Human Rights Watch study revealed that hundreds of thousands of people with mental health conditions across the globe are still being ‘chained’.

The study stats that men, women and children – some as young as 10 – are regularly shackled or locked in confined spaces for weeks, months, and even years, across Asia, Africa, Europe, the Middle East, and the Americas.

The report titled ‘Living in Chains: Shackling of People with Psychosocial Disabilities Worldwide” was documented across 60 counties, which revealed that how people with mental issues are often shackled against their will by families in their own homes or in overcrowded and unsanitary institutions because of widespread stigma and a lack of mental health services.

Many of those are forced to eat, sleep, urinate and defecate in the same tiny area.

Meanwhile, in state-run or private institutions, or other healing centers, they are shackled for restraint or punishment and often forced to fast or take medication or herbal concoctions and face physical and sexual violence.

The report also includes field research and testimonies from Afghanistan, Burkina Faso, Cambodia, China, Ghana, Indonesia, Kenya, Liberia, Mexico, Mozambique, Nigeria, Sierra Leone, Palestine, the self-declared independent state of Somaliland, South Sudan, and Yemen.

It is also learned that typically families use shackling practice, who links mental health conditions with evil spirits or an individual having sinned.

People often first consult faith or traditional healers and only seek mental health services as a last resort.

The report also include a story of Mura, 56, in Bali, Indonesia, who was taken to 103 faith healers, when that did not work, he was locked in a room for several year.

The documentary also included an interview of Paul, who is living a life in chains. “I’ve been chained for five years. The chain is so heavy. It doesn’t feel right; it makes me sad. I stay in a small room with seven men. I’m not allowed to wear clothes, only underwear. I eat porridge in the morning and if I’m lucky, I find bread at night, but not every night.”

Paul is among 350 people with psychosocial disabilities, including children, whose experiences were looked at by the group.

The senor disability rights researcher at HRW and author of the report Kriti Sharma said, “Shackling people with mental health conditions is a widespread, brutal practice that is an open secret in many communities.”

“People can spend years chained to a tree, locked in a cage or sheep shed because families struggle to cope and governments fail to provide adequate mental health services,” she added.

While a number of countries are paying greater attention to the issue of mental health, shackling remains largely out of sight. There is no data and no coordinated international or regional effort to eradicate the practice.

Globally, an estimated 792 million people, or one in 10, including one in five children, have a mental health condition. Yet governments spend less than 2% of their health budgets on mental health.

More than two-thirds of countries do not reimburse people for mental health services in national health insurance systems.

Even when mental health services are free or subsidised, distance and transport costs are significant barriers.