Gender-Related Differences in the Human Rights Needs of Patients with Mental Illness

精神病患者在人權需求性別之差異

10.1097/JNR.0b013e318257b57b

Poreddi Vijayalakshmi；Konduru Reddemma；Suresh Bada Math

性別差異 ； 人權 ； 需求評估 ； 精神疾病 ； gender differences ； human rights ； needs assessment ； mental illness

The Journal of Nursing Research

20卷2期（2012 / 06 / 01）

90 - 98

英文

Background: Individuals with mental illness commonly experience human rights violations while seeking to meet their basic needs. There is lack of research in developing countries on gender-related differences in human rights needs. Purpose: This study investigated gender differences in perceived human rights needs at the family and community levels in individuals with mental illness in India. Methods: This descriptive study surveyed 100 asymptomatic individuals with mental illness at a tertiary care center. Subject selection employed a random sampling method. Data were collected using face-to-face interviews based on a structured needs assessment questionnaire. Data were analyzed and interpreted using descriptive and inferential statistics. Results: Subjects enjoyed a satisfactory level of fulfillment in the physical dimension of human rights needs, which included food, housing, and clothing. Men expressed lower satisfaction than women with perceived human rights needs fulfillment in the emotional dimension. This included fear of familymembers (X^2 = 9.419, p ＜ .024) and being called derogatory names (X^2 = 8.661, p ＜ .034). Women expressed lower satisfaction than men with perceived human rights needs fulfillment in social and ethical dimensions. The former included freedom to leave the home (X^2 = 11.277, p ＜ .010), and the latter included sexual abuse by family members (X^2 = 9.491, p ＜ .019). Men felt more discriminated than women due to perceptions of mental illness in the community domain (X^2 = 10.197, p ＜ .037).Conclusion: This study suggests that family members and communities need to be educated regarding the human rights needs of people with mental illness and that legislation must be strengthened to meet the human rights needs of this disadvantaged population.

Background: Individuals with mental illness commonly experience human rights violations while seeking to meet their basic needs. There is lack of research in developing countries on gender-related differences in human rights needs. Purpose: This study investigated gender differences in perceived human rights needs at the family and community levels in individuals with mental illness in India. Methods: This descriptive study surveyed 100 asymptomatic individuals with mental illness at a tertiary care center. Subject selection employed a random sampling method. Data were collected using face-to-face interviews based on a structured needs assessment questionnaire. Data were analyzed and interpreted using descriptive and inferential statistics. Results: Subjects enjoyed a satisfactory level of fulfillment in the physical dimension of human rights needs, which included food, housing, and clothing. Men expressed lower satisfaction than women with perceived human rights needs fulfillment in the emotional dimension. This included fear of familymembers (X^2 = 9.419, p ＜ .024) and being called derogatory names (X^2 = 8.661, p ＜ .034). Women expressed lower satisfaction than men with perceived human rights needs fulfillment in social and ethical dimensions. The former included freedom to leave the home (X^2 = 11.277, p ＜ .010), and the latter included sexual abuse by family members (X^2 = 9.491, p ＜ .019). Men felt more discriminated than women due to perceptions of mental illness in the community domain (X^2 = 10.197, p ＜ .037).Conclusion: This study suggests that family members and communities need to be educated regarding the human rights needs of people with mental illness and that legislation must be strengthened to meet the human rights needs of this disadvantaged population.

1. Raha, S. (2009). Protecting women with disabilities from violence. InfoChange News & Features, Retrieved from http://www.infochangeindia.org
2. Konar, D. (2004). Rape fear sends father into tizzy. Calcutta Times, Times of India. Retreived from http://timesofindia.indiatimes.com/articleshow/861660.cms
3. Nieves, R. (1997). Gender-based violence: A human rights issue. Retrieved from http://www.google.co.in/#hl=en&biw=1276&bih=561&rlz=1R2ADRA_enIN418&q=Rico%2C+N.+(1997).+GENDER-ASED+VIOLENCE:+A+HUMAN+RIGHTS+ISSUE.&fp=c016430affb2e389
4. Krishnakumar, A. (2001). Deliverance in Erwadi. Frontline. Retrieved from http://en.wikipedia.org/wiki/Erwadi_fire_incident 24
5. Abel, K. M.,Drake, R.,Goldstein, J. M.(2010).Sex differences in schizophrenia.International Review Psychiatry,22(5),417-428.
6. Afifi, M.(2007).Gender differences in mental health.Singapore Medical Journal,48(5),385-391.
7. Allden, K.,Jones, L.,Weissbecker, I.,Wessells, M.,Bolton, P.,Betancourt, T. S.,Sumathipala, A.(2009).Mental health and psychosocial support in crisis and conflict: Report of the mental health working group.Prehospital and Disaster Medicine,24(4),217-227.
8. Andermann, L.(2010).Culture and the social construction of gender: Mapping the intersection with mental health.International Review Psychiatry,22(5),501-512.
9. Angermeyer, M. C.,Schulze, B.,Dietrich, S.(2003).Courtesy stigma-A focus group study of relatives of schizophrenia patients.Social Psychiatry and Psychiatric Epidemiology Zimbabwe,38(10),593-602.
10. Arvidsson, H.(2010).Gender differences in needs and care of severely mentally ill persons: Findings from a Swedish crosssectional and longitudinal study.International Journal of Social Psychiatry,56,424-435.
11. Badger, T. A.,McNiece, C.,Bonham, E.,Jacobson, J.,Gelenberg, A. J.(2003).Health outcomes for people with serious mental illness: A case study.Perspectives in Psychiatric Care,39,23-32.
12. Barbato, A.,Monzani, E.,Schiavi, T.(2004).Life satisfaction in a sample of outpatients with severe mental disorders: A survey in northern Italy.Quality Life Research,13(5),969-973.
13. Brunette, M.,Drake, R. E.(1998).Gender differences in homeless persons with schizophrenia and substance abuse.Community Mental Heath Journal,34,627-642.
14. Chandra, P. S.,Deepthivarma, S.,Michael, P. C.,Kate, B. C.,Shalinianant, M. P.(2003).A cry from the darkness: Women with severe mental illness in India reveal their experiences with sexual coercion.Psychiatry Prax,66(4),323-334.
15. Christensen, R. C.,Grace, G. D.(1999).The prevalence of low literacy in an indigent psychiatric population.Psychiatric Services,50,262-263.
16. Cloitre, M.,Tardiff, K.,Marzuk, P.,Leon, A.,Portera, L.(1996).Childhood abuse and subsequent sexual assault among female inpatients.Journal of Traumatic Stress,9,473-482.
17. Corrigan, P.,Thompson, V.,Lambert, D.,Sangster, Y.,Noel, J. G.,Campbell, J.(2003).Perceptions of discrimination among persons with serious mental illness.Psychiatric Services,54(8),1105-1110.
18. Flowers, N.,Bernbaum, M.,Rudelius-Palmer, K.,Tolman, J.(2000).The human rights education handbook: Effective practices for learning, action and change.
19. Ghai, A.(2002).Disabled women: An excluded agenda of Indian feminism.Hypatia,17(3),57.
20. Guy, W.(1976).ECDEU Assessment Manual for Psychopharmacology.Rockville, MD:U.S. Dept. Health,Education, and Welfare.
21. Kadri, N.,Manoudi, F.,Berrada, S.(2004).Stigma impact on Moroccan families of patients with schizophrenia.Canadian Journal of Psychiatry,49(9),625-629.
22. Kulhara, P.,Avasthi, A.,Sharma, A.(2000).Magico-religious beliefs in schizophrenia: A study from north India.Psycho-pathology,33(2),62-68.
23. Kumar, A.(2000).Manipal, India,Manipal Academy of Higher Education.
24. Lawska, W.,Zieba, M.,Nicka, L. Y.,Sulek, J.,Poltorakk, M.(2006).The way they perceive their own illness and their expectations from the society.Journal of Physiology and Pharmacology,57(Suppl 4),191-198.
25. Miles, S.,Davis, T.(1995).Patients who can't read: Implications for the health care system.Journal of American Medical Association,274,1719-1720.
26. Minas, H.,Diatri, H.(2008).Pasung: Physical restraint and confinement of the mentally ill in the community.International Journal of Mental Health System,2(1),8.
27. National Human Rights Commission(1999).Quality assurance in mental health.National Human Rights Commission.
28. Padmavati, R.,Thara, R.,Corin, E.(2005).A qualitative study of religious practices by chronic mentally ill and their caregivers in South India.International Journal of Social Psychiatry,51(2),139-149.
29. Parikh, N. S.,Parker, R. M.,Nurss, J. R.,Baker, D. W.,Williams, M. V.(1996).Shame and health literacy: The unspoken connection.Patient Education and Counseling,27,33-39.
30. Patel, V.,Bloch, S.(2009).The ethical imperative to scale up health care services for people with severe mental disorders in low and middle income countries.Postgraduate Medical Journal,85(1008),509-513.
31. Patel, V.,Simunyu, E.,Gwanzura, F.(1997).The pathways to primary mental health care in high density suburbs in Harare.Social Psychiatry and Psychiatric Epidemiology Zimbabwe,32(2),97-103.
32. Pinfold, V.,Byrne, P.,Toulmin, H.(2005).Challenging stigma and discrimination in communities: A focus group study identifying UK Mental Health Service users' main campaign priorities.The International Journal of Social Psychiatry,51(2),128-138.
33. Rao, P. N.(2004).Rehabilitation of the wandering seriously mentally ill (WSMI) womenVThe Banyan experience.Social Work in Health Care,39(1-2),49-65.
34. Read, U. M.,Adiibokah, E.,Nyame, S.(2009).Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana.Global health,14(5),13.
35. Schulze, B.,Angermeyer, M.(2003).Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals.Social Science & Medicine,56(2),99-312.
36. Sharma, S.(2003).The Indian institutional mental care experience.Current Opinion in Psychiatry,16,547.
37. Shekhar, S.,Graham, T.,Martin, K.,Harvey, W.(2007).Resources for mental health: Scarcity, inequity, and inefficiency.The Lancet,370(9590),878-889.
38. Thara, R.,Kamath, S.,Kumar, S.(2003).Women with schizophrenia and broken marriagesYdoubly disadvantaged? Part I: Patient perspective.International Journal of Social Psychiatry,49(3),225-232.
39. Thesen, J.(2001).Being a psychiatric patient in the community- Reclassified as the stigmatized "other.".Scandinavian Journal of Public Health,29(4),248-255.
40. United Nations(1998).The Universal Declaration of Human Rights Adopted and proclaimed by the General Assembly of the United Nations on 10 December 1948.International Social Science Journal,50,471-474.
41. Vindhya, U.(2001).Mental health care: A review of gender differences.International Journal of Diabetes Developing Countries,21(2),86-95.
42. Wahl,O.(1999).Mental health consumers' experience of stigma.Schizophrenia Bulletin,25,467-478.