Prevalence of complex post-traumatic stress disorder in survivors of human trafficking and modern slavery: a systematic review

Background and objectives. The human rights violation of human trafficking and modern slavery could be described as multiple and prolonged traumatisation. This corresponds to the type of trauma identified as most likely to be associated with ‘complex post-traumatic stress disorder’ (CPTSD) as identified in the new 11th edition of the International Classification of Diseases (ICD-11). This review aims to collate the evidence of complex post-traumatic stress disorder in populations that have been trafficked, with the intention to highlight important considerations to be made in terms of managing survivor's health care needs and minimising further traumatisation. Methods Five databases were searched using key terms related to human trafficking, modern slavery, and complex post-traumatic stress disorder. Results Five studies reporting on a total of 342 participants were included in the review. These studies indicated that an average of 41% of survivors of modern slavery and human trafficking had CPTSD. This was higher than the 14% diagnosed with PTSD. Post-trafficking stress, endured whilst living in refugee camps, was higher in individuals with CPTSD than in those living with PTSD. Healthcare was more difficult to access by populations with PTSD and CPTSD compared to those with no diagnosis. Conclusion There is a high prevalence of CPTSD in modern slavery and trafficking survivors therefore a need for identification and specialised treatment. Consideration should be given to consequent biopsychosocial needs, particularly access to healthcare and minimisation of post-trafficking stress.

Psicologia e direitos humanos: um relato de experiência sobre oficinas com adolescentes / Psicología y derechos humanos: un relato de experiencia sobre talleres con adolescentes / Psychology and human rights: an account of experience with workshops for adolescents

RESUMO. Diante das necessárias interfaces entre a psicologia e os direitos humanos, este estudo pretende relatar e analisar, reflexivamente, uma intervenção em educação em direitos humanos com adolescentes participantes de um projeto social de uma cidade situada na região metropolitana de Porto Alegre. O percurso metodológico escolhido para este estudo foi o relato de experiência de oficinas de educação em direitos humanos que ocorreram durante os meses de maio e junho de 2017. Os participantes foram 15 adolescentes de diferentes níveis de escolaridade, com idade média 13,9 anos, todos participantes de um projeto social. A experiência foi relatada em Diário de Campo e analisada pela metodologia da Análise temática de Minayo. Como resultado deste estudo, foram relatados os desafios e as contribuições da psicologia na construção de oficinas de educação em direitos humanos com adolescentes. Verificou-se a importância de construir as oficinas de educação em direitos humanos com o grupo, permitindo o compartilhamento e o reconhecimento da realidade dos participantes. Neste sentido, ressalta-se a importância de trabalhar esta temática com adolescentes, além da potência existente na contribuição da psicologia diante da articulação com os direitos humanos.

RESUMEN Delante de las necesarias interfaces entre la Psicología y los Derechos Humanos, este estudio pretende relatar y analizar, reflexivamente, una intervención en Educación en Derechos Humanos con adolescentes participantes de um proyecto social de una ciudad situada en la región metropolitana de Porto Alegre. El recorrido metodológico escogido para este estúdio fue el relato de experiencia de talleres de Educación en Derechos Humanos que acontecieron durante los meses de mayo y junio de 2017. Los participantes fueron 15 adolescentes de diferentes grados de escolaridad, com edad media 13,9 años, todos participantes de um proyecto social. La experiencia fue relatada em Diario de Campo y analizada a través de la metodología de la Análisis Temática de Minayo. Como resultado de este estudio, fueron relatados los desafíos y las contribuciones de la psicologia en la construcción de talleres de Educación en Derechos Humanos con adolescentes. Se verifico la importancia de construir los talleres de Educación en Derechos Humanos com el grupo, permitiendo la compatibilidad y el reconocimiento de la realidad de los participantes. En este sentido, se resalta la importancia de trabajar esta temática con adolescentes, además de la potencia existente en la contribución de la psicología frente de la articulación com los Derechos Humanos.

ABSTRACT Due to the needed interfaces between Psychology and Human Rights, this study intends to report and analyze, reflectively, an intervention in Human Rights Education with adolescents who took part in a social project of a city located in the metropolitan region of Porto Alegre. As the methodological path chosen for the study, an account of experience with Human Rights Education workshops that took place during the months of May and June of 2017. The participants were 15 adolescents of different educational levels, with a mean age of 13.9 years, all of whom participated in a social project. The experience was reported in a Field Journal and analyzed through Minayo's Thematic Analysis methodology. According to the study's, challenges and contributions of Psychology in the development of Human Rights Education workshops with adolescents were reported. The importance of building the Human Rights Education workshops with the group was noticed, which allows the sharing and recognition of the participants' reality. Thus, the importance of addressing this topic along with adolescents, as well as the power in the contribution of Psychology to the articulation with Human Rights are highlighted.

El derecho a ser donante de órganos es una responsabilidad de todos / The right to be an organ donor is the responsibility of us all

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Salud mental y COVID-19: una prioridad para los derechos humanos de las mujeres

Piloting forensic tele-mental health evaluations of asylum seekers.

While the number of medical human rights programs has increased, there is substantial unmet need for forensic evaluations among asylum seekers throughout the United States. From September 2019 through May 2020, the Mount Sinai Human Rights Program has coordinated pro bono forensic mental health evaluations by telephone or video for individuals seeking protected immigration status who are unable to access in-person services. The national network clinicians conducted 32 forensic evaluations of individuals in eight U.S. states and Mexico seeking immigration relief. Remote forensic services have been a relevant solution for individuals in immigration detention, particularly during the COVID-19 pandemic.

Capacity in the time of Coronavirus.

In the course of a few short weeks, many of the established legal frameworks relating to decision-making in England & Wales in respect of those with impaired decision-making capacity have been ripped up, or apparently rendered all but unusable. Although the Mental Capacity Act 2005 itself has not been amended, the impact of other legislation (especially the Coronavirus Act 2020) means that duties towards those with impaired decision-making capacity have been radically changed. This article reflects the experience of a practising barrister in England & Wales grappling with the impact of COVID-19 upon the Mental Capacity Act 2005 across a range of fields in the weeks after the world appeared to change in mid-March 2020.

The mental health of those whose rights have been taken away: An essay on the mental health of indigenous peoples in the face of the 2019 Coronavirus (2019-nCoV) outbreak.

Background: : In Latin America there are about 45 million indigenous people in 826 communities that represent 8.3% of the population. An estimated 798,365 Aboriginal and Torres Strait Islander were in Australia, 5,2 million indigenous people living in America and 2,13 million in Canada. Racial/ethnic disparities in mental health service use have increased especially in the context of the new coronavirus pandemic. Thus, we aimed to describe the mental health situation of the indigenous population in the context of the COVID-19 pandemic. Method: : The studies were identified in well-known international journals found in three electronic databases: PubMed, Scopus, and MEDLINE. The data were cross-checked with information from the main international newspapers. Results: : According to the literature, due to the COVID-19 pandemic there is a lack of specialized mental health services and professionals, a restricted access to quality information and a lack of access to inputs, causing negative feelings and it can exacerbate pre-existing mental problems (eg: depression, suicidal ideation, smoking and binge drink). The cultural differences are a risk factor to worsen the mental health of this already vulnerable population. Conclusion: : providing psychological first aid is an essential care component for indigenous populations that have been victims COVID-19 pandemic.

Exercise of human rights of institutionalized persons: perception of psychiatric hospital professionals.

OBJECTIVE: to comprehend the existing possibilities for the exercise of human rights by persons with mental disorders who are institutionalized in a psychiatric hospital, from the perception of professionals. METHOD: this is a qualitative descriptive-exploratory study conducted at a Psychiatric Hospital in the state of São Paulo, Brazil. For data obtention, eleven professionals responded to a semistructured questionnaire. The traditional content analysis proposed by Bardin based the data analysis. RESULTS: the professionals know the human rights and try to preserve them in the hospital scope, although they recognize that the persons hospitalized are not entirely respected due to the lack of public policies or their non-suitability to the Brazilian reality. FINAL CONSIDERATIONS: the structuring of extra-hospital services is necessary, as well as the comprehension of the professionals that act in psychiatric hospitals about the objectives and the functioning of such devices to assure opportunities of exercising rights by institutionalized persons.

Deficiência e capacitismo: correção dos corpos e produção de sujeitos (a)políticos / Disability and ableism: correction of bodies and production of (a)political persons / Discapacidad y capacitismo: corrección de los cuerpos y producción de sujetos (a)políticos

Este estudo objetivou investigar os significados acerca da deficiência presentes no processo de cria-ção e implementação de um Conselho Municipal de Direitos para Pessoas com Deficiência de uma cidade do sul do Brasil. Para tanto, foram realizadas entrevistas semiestruturadas com nove participantes da criação e implementação desse Conselho, as quais foram analisadas a partir da análise dos processos de significação. A pesquisa foi baseada nos Estudos da Deficiência, com destaque para a perspectiva da pesquisa emancipatória. Os participantes relataram haver uma compreensão da de-ficiência circunscrita ao modelo médico, que reiterava a hierarquização dos corpos, a busca pela cu-ra e que deslegitimava o corpo com deficiência como político. Todavia, a apropriação do campo dos estudos da deficiência e o conhecimento dos direitos previstos na legislação contribuiu para a signifi-cação da deficiência como circunscrita à justiça social e para fortalecer a luta pela aprovação do conselho de direitos

This study aimed to investigate the meanings about disability present in the process of creating and implementing a Municipal Council of Rights for People with Disabilities in a city in southern Brazil. To this end, semi-structured interviews were conducted with nine participants in the creation and implementation of this Council, which were analyzed based on the analysis of the processes of meaning. The research was based on Disability Studies, with emphasis on the perspective of emancipatory research. Participants reported an understanding of disability limited to the medical model, which reiterated the hierarchy of bodies, the search for a cure and that delegitimized the disabled body as a politician. However, the appropriation of the field of disability studies and the knowledge of the rights provided for in the legislation contributed to the meaning of disability as social justice and to strengthen the struggle for the approval of the rights council

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Sobreviver nas ruas: percursos de resistência à negação do direito à saúde / Sobrevivir en las calles: resistencias a la negación del derecho a la salud / Surviving on the streets: paths of resistance to the denial of health rights

RESUMO. Contextos de exclusão conformam ciclos de marginalização de grupos populacionais, como a população em situação de rua (PSR). Nesse contexto violações de direitos humanos são recorrentes, em especial a dificuldade de acesso à saúde. A efetivação das políticas para a PSR nas cidades brasileiras ainda é escassa, por sua restrição a cidades de médio e grande porte e ao parco investimento público. Dessa forma, o estudo tem por objetivo investigar os percursos de cuidado à saúde da PSR em um município de pequeno porte. Foram realizadas observações de campo e entrevistas semiestruturadas para identificação e compreensão dos recursos acionados nas trajetórias de cuidado à saúde, que foram analisadas a partir da análise de conteúdo temática. Ressaltaram-se as diversas estratégias desenvolvidas pelo público diante da negação do direito à saúde e ao autocuidado. Destacam-se entre os resultados a precariedade de ofertas ao cuidado da saúde da mulher, a restrição do cuidado em saúde ao uso de substâncias psicoativas, de cunho medicalizante e centrado no paradigma da abstinência. Observou-se a importância da moradia para o cuidado integral, e das redes sociais e comunitárias como forma de restabelecimento da saúde nas ruas.

RESUMEN. Los contextos de exclusión conforman ciclos de marginación de grupos poblacionales, como la población en situación de calle (PSC). En este contexto, violaciones de derechos humanos son recurrentes, en especial la dificultad de acceso a la salud. La efectividad de las políticas para la PSC en las ciudades brasileñas sigue siendo escasa, por su restricción a ciudades de mediano y gran porte y a la poca inversión pública. Así, el estudio buscó investigar los recorridos de cuidado a la salud de la PSC en una ciudad de pequeño porte. Se realizaron observaciones de campo y entrevistas semiestructuradas para identificación y comprensión de los recursos accionados en las trayectorias de cuidado de la salud, que fueron analizadas a partir del análisis de contenido temático. Se resaltan las diversas estrategias desarrolladas por este público como forma de resistencia a la negación del derecho a la salud y autocuidado. Se destacan la precariedad de ofertas al cuidado de la salud de la mujer, la restricción del cuidado en salud al uso de sustancias psicoactivas, de cuño de medicalización y centrado en el paradigma de la abstinencia. Se observaron la importancia de la vivienda para el cuidado integral, y de las redes sociales y comunitarias como forma de restablecimiento de la salud en las calles.

ABSTRACT. Exclusion contexts constitute cycles of marginalization of population groups, such as the homeless people (HP). In this context, human rights violations are recurrent, especially related to the difficulty of access to health services. The effectiveness of the policies for HP in Brazilian cities is still scarce, due to its restriction to medium and large cities and the limited public investment. Thus, the study sought to investigate HP health care paths in a small city. Field observations and semi-structured interviews were carried out to identify and understand the resources used in health care trajectories, which were analyzed based on thematic content analysis. Several strategies developed by the public in the face of the denial to the health rights and self-care are highlighted. Among the results, the precariousness of offers to women's health care, the restriction of health care to the use of psychoactive substances, of medicalizing nature and centered on the abstinence paradigm were stood out. It was observed the importance of housing for comprehensive care, and social and community networks as a way of restoring health on the streets.

The right to liberty of persons with psychosocial disabilities at the United Nations: A tale of two interpretations.

This article explores the current debate which exists within the United Nations human rights system regarding the right to liberty of persons with psychosocial disabilities. Article 14 of the UN Convention on the Rights of Persons with Disabilities states that the existence of a disability cannot be a justificatory ground for the involuntary detention of a person. In interpreting Article 14, the UN Committee on the Rights of Persons with Disabilities has called for States Parties to repeal legislation which provides for detention based on the existence of a psychosocial disability, either solely or in combination with other factors such as a perceived dangerousness or need for treatment - essentially requiring the abolition of mental health laws. However, a number of other human rights bodies within the UN, including the Human Rights Committee, have continued to affirm the lawfulness of deprivations of liberty under mental health legislation in certain circumstances. This article will set out the current state of this discourse and conclude by making a determination on the governing legal interpretation of the right to liberty of persons with psychosocial disabilities under international law.

The meaninglessness of doing bioethics: Reality check from a conflict zone.

Running bioethics workshops one after the other can become a mundane affair, primarily because of the similarity of their content and discourse. However, conducting a workshop for participants from conflict zones such as Palestine provided an entirely new perspective for this author. While the bioethics discourse may translate into useful and actionable guidelines in the free world to help uphold human dignity, to those living in occupied territories and conflict zones, in the face of their lived lives, it appears little more than a self-serving academic exercise by "parachute bioethicists".

Framing Sexual Violence in Portuguese Colonialism: On Some Practices of Contemporary Cultural Representation and Remembrance.

This essay examines two Portuguese novels about colonialism and its legacies: António Lobo Antunes's Fado Alexandrino (1983) and Aida Gomes's Os Pretos de Pousaflores (The Blacks from Pousaflores) (2011). Fado Alexandrino perpetuates the use of Black women's raped bodies as a plot device to represent colonial violence, while Gomes's narrative empowers racialized victims of sexual abuse and challenges dominant public memories of the Colonial War. A close reading of these novels, contextualized against the background of scholarly debates about the representation of sexual violence, exposes both the perils and potential of cultural works to preserve the memory of rape in armed conflict.

The Right (Way) to Represent: The Emotional Politics of Remembering Mass Rape in Germany After 1945.

A Woman in Berlin (1954) has undoubtedly shaped global understanding of wartime rape. The present article focuses on the diarist's use of humor to process her disorientation, assert her subjectivity, and build affective links with other victims. I consider how the diary's tone influenced its reception and thus how aesthetic analysis might illuminate the conditions under which stories about sexual violence become audible, as well as the ways in which the "cultural politics of emotion" (to quote the title of Sarah Ahmed's 2004 study) can both foster and obstruct human rights projects.

Addressing Global Human Rights Violations in Rhode Island: The Brown Human Rights Asylum Clinic.

The Brown Human Rights Asylum Clinic (BHRAC) is a medical student-led organization affiliated with Physicians for Human Rights that collaborates with medical and mental health clinicians, lawyers, and community organizations to provide pro bono medical affidavits to undocumented individuals seeking legal status in the United States. Affidavits can document and corroborate the physical and psychological evidence of trauma alleged by asylum seekers, leading to better legal outcomes. This article describes our innovative program, partnerships, and workflow, as well as demographics and statistics from our past seven years of operation. Since its founding in 2013, BHRAC has conducted 55 medical evaluations, the majority involving Spanish-speaking female-identifying individuals from Guatemala, El Salvador, and the Dominican Republic. Thirteen individuals have been granted legal status, one individual was denied status, and the rest of the cases are pending. BHRAC has experienced a marked increase in affidavit requests. This paper serves as a call to action for medical professionals to become involved in this work.

Social construction of obstetric violence of Tenek and Nahuatl women in Mexico. / Construcción social de la violencia obstétrica en mujeres Tének y Náhuatl de México.

OBJECTIVE: To explore the social construction of obstetric violence developed by Tenek and Nahuatl women in Mexico. METHOD: Qualitative, socio-critical study conducted through focal groups in which were deepened the childbirth experiences lived in the period 2015-2016. RESULTS: Participation of 57 women. Through discourse analysis, it was identified that participants do not have enough information about obstetric violence and/or sexual and reproductive rights. This makes the association of their negative experiences with the legal term "obstetric violence" impossible. Most of their speeches correspond to the legal denomination of "obstetric violence". Experiences like prolonged fasting or the use of technologies for invading their privacy were narrated like situations they perceive as violent, but have not been incorporated within the legal term. CONCLUSION: Multiple actions against women's human rights take place within delivery rooms. Most remain unidentified by users, since they have not socially constructed the image of obstetric violence. However, that fact does not make them less susceptible to feel attacked and denigrated during their childbirth experiences.

Offenders' perceptions of the UK prison smoking ban.

PURPOSE: Despite overall reductions in levels of smoking in the UK, rates of offender smoking remain high. In 2016, it was announced that prisons in England and Wales would gradually introduce a smoking ban. The purpose of this paper is to explore offenders' perceptions around the upcoming smoking ban. DESIGN/METHODOLOGY/APPROACH: A total of eight focus groups were conducted in four prisons across the North of England. Both smoking and non-smoking offenders participated in the focus groups, and thematic analysis was used to explore the findings. FINDINGS: Themes generated from the data were "freedom and rights", "the prison environment" and "guiding support". Participants discussed how the smoking ban was viewed as a punishment and restricted their freedom, with perceptions as to why the ban was being implemented centring around others trying to control them. Participants expressed concerns around the financial implications of the smoking ban on already stretched prison resources. Participants also recommended improving the nicotine replacement therapy on offer, and increasing the range of leisure activities within the prison to prepare for the smoking ban. ORIGINALITY/VALUE: Overall, it was apparent that participants' awareness of the smoking ban was generally poor. It is recommended that offenders need to be made more aware of the smoking cessation support they will receive and given the opportunity to ask questions about the smoking ban. Increasing offenders' awareness of the ban may reduce stress associated with a perceived lack of choice around their smoking behaviours.

Health as a right and the care of the self: conception of nursing professionals.

OBJECTIVE: To analyze health as a right from the perspective of care of the self, in the conception of nursing professionals. METHOD: Qualitative study, carried out in a Federal Hospital of the city of Rio de Janeiro, with the participation of 10 nurses and 20 nursing technicians through interviews recorded, transcribed and analyzed in light of the Discursive Textual Analysis. RESULTS: Two categories emerged: Health as the right of professionals and their "non-right" to health; and Care of the self for the health professional: work and torture. CONCLUSION: There are many challenges to overcome, such as the search for satisfactory public funding, the need to improve the quality of Primary Health Care services, the implementation of a care model compatible with the country's demographic and epidemiological situation; all professionals need an effective endorsement for care of the self, such as their knowledge of the right to health.