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Chain Free

Organization: Habeb Public Mental Hospital

Country: Somalia

Forum: Mental health

It is estimated that one in three Somalis has been affected by some kind of mental illness and yet mental health care systems in the country remain limited. Care is delivered through a small number of psychiatric facilities where conditions and access to drugs are poor and the practice of keeping mentally ill people in chains is common.

The Chain-Free Initiative aims to improve the quality of life for people with mental disorders and restore their rights and dignity. The programme has been organized into 3 main phases:

  • Phase one focuses on reforming current hospitals into chain-free, humane facilities where patients can receive treatment and care with minimum restraints.
  • Phase two provides education and training to the families of people living with mental health problems in order to reduce the use of chains in private residences.
  • The final phase seeks to remove the “invisible chains” of societal stigma and human rights restrictions.

Between 2007 and 2010, over 1700 people had their chains removed. The majority of these people were receiving treatment at Habeb Hospital but over 400 people in private residences were also unchained. In addition, the WHO delivered training to 55 health workers to equip them with the knowledge and skills needed to provide and organize mental health care in the community, while taking into account the resource constraints in the country.

The Initiative has raised national and international awareness of the lack of mental health care in Somalia. The European Union has since provided funding for the cause and a national mental health policy working group has been set-up to support the integration of mental health services into primary care.

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