explosion and current district of residence. Controls (n = 288) were recruited from among individuals who had moved into the area from outside Nagasaki 5–15 years after the bombing, matched for gender, age and district of residence. The primary outcome measure was the proportion of those at high risk of mental disorder based on the 28-item version of the General Health Questionnaire, with a cut-off point of 5/6. Other parameters related to individual perception of the explosion, health status, life events and habits were also assessed.
Results
Having been in the vicinity of the explosion was the most significant factor (OR = 5.26, 95% CI 2.56–11.11) contributing to poorer mental health; erroneous knowledge of radiological hazard showed a mild association. In the sample group, anxiety after learning of the potential radiological hazard was significantly correlated with poor mental health (P<0.05), whereas anxiety about the explosion, or the degree of perception of it, was not; 74.5% of the sample group believed erroneously that the flash of the explosion was synonymous with radiation.
Conclusions
Having been in the vicinity of the atomic bomb explosion without radiological exposure continued to be associated with poorer mental health more than half a century after the event. Fear on learning about the potential radiological hazard and lack of knowledge about radiological risk are responsible for this association.
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