What Does Mental Health Care Look Like Abroad? This Is How 9 Countries Treat Mental Illness
Being a mental health and disability rights advocate who lives with severe mental illness in the United States is exhausting, and it can feel like never ending battle of fighting discriminatory mental health care policies. According to the World Health Organization (WHO), the United States ranks in third when measuring countries that face the greatest “burden” of mental health and behavioral disorders worldwide — a statistic that’s determined by the years of life lost to a mental disability, and death rates of those with mental illness. There is an alarming amount of improvements that need to be made to the mental health care system in the United States, but mental illness is a global issue that pervades all countries and cultures. Depression is the leading cause of disability worldwide, and despite that fact, many countries still do not actively prioritize mental health care.
WHO, in partnership with the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD), has combatted that inaction, and advocated for equal rights of mentally ill people around the world. CRPD set forth guiding principles to ensure “persons with disabilities are entitled to the full spectrum of human rights and fundamental freedoms without discrimination.” However, mentally ill folks still face stigma, discrimination, and violations of their basic human rights on a global scale. This is how mental illness is treated in nine different countries around the world.
According to 2017 Business Insider article, Luxembourg has the top rated healthcare system in the entire world, with an average life expectancy of 82 years. In regards to mental health treatment, Luxembourg focuses on the "Positive Education" model, which "bridges the gap between the skills of wellbeing and the skills of achievement." Basically, Luxembourg teaches adolescents to discover their unique strengths — unlike traditional teaching methods that encourage conformity — effectively destigmatizing mental illness and creating happier, more productive citizens.
While Canada is often lauded for its universal healthcare system, the country lacks a bit when it comes to effective mental healthcare. 1 in 5 Canadians live with a mental illness, but over 60 percent will not seek treatment out of fear of being stigmatized. Though Canadians can be readily prescribed psychiatric medication, the wait lists for psychotherapy is long and limited, leaving over 35 percent of Canadians feeling as though they didn't receive the therapeutic treatment they needed.
Over 100 million Chinese people live with mental illness, and the country has struggled to create effective and accessible mental health treatment that meet the country’s growing demands. Under 6 percent of mentally ill Chinese people seek mental health treatment. Many do not seek or receive proper mental health care due to mental health stigma, unlicensed psychologists who pose as counselors, and the practice of forced mental institutionalization. Nicholas Bequelin, a senior researcher at Human Rights Watch, describes the confinement method as “an absolute violation of medical ethics." In May 2013, the first mental health law in China was passed — a bill that contains seven chapters and 85 articles of protections for mentally ill citizens, and goals to strengthen China’s mental health care system.
Germany's mental healthcare system is shown to be of one the leading countries in terms of mental health treatment and integration, despite Europe's overall treatment gap for people with mental illness. Germany has advocated for community-based mental healthcare since the 1970s, providing mentally ill citizens with "financial support for patients, access to healthcare services, help finding or staying in work, outreach programs and awareness campaigns." To combat the complete lack of mental health services for refugees, Germany has implemented a program that trains refugees to become counselors, who in turn teach therapeutic classes and coping skills to newly-arrived refugees. Pretty cool, huh?
In Buenos Aires, Argentina, seeking counseling and visiting a psychologist is commonplace — unlike other countries that view mental health treatment and mental illness as taboo. Though mental illness is more destigmatized in Argentina, and it has the highest amount amount of psychologists per capita in the world, the country has had its fair share of human rights violations against mentally ill people. It has been reported that some Argentine institutions abused patients, forced them to live in unsanitary or unsafe conditions, and didn’t provide proper mental health care.
In March 2016, the Human Rights Watch released a 74-page report entitled “Living in Hell: Abuses Against People with Psychosocial Disabilities in Indonesia” that detailed the horrible, unsanitary conditions in which many mentally ill Indonesians experience. Despite pasung (the practice of shackling people with real or perceived psychosocial disabilities) being banned in 1977, people with mental health issues in Indonesia are routinely chained with restraints, or put into cells and cages. Unfortunately, impoverished families are often forced to institutionalize loved ones in these inhumane ways due to a lack of mental health care, and many Indonesian disability rights advocates have called on their government to pass laws that demand equal rights for mentally ill citizens.
In Australia, those seeking mental health treatment faced double the death rate compared to the general population— a harrowing statistic that reminds us all mental health is just as valid as physical health. In an effort to reduce the death rate among mentally ill Australians, the government released a digital mental health care program in 2017 that provides citizens with online therapy, resources, and a variety of other on-demand psychotherapeutic tools.
In February 2017, South Africa’s health ombudsman announced 94 state mental health patients died due to general lack of care after being prematurely removed from state-contracted institutions. South Africa is in the midst of a mental health care crisis because the country does not have enough psychologists or funding to support mentally disabled citizens, and stigma is still rampant in the country. Additionally, studies suggest over half of South Africans who live with mental illness consult a faith or traditional healer as a form of counseling, despite healers' lack of training in psychology.
Norway is one of the leading countries for comprehensive mental health care, providing mentally ill citizen with an abundance of inpatient and outpatient resources, including psychiatric casualty clinics — which basically are emergency rooms for people with mental health issues. Additionally, Norway announced a groundbreaking “medication free treatment” initiative in 2017 that provides psychiatric wards for people with mental illness who do not want to take psychiatric medication, or who want to taper off these meds. The resolution prioritizes bodily autonomy and choice for mentally ill people.
Despite this, notably, this past week, the Norwegian newspaper Verdens Gang reported that at least 40 patients received Electroconvulsive Therapy (aka, what used to be known as electroshock) without their expressed consent. This alleged violation is a reminder that people with mental health issues are always uniquely vulnerable to basic rights violations, even in countries like Norway that take a progressive approach to mental health treatment. There is always room to create better, more sustainable, and more accessible mental health care — no matter what country you live in.