Comparative Study to Assess the Knowledge on Human Rights of Mentally Ill individuals in Urban and Rural areas at Bangalore

Introduction

Mental illness represents a range of diverse conditions where serious infringement of human rights can occur from deprivation of a person’s dignity and right to life, to complete denial of the right to lead a fulfilling life. If the rights of the mentally ill are to be assured and protected, several players from diverse areas of society need to play an active role. In this article, we examine the specific role of the judiciary in addressing some of the critical mental health care needs of the country and highlight the landmark role of the National Human Rights Commission (NHRC) in addressing and being a part of mental health change in the country.¹

Chapter VIII of Mental Health Act, 1987 contains a very novel and explicit provision of protection of human rights. Universal Declaration of Human Rights (UDHR) in Article 24(1) explicitly mentions that “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services.” Article 5 of UDHR states “no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” Psychiatric patients are often the least capable of protecting their own rights. It is therefore one of the responsibilities of the nurse to guide the patients and relatives in matters related to their rights and protect the patient from any mistreatment.²

The human rights of mentally ill clients are very important because, unlike other aggrieved groups, they are unaware of their rights most of the time, hence do not stand up and fight for them. People suffering from mental illness are among the most disadvantaged groups in society. Further, they suffer severe personal distress and they are stigmatized, discriminated against, marginalized and often left vulnerable.

Everyone has the basic human rights, including those who are mentally ill. Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, and housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.³ 

It was estimated that over 1.1 billion people worldwide had a mental disorder in 2016.An estimated 4.5 million Americans today suffer from the severest forms of brain disorders, schizophrenia and manic-depressive illness. And out of 4.5 million, 1.8 million or 40% are not receiving any treatment, resulting in homelessness, incarceration, and violence. So, it is hardly surprising that approximately 1/3^rd of homeless persons suffer from severe and disabling mental illness.⁴

Objectives

1.  To assess the level of knowledge regarding human rights of mentally ill individuals among urban and rural population. 
2. To compare the knowledge between urban and rural population regarding human rights of mentally ill individuals. 
3. To determine the association between knowledge of urban population regarding human rights with their selected demographic variables. 
4. To determine the association between knowledge of rural population regarding human rights with their selected demographic variables.

Material and Methods

A comparative descriptive design was used to conduct the study. The study was conducted in urban and rural areas of Bangalore. The data were collected from two hundred subjects by convenient sampling. Written consent was obtained from all the subjects. Tools used were demographic variables such as age, gender, religion, education, employment, marital status, place of residence, history of mentally ill person in the family and previous knowledge regarding human rights of mentally ill individuals and a self-structured knowledge questionnaire that included items on knowledge regarding human rights of mentally ill individuals. It had 25 items on aspects of human rights of mentally ill people. Informed consent was taken from the respondents. The maximum score for correct response to each item was “one” and the incorrect was “zero.” The total possible score of the self-structured questionnaire was 25. Questionnaire was administered and data was collected. Ethical clearance was obtained from ethical committee. Content validity of the tool was established by Split half technique with raw score method by Karl Pearson Formula. The obtained score was 0.763 and it was found to be reliable. Pre-testing of tools was done. A pilot study was conducted to see the feasibility. The obtained data were analyzed based on the objectives and hypothesis by using descriptive and inferential statistics.

Bar graph shows that 10 (10%) from urban and 27 (27%) from rural areas had inadequate knowledge, 23 (23%) from urban and 42 (42%) from rural had moderate knowledge and 67 (67%) from urban and 31 (31%) from rural had adequate knowledge

Comparison of the Knowledge Scores of Urban and Rural Population

Table 1 shows the results of application of Z test to knowledge scores of urban and rural population. The overall mean score of urban population was 18.33, whereas mean score of rural population was 13.45. The standard deviation of urban people was 5.07 and of rural people was 6.15. The table value of ‘Z’ at 0.05 level of significance was found to be 1.96 and calculated value was found to be 6.1.

Table 2 shows the outcome of chi square analysis being carried out to find out association between knowledge of urban and rural people regarding human rights of mentally ill individuals with their selected demographic variables. The categories such as age, gender, religion, employment and previous information received regarding human rights of mentally ill individuals were found to be significant at 5% level. Out of which, educational qualification, marital status and history of mentally ill person in the family were found to be not significant for urban people, whereas the categories such as gender, religion, marital status and previous information received regarding human rights of mentally ill individuals were found to be significant at 5% level. Out of which, age, educational qualification, employment and history of mentally ill person in the family were found to be not significant for rural people.

Discussion

The present study revealed that there was significant association at 0.05 level between knowledge of urban and rural people and their selected demographic variables. The present study emphasizes on enhancements regarding knowledge of human rights of mentally ill individuals mainly in rural areas. This study also emphasizes continuing education, seminar and conferences through mass media, so that both urban and rural people can educate their family members too. The findings of the research are fruitful only when incorporated into practice. It is the responsibility of the each and every member in the society to be aware about the rights of mentally ill individuals.

Conclusion

The present study concluded that the knowledge of urban people regarding human rights of mentally ill individuals was adequate in comparison to rural people. There was significant association between knowledge of urban and rural people regarding human rights with their selected demographic variables.