Mental Health: Stigma and Prejudice

The video below shows that mental health problems carry a great burden of stigma and prejudice. In a country like Uganda, with 1 psychiatrist for every million people the stigma and prejudice associated with mental illness are a significant problem that often forms a barrier to proper treatment.


It is thought that 90% of people do not receive the medical attention they require. Witchcraft, curses or evil spirits are often thought to be the cause of mental health problems, meaning that traditional and spiritual healers have a significant role to play in treatment.  

People with mental illness and their families often feel isolated and alone. A strong psychosocial support network of family, friends and peers is essential. Thus, creating a climate for open discussion ensures the whole family can receive the care and support they need.

Transforming the Lives of Deaf People

This short video shows how sign language has transformed the life of a young boy, Patrick, in rural Uganda. It is a follow up to a longer documentary from Channel 4 in the UK, which you can see here: See how sign language can transform lives.

Before learning sign language Patrick and his father faced insurmountable communication barriers. Patrick was disabled by the barriers he encountered. He had low selfesteem, was isolated and did not contribute to society.

With sign language he has an impairment but he has ceased to be disabled.

When disability is inability

Ugandan legal activist Medi Ssengooba talks about the barriers he and other persons with disabilities (PWDs) face in Uganda.

Medi gives an interesting insight into the way that barriers prevent PWDs from achieving their full potential. In the United States he was able to study in a barrier free environment and live independently - he was a straight 'A' student. By contrast in Uganda he was dependent, needed help and could not access libraries, toilets, classrooms and other facilities - he was a mediocre student.

If you are a PWD in Uganda, and you can't get to America to study in a barrier free environment, you will always be undervalued.

This short clip illustrates that disability rights are a moral issue. Receiving your rights means you get the selfesteem and self worth that are your entitlement. 

Changing Attitudes

A stereotype is a rapid way to make a decision. It is a way of simplifying complex data and making information manageable. Everyone uses stereotypes to simplify their thinking.

Stereotypes can be both positive and negative. Stigma and prejudice are based on negative stereotypes.

When stereotypes, stigma and prejudice are mixed with knowledge they become attitudes. People form attitudes about groups based on their positive or negative attitudes. This creates ingroups and outgroups.

Non disabled people often see themselves in one group whilst persons with disabilities (PWDs) see themselves in another group. Both groups are associated with a mixture of positive and negative attitudes.

When a child with a disability attends school attitudes are changed.

To change attitudes, ingroups and outgroups need to meet in the following conditions (see the blog post Contact Hypothesis):

• Both groups should engage equally in the relationship. 
• Both groups must share a common goal.
• Both groups should work together for their common goals without competition.
• Both groups must acknowledge some authority that supports the contact and interactions between the groups on an equal basis.
• Members of the conflicting groups need to mingle with one another fostering cross-group friendships.

Prejudice

When persons with disabilities (PWDs) talk about the challenges they face prejudice is always joined to Stigma. Everyone faces prejudice in their lives. Everyone is prejudiced. It is only when prejudice is acted on, it becomes discrimination.

When acted on prejudice can lead to depression. Depression has both physical and mental effects. The effects of prejudice can be disabling.
Prejudice can therefore cause further disability and can feed into the poverty cycle. Prejudice is far from only a moral and ethical issue it can have severe effects on your health.

Acting on prejudice is discrimination. Discrimination is against human rights. It is illegal to discriminate against PWDs in Uganda.

Human Rights for Persons With Disabilities and the Law

The Convention on the Rights of Persons with Disabilities (CRPD) guarantees fundamental human rights to all persons with disabilities (PWDs). These rights are put into law in the Constitution of Uganda.

This is what the Constitution of the Republic of Uganda, 1995 (see The State House of Uganda for more information) has to say about the rights of PWDs. In the Social and Economic Objectives:

XVI. Recognition of the dignity of persons with disabilities.

Society and the State shall recognise the right of persons with disabilities to respect and human dignity

And in Chapter Four—Protection and Promotion of Fundamental and Other Human Rights and Freedoms the Constitution contains the following Articles:

32. Affirmative action in favour of marginalised groups. 

(1) Notwithstanding anything in this Constitution, the State shall take affirmative action in favour of groups marginalised on the basis of gender, age, disability or any other reason created by history, tradition or custom, for the purpose of redressing imbalances which exist against them. 

(2) Parliament shall make relevant laws, including laws for the establishment of an equal opportunities commission, for the purpose of giving full effect to clause (1) of this article.

35. Rights of persons with disabilities. 

(1) Persons with disabilities have a right to respect and human dignity, and the State and society shall take appropriate measures to ensure that they realise their full mental and physical potential. 

(2) Parliament shall enact laws appropriate for the protection of persons with disabilities.

 Know your rights, don't allow discrimination.

Angelo Kakande, On Euphemisms of Exclusion: Disability is/as a Synonym for Dependency, 2016

Articles 32 and 35 of the Constitution of Uganda say that the Government must make laws to protect PWDs. The main law that supports the rights of PWDs is called the Persons with Disabilities Act 2006 (PWDA). The PWDA aims at providing equal opportunities and eliminating all forms of discrimination against PWDs. This is what the PWDA says:

THE PERSONS WITH DISABILITIES ACT, 2006 AN ACT to Provide a Comprehensive Legal Protection for Persons With Disabilities in accordance with Article 32 and 35 of The Constitution; to make Provisions for the Elimination of all forms of Discrimination against Persons with Disability towards Equalization of Opportunities and For Related Matters.

By law you can demand your rights, you are supported by good legislation, don't stand for inequality and  discrimination.

Human Rights: Education in Uganda

Article 24 of the Convention on the Rights of Persons with Disabilities (CRPD) guarantees that persons with disabilities (PWDs) have the right to education and states that PWDs should be able to access education. 

The right to education is enshrined in Ugandan law in the Social and Economic Objectives and Articles of the Constitution.

It is important to know and understand your rights because they are supported by law. PWDs have these rights just like anyone else in Uganda.

Charles Bignon 'Hands up'

This is what the CONSTITUTION OF THE REPUBLIC OF UGANDA, 1995 (see The State House of Uganda for more information) has to say about your legal rights. Firstly in the Social and Economic Objectives:

XIV. General social and economic objectives. The State shall endeavour to fulfill the fundamental rights of all Ugandans to social justice and economic development and shall, in particular, ensure that...

(b) all Ugandans enjoy rights and opportunities and access to education, health services, clean and safe water, work, decent shelter, adequate clothing, food security and pension and retirement benefits.

XVIII. Educational objectives. 

(i) The State shall promote free and compulsory basic education.
(ii) The State shall take appropriate measures to afford every citizen equal opportunity to attain the highest educational standard possible.
(iii) Individuals, religious bodies and other nongovernmental organisations shall be free to found and operate educational institutions if they comply with the general educational policy of the country and maintain national standards.

CHAPTER FOUR—PROTECTION AND PROMOTION OF FUNDAMENTAL AND OTHER HUMAN RIGHTS AND FREEDOMS of the Constitution contains the following Articles:

30. Right to education.

All persons have a right to education.

34. Rights of children. 

(2) A child is entitled to basic education which shall be the responsibility of the State and the parents of the child.

The Constitution of Uganda

Uganda has more than 20 years of history of granting Human Rights to persons with disabilities (PWDs) through its laws. It is often said that Uganda has disability rights laws that are second to none in Africa. The constitution of Uganda guarantees rights and dignity of PWDs in article 35. The state moreover has a duty to protect PWDs with appropriate laws. 

The constitution of Uganda provides for disabled people in the following articles (see African Rights Disability Year Book: Uganda):

• National Objective XVI provides that the state shall recognise the rights of PWDs to respect and human dignity.
• National Objective xxiv(C) of the Constitution provides that the state shall promote the development of sign language for the deaf.
• Article 21 provides for equality and prohibits discrimination against all persons and specifically includes PWDs.
• Under article 32 the state shall take affirmative action in favour of marginalised groups including PWDs and shall make laws including laws to establish and Equal Opportunities Commission for the full fulfilment of this clause.
• Article 75 provides for the composition of parliament to include such representatives including representatives of PWDs.

The Constitution of Uganda also provides for the rights of PWDs:

• Article 20 provides for the fundamental rights of all individuals and groups (including PWDs) to be respected and protected by the state.
• Article 22 provides for the right to life of all persons.
• Article 24 protects all persons and groups from torture or cruel, inhuman or degrading treatment and punishment.
• Article 26 provides for the right to property for all persons.
• Article 28 provides for the right to a fair hearing for all persons in the formal justice system including disabled persons.
• Article 30 provides for the right to education for all.
• Article 31 provides for the right to found a family? for all persons.
• Article 36 provides for the rights of minorities to participate in the judicial making process.
• Article 38 provides for the civic rights for all persons.

Having rights guaranteed by law does not mean that the rights of PWDs are assured. The 2013 report ACCESS TO EDUCATION BY PERSONS WITH DISABILITIES IN UGANDA’S EDUCATION SYSTEM sums up the situation:

The evidence has shown that the Ugandan government has breathed new life into the rights of PWDs since adopting the CRPD (United Nation Convention on the Rights of Persons with Disabilities) but the lack of resources, weak legal enforcement, unsecure financial commitments and inadequate facilities, have overshadowed these developments.

Providing for Human Rights does not automatically mean that equality and social inclusion are granted. There is still a long way to go and a lot of work to be done.

Human Rights

Human dignity is the basis of human rights law. Article 1 of the Convention on the Rights of Persons with Disabilities states:

The purpose of the present Convention is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.

This blog has shown that disability is viewed as a curse in Uganda. Time and again persons with disabilities (PWDs) have told about the stigma and prejudice they face. If you accept that disability is a curse then you make stigma and prejudice acceptable; you take away human rights and human dignity.

Due to poor hygiene conditions characterized by dirty and inaccessible toilets in local schools has led to school dropout and infectious diseases among pupils with disabilities

Disabled people have the same rights as everyone else. Disability is a natural part of human diversity.

Beware of Statistics

This headline from April 2016, Special Needs Education budget increased by 34.4% deserves further investigation.

Special needs education is a term used by the Ugandan government to describe the education of children with disabilities (CWDs).

As a proportion of the population there are between 11.5-12.3% (CWDs). How much of the education budget would you expect was allocated to special needs?

These figures are taken from Uganda Budget Information. They are in billions of Shillings.

Financial Year	Total Education Budget	Total Special Needs Budget
2014-15	1,674.50	2.25
2015-16	1,741.00	2.25
2016-17	923.89	2.18

The 2015-16 special needs budget was a paltry 0.12% of the total education budget. In the 2016-17 budgetary period there was a clear decline in spending on special needs education.

Do you think more money should be allocated to special needs education?