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3 Mental Health Care for Deaf People: An Approach Based on Human Rights Ana María García García Javier Muñoz Bravo Since Deaf people who have a mental illness are often viewed as a minority within a minority, this topic would seem to be of interest to very few people. In fact, the number of professionals interested and/or active in this field is quite small worldwide. However, we believe that the experiences of Deaf people who suffer mistreatment and/or discrimination at the hands of health-care services are universal and therefore not minor. Given that health care is considered a fundamental human right, denial or ignorance of the specific mental health–care needs of Deaf people may be a violation of this right and thus should be of concern to the treating professionals, the governing representative, and every citizen as well. HEALTH AND HUMAN RIGHTS In 1946 the right to health was spelled out in the Constitution of the World Health Organization (WHO) as follows: “The enjoyment of the highest attainable health is one of the fundamental rights of every human being without distinction of race, religion, political beliefs, economic or social condition.” The right to health care was reaffirmed by the Declaration of Alma-Ata in 1978, by the World Health Declaration , which was adopted by the World Health Assembly in 1998, and by a number of other international and regional human rights instruments.1 Because health is a variable beyond the direct control of governing states and depends on a variety of environmental, genetic, cultural, and individual factors, the right to health is not the right to good health or freedom from disease. 1 ara86542_01_ch01.indd 3 ara86542_01_ch01.indd 3 13/10/15 12:43 PM 13/10/15 12:43 PM Ana María García García and Javier Muñoz Bravo 4 The right to health refers to the obligation of states to create conditions that permit all citizens to live as healthily as possible. These include, of course, the guaranteed availability of equitable and appropriate health services, as well as of the primary health-determining conditions, such as access to potable water; adequate sanitation services; a nutritious food supply; appropriate housing; a healthy work environment; and access to education and to information on health issues, including sexual and reproductive health. Established as a fundamental and universal human right that is guaranteed under and protected by international law, the right to health is therefore very important inasmuch as human rights protect individuals and groups of people from actions that undermine their fundamental freedoms and human dignity. The right to health imposes three types of obligations on the states that ratify them: • Respect: the enjoyment of the right to health • Protection from actions of third parties (with the possible exception of the state) that would interfere with the enjoyment of the right to health • Compliance: the implementation of positive measures to make the right to health a reality by establishing policies and action plans that provide access to health care for all people as soon as possible. States must adopt measures in accordance with the principle of progressive realization. This means that they must go forward as quickly and efficiently as possible, by their own means as well as with international help and cooperation up to the maximum extent of the available resources. Human rights are interdependent and interconnected. The Vienna Declaration and Programme of Action states the following:2 “The international community must treat human rights globally in a fair and equal manner, on the same footing, and with the same emphasis . . . [I]t is the duty of States, regardless of their political , economic and cultural systems, to promote and protect all human rights and fundamental freedoms.” Since health as a right is affected by other rights having to do with the maintenance of an adequate standard of living, such as access to education or employment, then people who live in poverty or are inadequately educated are more likely to have poorer health than those who enjoy economic security and decent living conditions. It is significant that poverty, inadequate access to education, and other factors that have a negative impact on human rights appear disproportionately among people with disabilities, including Deaf people. The universality of human rights means they are applicable to everyone worldwide , including people with disabilities and/or mental health problems. Despite the fact that the United Nations resolutions that protect individuals with mental health problems explicitly forbid...


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