Behind Closed Doors*
“The history of this type of madness has to be
written down: Within the dominant rationalistic
culture, before the other form in which people use
the cruel language of being unable to be mad takes
its own space within the authority of the truth,
before it is revived by the lyrism of protest, this
moment of conspiracy should be caught. “‘
“Our society still excludes insane people. ” 1
Michel Foucault 2
We, being human rights activists, were shocked when we read three years ago reports of arbitrary detention and mistreatment of people with mental disabilities in social care and psychiatry institutions like Dragash Voyvoda in Bulgaria. The images that reminded us of the concentration camps were horrifying. It is another shocking reality to see that the discrimination that occurs in places far from the eyes of the society in Bulgaria3 also occurs in our country.
The report titled “Behind Closed Doors” prepared by MDRI, that describes the problems in psychiatric facilities, orphanages and rehabilitation centres of Turkey from a human rights perspective describes the reality in Turkey. The report includes the results and observations that were accumulated within the two-year investigation. According to the terrifying findings, the inhumane and degrading conditions that people with mental disabilities are exposed to in the institutions far away from public attention are equivalent to torture. This is a very serious claim that needs to be taken seriously.
According to the report, as there is no applicable procedure or law for the independent legal bodies, anyone can be arbitrarily detained in psychiatric institutions, disregarding the international human rights law. This means that you are under serious danger of being exposed to torture and mistreatment. As an example, if you are detained at a psychiatry hospital like Bakirkoy, it is quite possible that you will be given electroshock treatment without anesthesia or muscle relaxants. What is more horrifying is that you might be given this treatment not only for the purpose of treatment, but also as punishment. Another terrifying finding is that electroshock is also applied to children.
According to the WHO standards, electroshock should never be conducted on children, even with anesthesia.
Another terrifying dimension of the seriousness is that basic needs such as food and water are not sufficiently provided in the rehabilitation centres and orphanages. We also learn from the report that medical care and adequate rehabilitation are lacking in these institutions. Isolation is a widespread method that is applied both on children and adults. The indifference of society regarding the issue makes the situation much more serious.
As in many other places, also in our society, the prejudice against people with mental disabilities is the main reason underlying all these problems. Another important reason is the economic difficulties. Discriminatory treatment due to prejudices breaks off the humane connection between people and results in treating the other like an object. These discriminatory treatments sometimes can also occur at the institutional level and result in suffering that is very difficult or even impossible to repair.4
According to the temporary results of Turkey Disability Research, 12.29 % of the whole population, in other words approximately 8.5 million people have disabilities. As the State Minister Guldal Aksit responded to the written inquiry proposal of Bursa Parliamentarian Kemal Demirel, 8,431,937 out of the total population of 68,622,559 have disabilities: 3,783,197 of these people with disabilities are men, whereas 4,648,740 are women. The percentage of men with disabilities is 11.1%, whereas of women is 13.4%. There are also differences in how people with disabilities are scattered within Turkey. The highest number of people with disabilities is located in the north-western Marmara region, whereas the lowest number is located in the south-eastern region. 13.1% of the whole population in the Marmara region has disabilities, whereas this ratio is 9.9% for the south-eastern region. 12.69% of people with disabilities live in urban areas, while 11.67% live in rural areas. 1.25% of people with disabilities have orthopedic disabilities, 0.38% has speech disabilities, 0.60% has visual disabilities, 0.37% has hearing disabilities and 0.48% has mental disabilities. Other types of disabilities are around 9.7%.5
We do not have quantitative data on the number of people who are getting (or cannot get) psychiatric treatment. Even the lack of regular data itself can be a good¬enough reason to regard the issue as a suspicious one. In addition, as experts also admit, it is difficult for people who have mental disabilities and who are under psychiatric treatment to defend themselves against possible abuses.6 When combined with the fact that the European Human Rights Court has decided many times that Turkey has violated the 3rd article of the European Human Rights Declaration, all these data demonstrate that our suspicions are not irrelevant.
Another dimension of the terrifying reality is that most cases of abuse occur at state institutions and are conducted directly by the state officials. One of the main reasons underlying this is that these abuses occur in remote places far away from public monitoring and behind closed doors. The ones who conduct the inhumane and degrading acts feel more comfortable when they know that no one is aware of what they are doing. When people become aware of the situation, it becomes possible to stop the tyranny or at least to reduce it. The key word in such cases is information because information is the only key to open the closed doors. The success of reliable organizations like MDRI lies in this. They provide us, the public, with sufficient and correct information at the right time so that we can begin to act.
When the above-mentioned perspective is taken, we welcome MDRI’s efforts with respect as the Human Rights Agenda Association. The report “Behind Closed Doors ” does not only describe the human rights violations in psychiatric facilities, orphanages and rehabilitation centres of Turkey, but also provides us with constructive suggestions for solutions. To be able to reach the solutions, it is of vital importance thatTurkey signs the Optional Supplementary Protocol to the UN Convention Against Torture, that suggests that all places of detention including psychiatric facilities, orphanages and rehabilitation centres are monitored by independent experts through visits and in cooperation with NGOs. This obliges us to establish an independent human rights institution as soon as possible. An independent human rights organization embodying the NGOs in a democratic way can initiate processes like the Optional Supplementary Protocol to the UN Convention Against Torture, provide correct evidence for incidents, and the presence of such an organization itself can be preventive. Most importantly, we have to remember that it becomes possible to open the doors only if we can open the doors in our minds.
Hoping that the world will become a place where there are no human rights violations…
HAKAN ATAMAN**
* Behind Closed Doors: Human Rights Abuses in the Psychiatric Facilities, Orphanages and Rehabilitation Centers of Turkey, Mental Disability Rights International (MDRI), http://www.mdri.org/
** Secretary General of Human Rights Agenda Association
1 Ibid., p.84.
2 Michel Foucault; “Great Detention – Preface to the History of Madness”, pp. 20-21.
3 Bulgaria Arbitrary Detention and Ill-treatment of People with Mental Disabilities; Al Index: EUR 15/008; 10 October 2002; www.amnesty.org/library/index/ENGEUR150082002 . The reports prepared by Amnesty International, Bulgarian Helsinki Committee and MDRI included investigations between October 2001 and January 2002.
4 Zaman newspaper, Nihat Yildiz, Fikri Kaya, Izmit, 22.03.2002; www.zaman.com.tr/2002/03/22/marrnara/butun.htm ; Radikal newspaper, 18.09.2004, www.radikal.com.tr/haber.php?haberno=128356 .
5 CNN TURK, 23.10.2004, 13:08:00 (TSI),
www.cnnturk.com.tr/arama/haber detay.asp?PID=0031&haberID=45440 . Also in TURKEY 2003 DISABILITY RESEARCH, State Statistics Institute,
http://www.tsd.org.org.tr/istatistik/ Engelli_Istatistikleri_02Aralik2003.doc
6 Milliyet newspaper, http://www.milliyet.com/2005/02/25/yasam/yasOl.html .