USPKENYA

USP

Study on human rights violations of persons with psychosocial disabilities

2013

TABLE OF CONTENTS
TABLE OF CONTENTS 2 ACKNOWLEDGEMENTS 3 EXECUTIVE SUMMARY 4 LIST OF ABBREVIATIONS 6 PURPOSE OF THE STUDY 7 METHODOLOGY 7 FINDINGS 8 CONCLUSION 25 RECOMMENDATIONS 27

ACKNOWLEDGEMENTS
The research team wishes to acknowledge the contribution of all those people who participated in the organization and execution of this exercise. Our particular gratitude goes to all those respondents whose input and insight saw to the success of the study.

We would also like to convey our gratitude to the peer support groups in the four counties namely: Nyeri, Kiambu, Nakuru and Nairobi for allowing us to work with you. Utmost gratitude goes to the Disability Rights Initiative of the Open Society Foundation for financial and technical support that made this research possible.

EXECUTIVE SUMMARY
Recent research shows that persons with disabilities still face serious human rights violations. Various forms of violations are meted out against persons with psychosocial disabilities. Most of the human rights violations go unreported and this has resulted to lack of information to help in policy formulation. This report has reviewed the evidence for different types of human rights violations experienced by persons with psychosocial disabilities both in the community setting and in the health institutions in Kenya. The report is guided by the provisions of the Constitution of Kenya 2010 and the UN Convention on the Rights of Persons with Disabilities (CRPD). The study revealed that despite Kenya enacting a new Constitution and also having ratified the CRPD in 2008, persons with psychosocial disabilities encounter a lot of challenges in the enjoyment and realization of their fundamental rights and freedom. The study revealed that most respondents experienced stigma and discrimination in various spheres of life. Further to this, users and survivors are subjected to a lot of violence in various forms which include rape and physical & verbal abuse. The research further established that there were numerous cases of involuntary treatment where medical interventions were not administered on the basis of free and informed consent. Some of the respondents cited cases of misdiagnosis and also forced sterilization on women with psychosocial disabilities. There were instances where users and survivors were deprived of their liberty on the basis of perceived danger to themselves/others or when they were deemed to be a nuisance to their families. One of the respondents reported deprivation of child custody informally on the basis of being perceived unfit by the family members to bring up the child. Both women and men cited desertion by their spouses upon discovering that they had a mental illness. Exploitation was also common and it was manifest in different forms including sexual, social life and employment. AIM AND OBJECTIVES The aim of the study is to document human rights violations meted on persons with psychosocial disabilities. The objectives are: To explore the human rights violations directed towards persons with psychosocial disabilities

To review and document experiences and views of persons with psychosocial disabilities regarding human rights violations To form a basis for engaging with the justice sector on access to justice by persons with psychosocial disabilities

SCOPE OF THE STUDY The study was carried out in four counties, namely Nairobi, Nyeri, Kiambu and Nyeri. All the respondents were persons with psychosocial disabilities. These respondents were members of the USPKenya grass root movement. The research targeted 20 respondents with 5 respondents from each of the above mentioned counties. On gender participation, 10 males and 10 females were interviewed. Only questions on human rights violations were posed.

INTRODUCTION Users and Survivors of Psychiatry in Kenya (USPKenya) is a non-governmental organization that was established and registered in Kenya in the year 2007. It is a membership organization whose major objective is to promote and advocate for the rights of people with psychosocial disabilities. The organization is affiliated with the World Network of Users and Survivors of Psychiatry (www.wnsup.net) and its African affiliate the Pan-African Network of People with Psychosocial Disabilities (PANPEP formerly PANUSP). Working with the Open Society Foundation USPKenya has been actively involved in the human rights discourse of persons with psychosocial disabilities in Kenya. The organization is currently using the following strategies to address the human rights violations of persons with psychosocial disabilities. Building the capacity of users/survivors and their families to understand and claim their rights. Working with local authorities and families to address human rights violations of persons with psychosocial disabilities Strategic relationships with the Kenya National Commission on Human Rights (KNCHR) to counter discriminatory practices and also in law reform. Engaging the media to focus on issues of stigma, abuse, violence, rape and other violations that are meted against persons with psychosocial disabilities.
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LIST OF ABBREVIATIONS
USPKenya: KNCHR: FIDA: CRPD: CRADLE: CoK 2010 : ECT: Users and Survivors of Psychiatry in Kenya Kenya National Commission on Human Rights Federation of women lawyers in Kenya Convention on the Rights of Person with Disability The Children Foundation Constitution of Kenya 2010 Electro Convulsive Therapy.

PURPOSE OF THE STUDY

Following the ratification of the CRPD by Kenya in 2008, there has been a great awakening among different stakeholders in the disability movement. Efforts are now being put in place to ensure that persons with disabilities get to exercise their human rights on an equal basis with others. The purpose of this study is to document the human rights violations against persons with psychosocial disabilities. Most data on these human rights violations is anecdotal, and this is an attempt at documenting such violations. This document will provide authoritative evidence for advocacy for the rights of persons with psychosocial disabilities. The report will be strategically used to engage players in the justice sector including but not limited to the judiciary, police and probation departments. The other stakeholders who will be targeted include the media, medical professionals, Law Society of Kenya, the Kenya National Commission on Human Rights (KNCHR), the Kenya Law Reform Commission (KLRC), FIDA Kenya, the CRADLE and the devolved government structures. This will help in developing strategies and methods of dealing with the human rights violations meted on persons with psychosocial disabilities.

METHODOLOGY
SAMPLING Purposive sampling was used whereby leaders from different support groups in the four (4) counties that USPKenya operates in were used to identify respondents from their respective peer support groups.

DATA COLLECTION TOOLS An interview guide was developed to probe on the human rights violations experienced by persons with psychosocial disabilities. The interview guide proved to be most helpful because it was used to guide the interviews, and allowed the interviewer some latitude to pose questions in a different manner in order to generate comprehensive information from respondents. All interviews were recorded using an audio recorder which was followed by transcription of the interviews. The consent of all the respondents was
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sought before the beginning of the interviews and the respondents were given the option of terminating the process if they felt uncomfortable at any given time. The issue of confidentiality was addressed whereby no name of the respondent was given but every interview was allocated a specific code.

DATA ANALYSIS All the data collected in this documentation was qualitative in nature. It was recorded using an audio recorder then transcribed. The themes and categories were developed and analyzed using content analysis. This formed the foundation of the presentation of the findings.

FINDINGS
The backdrop of the findings of this study was anchored on the experiences of persons with psychosocial disabilities which have been narrated in this report. This section therefore contains a verbatim account of the experiences of persons with psychosocial disabilities. Key findings: 1. Persons with psychosocial disabilities in Kenya experience human rights violations on a range of issues. The most commonly reported are stigma and discrimination, verbal and physical abuse, exploitation and rape. 2. Most persons with psychosocial disabilities do not report the human rights violations that they encounter to the justice sector. This is mainly because of lack of awareness on their human rights at both the individual and family level. Lack of support from family members when such incidents occur especially in instances where some of the violations are committed by close family members. Prejudice and discrimination from local dispute resolution mechanism.
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3. Women are at greater risk of experiencing human rights violations as highlighted by the numerous cases of rape in the study. 4. There is a link between poverty and human rights violations. Most of the people interviewed had no jobs and were fully dependent on their families for support.

STIGMA AND DISCRIMINATION Research has shown that stigma and discrimination lead to pervasive human rights violations against persons with mental and psychosocial disabilities. All countries struggle with stigma and discrimination associated with mental illness and the negative personal, social and economic outcomes that arise due to inadequate health and social services. Article 5 of the CRPD on - Equality and non-discrimination states that States Parties recognize that all persons are equal before and under the law and are entitled without any discrimination to the equal protection and equal benefit of the law and that state parties shall prohibit all discrimination on the basis of disability and guarantee to persons with disabilities equal and effective legal protection against discrimination on all grounds. The report collected experiences of various aspects of discrimination against persons with psychosocial disabilities. Most of the persons interviewed stated how they had been discriminated against in their families, communities and also at the work place. Discrimination in the community I have gone through a lot of stigma and discrimination from my community on the basis of having a disability. You know, here in Kenya, we live as a community and if one feels isolated from that same community, you feel like you have stopped existing. That is what I go through every day. They see me as not fit to be in the community. I do not attend any community function because nobody wants to involve me in their activities. Recently a neighbours son was getting married and there was a big function there, but I was not invited, yet they are my next door neighbours. It feels very bad when one cannot integrate with members of the community. Sometimes even as I am walking past a group of women, I see them gossiping me and referring to me as a mad person but nowadays I dont bother. And this discrimination is not only limited to private ceremonies. Even in public gatherings, like if a meeting has been called by the chief, you will find a person chasing me away from the meeting. It is such a bad feeling to be discriminated and shunned by the society.

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Discrimination in education Article 24 of the CRPD stipulates that children with disabilities are not to be excluded from the general education system on the basis of disability; that they have the same right to free primary education and to secondary education on an equal basis with others, as well as a right to general tertiary education, vocational training, adult education and lifelong learning. The CRPD further guarantees the right to be included and to receive the individual support required, within the general education system, to facilitate their effective education. However, the CRPD also requires that effective individualized support measures be provided in environments that maximize academic and social development, consistent with the goal of full inclusion. Despite all this provisions and safeguards a respondent narrated her experience of how she was discriminated against till she had to drop out of school. I did not complete my education the way I would have wanted to because I dropped out. The teachers in my school were very mean and they never saw anything good coming from me. I kept repeating classes because my grades were not as good as the teachers wanted them to be. When I got to grade 8, I was not allowed to sit for my national exams because I would lower the mean score. So I could not go to school anymore and that was the end of my schooling. My parents were not educated themselves so they did not know of where they could go to seek for justice and I havent been to school since then. I normally feel bad about it because I know I would have gotten something good from education. I now see those whom I was schooling with, living very well, and I can only imagine what I would have achieved by now, if only I had not dropped out of school. I am sure I would have succeeded and I would not be as dependent as I am now, because I would have made something out of my life and become a productive citizen

Discrimination at work Article 27( 4) and (5) of the CoK 2010 states that The State shall not discriminate directly or indirectly against any person on any ground, including race, sex, pregnancy, marital status, health status, ethnic or social origin, colour, age, disability, religion, conscience, belief, culture, dress, language or birth. (5) A person shall not discriminate directly or indirectly against another person on any of the grounds specified or contemplated in clause (4).

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The CRPD in Article 27 on work and employment obliges state parties to prohibit discrimination on the basis of disabilities in all forms of employment whether in the public, private and non-profit sectors and in any stage of employment One of the respondent shared how he had been discriminated at his work, not just once but four times I have been discriminated at work in 4 different work stations hence, leading to loss of employment. When I was first diagnosed by my doctor as having a mental illness, he gave me a letter that I could show to my employer to enable him and other managers understand my condition. I had prior to that resigned in haste. I therefore decided to reverse my decision by writing a revocation letter and attached the doctors letter. The employer refused to reverse my resignation and I was rendered jobless. I am sure they failed to reinstate me because of the diagnosis letter that I had attached. I did not give up. I got another job which I carried on very well. Unfortunately, I had a relapse for a day and I could not go to work. The following day I went to see my boss and explained to her, as I also confided in her, about my disability. Consequently she swiftly discontinued my services. Being the independent man that I am, all was not lost. I managed to get a job in two more companies and the story was the same. Whenever I had a relapse, I would choose to explain myself and confide in the boss. That would be my undoing as they would quickly sack me. However, in my last work station, when I revealed to my employer that I had a psychosocial disability and requested an adjustment, for reasonable accommodation, the boss agreed half heartedly. He however made it impossible for me to work with the schedule that he proposed and I therefore ended up quitting the job. With the previous experience of being discriminated at work due to the psychosocial disability, I would not now disclose to an employer about it. I am now in a dilemma not only when looking for employment but also in updating friends or when going into a relationship, because I always feel I will be discriminated. Surprisingly though one lady I was courting did not seem to mind. The biggest hurdle is in the work environment when it comes to reasonable accommodation. I feel the consequences one would suffer after disclosing of a psychosocial disability vary from losing a job to falling out with previously close friends or family members and also loss of a place in the society.

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CHILD CUSTODY Article 23 of the CRPD is on respect for home and family. In part, it states that States Parties shall render appropriate assistance to persons with disabilities in the performance of their child rearing responsibilities. Article 23(4) states that In no case shall a child be separated from parents on the basis of a disability of either the child or one or both of the parents Article 53(1)(e) of the Constitution provides that every child has a right to parental care. Article 45 recognizes the family as the natural and fundamental unit of society, and recognizes that the family is owed the recognition and protection of the State. Further to this Section 6(1) of the Childrens Act provides that A child shall have a right to live with and to be cared for by his parents. In this research, a middle aged woman talked of how, her daughter was taken from her to a government childrens home because she was deemed unfit and also unable to raise her up. I have 3 children but the youngest of them all does not live with me. I used to get sick when this girl was very young, and I was deemed not fit to bring up my daughter in the way the society saw it best. So, I think it was my family that organized for the government officers from the childrens department to come and take my child away from me. Though feeling deprived, I accepted the decision because I did not have the means and resources needed for her up-bringing, but if it was today I would not have allowed that to happen. I would have wanted to raise her and be there for her as a mother. At least I am happy that I am allowed to go and visit her, which I do once a year at the childrens home. She knows me as her mother and I am happy about that. I was told that she would be there till she is of the legal age of 18 years. She has been there for 10 years now, so she has 8 more years before she comes back home. At least what keeps me going is because she has been able to get educated thanks to the government.

RAPE (COMMUNITY, HEALTH INSTITUTIONS) Article 16 of the CRPD is to the effect that State Parties shall take the necessary measures to protect persons with disabilities, both within and outside the home, from all forms of exploitation, violence and abuse, including their gender based aspects .

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Article 29(c) of the Constitution provides that every person has the right to freedom and security of the person, which includes the right not to be subjected to any form of violence, from either public or private sources. Section 3 of the Sexual Offences Act defines the crime of rape in the following manner: A person commits the offence termed rape if (a) he or she intentionally and unlawfully commits an act which causes penetration with his or her genital organs; (b) the other person does not consent to the penetration; or (c) the consent is obtained by force or by means of threats or intimidation of any kind. The prescribed punishment upon being found guilty is imprisonment for a term which shall
not be less than ten years but which may be enhanced to imprisonment for life.

Persons with psychosocial disabilities, especially women, are often victims of sexual violence as evidenced below I was one time taken to the police station, because I was walking in town while I had stripped. I did not realize that I was not wearing any clothes. I must have been quite sick because ordinarily, I wouldnt walk without wearing clothes. The people around realized that something must have been wrong with me so they took me to the police station. It is always nice to be taken to a hospital when in such a crisis, I did not understand why they took me to a police station, yet I was not a criminal. As they took me, I was tied up with ropes. Note as they tied me up with ropes, I was not resisting, but they chose to tie me up. After I got to the police station, the police saw my state and they decided to take me to a mental hospital. I was admitted in the hospital and with medication, I was feeling better. It is while I was there at the mental hospital, that I was raped by the male doctors. Sometimes it would be in the evening when am washing dishes all alone and then I would get raped. This I did not report because nobody would have believed me. They would have said that I was a mad woman who did not know what she was talking about. So that is how I ended up not reporting to any authority. Back in the community and with nowhere to sleep, I took to sleeping on the streets. Men, both known and unknown to me would rape me, while I slept on the corridors of the streets. I had no one to turn to, because I did not have a home. This was repetitive though I never reported to the authorities. I am now infected with HIV and without an idea of how I got it. I just found out that I had been infected as I carried out medical check-ups.

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Another respondent narrated how she had also been sexually assaulted I was from the market on my way home. Our home is quite a distance from the market and in the evening it is advisable to take a boda boda (motorbike). Finally one came my way and I negotiated the charges and off we went. Little did I know that the rider had some other ulterior motives. Instead of taking me towards my home, we took a route that was unfamiliar to me. When I started screaming, he threatened that he would kill me and ordered me to shut up. He took me to a house, which I thought was his house and dragged me inside. He then raped me and afterwards took me to our home. When I got home I informed my mother who hurriedly took me to the hospital, where I got medical help. I had wanted to pursue the case till justice is done but my pastor advised me against it. He told me that the perpetrator would get punishment from God and that I should forgive him. I have never seen the perpetrator since he did that to me. I am however happy that such a thing has not happened again. I now take so much precaution so that it never happens again. I get home quite early and I am hardly late in getting home. Previously, after the incident I would get hallucinations playing through my mind, but not anymore. It is something that I would never want to experience ever again.

Another respondent shared on the numerous times that she had been sexually assaulted I have been raped so many times, both by men that are known to me and those that I dont know. Most times I have been waylaid as I walked in the village. One day, during the day, as I walked around minding my own business, a man jumped at me from the bush and tried to strangle me as he dragged me to the bushes. That is where he raped me and left me bleeding as he escaped. Though it was during the day, I did not see the mans face. Afterwards I went home and my parents took me to a nearest clinic for medical attention. Several times men have cheated me that they want to show me something in their houses. So after they get me to the house, they force themselves on me and rape me. It got to a point that I even stopped seeking medical help as it was too many times that this was happening to me. Recently, I had gone to help my sister who has a pub in the village. She sells the traditional alcohol and closes the pub quite late at night. So one of the days when I was helping her, I decided to go for a short call outside. There was this drunkard who saw me and came and started telling me that he wanted me. I refused because I did not know him, but apparently he knew even my name. Before I could even scream, his hand was in my mouth and I got raped. Few
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days later, I started experiencing a discharge and much pain. I informed my parents who took me to the clinic and had the infection treated. A HIV test was also carried out, and fortunately I did not have the HIV infection. So after the STD was cured, my parents resorted to keeping me locked up. I only go where my parents feel is important and I am always accompanied by a relative.

EXPLOITATION Article 16 of the CRPD provides for freedom from exploitation, violence and abuse. Going by the findings, this report revealed that most persons with disabilities had experienced a kind of exploitation, be it financial, at work or materially.

I usually go to work in my neighbours farm, because I am not in any formal employment. I go there every morning and work all day. Sometimes I get lunch but other times I dont. At the end of the day I get KES 100 which I use to buy necessities. I wish my employer could be paying me a little more so that it can be enough, but I feel what I get is not commensurate to the work that I do. The work I do is usually so strenuous. I have talked to him about it, but he does not look concerned about my welfare. Even if he does not pay me more money, I will not leave because even that KES100 still helps me a long way and it is frequent. There is this woman who asked me to report to her homestead one morning that was sometimes last week. I got there quite early as she had asked me to. I found some other young men like me who had also reported to work. We were to dig a pit latrine for the homestead which was almost 20ft. We started work immediately, and by lunch time we were almost half way. At around 6pm, when we were about to leave, the woman who had given us the work called the others by the side and they were paid wages for the day. When it was my turn, she said that she would pay me later. So I took her to task and asked her why she had paid everyone else apart from me. That is when she said that my mother had her debt and that my mother had asked her to have me work for her for the debt to be settled. I felt so used and cheated. When I got home, I asked my mother about it and she gave me so many explanations. What I can say is, it is not acceptable to exploit people.

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Another young man who was interviewed had this to say Various people in the village call me anytime they need some work to be done in their homesteads. This is mostly to work in the farm or to graze animals. I am usually paid at the end of the day, but this does not always happen. Some people give me food for a hard days work and that is all I get. They say that I dont need money, since I dont need to shop for anything. They end up not paying me and this makes me feel discriminated. It is inappropriate to pay one with food, because at times you would like to buy other necessities and not necessarily food. Besides, food wouldnt last for long as money would. I have raised this concern with prospective employers, who still insist on giving me food as a form of payment. Other labourers dont get food as a form of payment; they get money, which they spend as they please. Actually, they even get more money than me, having done the same work during the day. Anytime I raise this concern, none of the employers heed to it. So I just take the little money they offer to take care of my needs though it is usually not commensurate to the work I do in a day.

INVOLUNTARY TREATMENT The Mental health Act provides the following, with regard to involuntary treatment: Power to take person suffering from mental disorder into custody 16.(1) Any police officer of or above the rank of inspector, officer in charge of a police station, administrative officer, chief or assistant chief may take or cause to be taken into his custody (a) any person whom he believes to be suffering from mental disorder and who is found within the limits of his jurisdiction; and (b) any person within the limits of his jurisdiction whom he believes is dangerous to himself or to others, or who, because of the mental disorder acts or is likely to act in a manner offensive to public decency; and (c) any person whom he believes to be suffering from mental disorder and is not under proper care and control, or is being cruelly treated or neglected by any relative or other person having charge of him. (2) Any person taken into custody under subsection (1) shall be taken to a mental hospital by the person taking him into custody within twenty-four hours of being taken into custody or within a reasonable time, and the burden of proving that the person was taken to a mental hospital within a reasonable time shall lie on the person taking him into custody.
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(3) The person in charge of the mental hospital to which a person is taken under this section shall admit that person for a period not exceeding seventy-two hours for the purpose of enabling him to be examined and of making any necessary arrangements for his treatment and care. (4) The person in charge may after examination under subsection (3), if he thinks fit, make the person admitted into he mental hospital over to the care of any relative or detain the person in the mental hospital as an involuntary patient deemed to be admitted under Part VI. The Mental Health Act has not adopted the paradigm shift in the CRPD as envisaged in Article 12 on legal capacity, Article 14 (1)(a) of the CRPD in part provides that the existence of a disability shall in no case justify a deprivation of liberty. Article 25(d) on the right to health requires health professionals to provide care of the same quality to persons with disabilities as to others, including on the basis of free and informed by inter alia, raising awareness of the human rights, dignity, autonomy and needs of persons with disabilities through training and the promulgation of ethical standards for public and private health care Despite the above safeguards and provisions in the CRPD, persons with psychosocial disabilities however continue to be treated against their will. Sometimes being tied up with ropes and bundled into cars while being taken to the hospital. I was just at home and was having many thoughts in my mind. I think I kept pacing up and down the compound and was not talking to anyone. This is because I had this feeling of being unwanted so I just wanted to keep to myself. My husband and children tried to talk to me but I couldnt talk to them. That is when they held me by force, and they tied me up with ropes so that I could not move. They then put me in a car and I was taken to a mental health hospital. While we reached at the hospital, the doctors just injected me, without even my consent or even without informing me why I was being injected. It was a very terrible experience that I dont like remembering. I wish they could just have advised me politely to seek medical attention which I would have done without going to the extent of humiliating me by tying me up with ropes like an animal. It felt very bad, and I always hope that such an incident will not happen again.

Another respondent shared his experience while being taken to hospital Previously, when the sickness would escalate probably due to, lack of taking my medication, I would pace up and down, get restless and go through long periods of silence. Sometimes, I would get so hyper and talk a little bit too much. This every time
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prompted my mother to ask me to accompany her to the hospital. So, there is this time that she wanted to force me to go to the hospital but I could hear none of it. I just wanted to be left alone and did not want to take any of my medication. What she did, I will never forget. She went to the police station that is near our home and came with two policemen who were armed with guns and hand cuffs. They found me at home and I could not have escaped because I was so scared to run away. They got hold of me, handcuffed me and took me to the nearest clinic where I was injected. I afterwards calmed down and the hand cuffs were taken off. Though I forgave her, because it was in my best interest that she acted that way, I would not want to be ever handcuffed again. It would be good if she would engage me in a conversation so that I can go to hospital.

A respondent shared her experience of how she was bundled in a car and taken to hospital by force.

My family and especially my husband would easily tell when I was about to get a relapse. Such times they would force me to take medication but I would be so stubborn and refuse to take them. I remember one time I had thrown away the medication because I had been prayed for by a prophet and I had believed that I was cured. I did not inform any of my family members about it. However, a few days afterwards, I was in a crisis. My husband decided to take me to hospital which I vehemently refused. I informed him that a prophet had prayed for me and I therefore did not need any medication. I even told him that I had thrown away the medicines because I was cured. It is at this point that he called his friend who owns a car. My hands and feet were tied up using ropes and I was bundled in the car and taken to hospital. I remember insulting them very much in English, because they were taking me to hospital against my will. Once we got to the hospital, I was injected and I remained tied up for some hours. Later on, I was given more medication to take while at home, which I continue taking to date.

ECT is also sometimes not administered on the basis of free and informed consent as noted in the following narrations I was not feeling very well and I found myself in hospital having been tied both hands and feet. I later was told that I had been disturbing the neighbours and that is why I had been tied up like that. At the hospital, the doctor wrote in my file that I was to go through ECT. I was not explained to what was the advantage of ECT or even the disadvantages.
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I just went through it and it was just a harrowing experience. Later on, after the ECT treatment, I forgot most of the things that I knew. The people whom I knew too were not spared as I couldnt remember very vital things and this was very frustrating. If I had been given all the facts about ECT, then I would have made an informed decision to go on with this form of treatment or not.

Another respondent also gave the following experience Since I started getting sick, I have always attended clinic as am supposed to, though, I have never been admitted in a psychiatric ward. Initially, my husband used to accompany me to the clinics then I later started going by myself. It is during one of the visits that I had gone to the clinic alone that the nurse told me that they were to pass electricity in my head (ECT) so that I can stop getting sick and so that all those feelings I was having could disappear. I had never heard about this form of treatment and the nurse did not explain to me what it involved. To make matters worse, I was all alone without my husband, friend or any carer. I was then taken to the ward where the treatment was done. I have never felt uncomfortable like that in my entire life. First, this treatment did not cure the feelings that I had and in any case it led to memory loss. I was not well informed about ECT and they did not give me the pros and cons in order to make an informed decision whether to go ahead with it. If the same scenario was to replay again today, I would vehemently refuse to undergo ECT as I now know my rights.

PHYSICAL AND VERBAL ABUSE This report documented several cases of abuse in the family, community and in health institutions Physical abuse An interviewee described her harrowing experience in the hands of her brothers. I live at my parents home. My parents are both deceased though I live in the house that they lived. My elder brothers are in the same compound and they are very hostile to me. They believe that they are the only ones with the right of living in our parents home. They have tried all ways to kick me out, but I have nowhere to go. They have labeled me a mad woman and that I belong to the streets. One time they destroyed my house, and it was the church members who intervened, and built my house again. There is one time that they beat me so severely that I thought I would die. The neighbours came to our home to rescue me. These scars (shows scars on the body) I got from that beating.
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I reported to the chief who took the case to the police station. The policemen came and arrested one of my brothers who was inciting the rest about me. Once he was taken to court, he was charged with assault and he was given a choice of a 2 year sentence or fine. He paid the fine. He was also issued with restraining orders on never to come near my house again. Since then, I have been fine with my children and the brothers dont bother me anymore. I am happy the chief took action.

Another respondent shared how she had undergone physical and verbal abuse in the hands of her husband. I am a married woman and a mother of 5 children. I started getting sick in 2002. Since then I have not known peace in my home. My husband, whom I stay with, does not understand about my sickness. He is an alcoholic and comes home drunk. Many times he has beaten me having come home very drunk. I once asked him where he was coming from because he got home very late and he beat me so badly that I had to go the hospital. I was advised by my friends to report him to the police, which I did. I afterwards dropped the charges and forgave him. There is also this time that his brothers wife talked to me rudely. In the evening when he came home, I reported to him what had transpired during the day with my sister-in-law. He started beating me, defending the brothers wife. He beat me so much that I could not wake up the next day. So as you can see it is very difficult to live with this man but I do not have much choice. He caters for all my medication bills though he keeps asking me that others get well when they go to hospital, and he wonders how I havent been cured all these years. He says that am forever pretending in order to get sympathy from him.

A respondent gave her chilling experience of how she had endured years of being beaten by her father My father is an ex-cop and people fear him very much in the village. You see these scars (Shows open wounds on her thighs), they are as a result of being beaten. My father beats me so mercilessly that at times neighbours scream pleading with him to stop beating me. He beats me the way you would hit a snake or a rat so that it can die. He uses a wooden rod and I even somehow got used to the beating. I dont even feel pain anymore, I think my body adapted to the pain. M y hands are so weak now; I cant even wash my own hankie because he has disabled my joints. He has been reported to the chief (local authorities) several times and warned not to beat me but he does not heed the warnings. While he is beating me, my children usually watch and they cry a lot
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when they see their mother being mercilessly beaten. There is nothing much that they do other than watch helplessly. There is this time that I was very angry with him that I decided to burn the room that I was in so that I would die. Unfortunately or fortunately, my family and neighbours rescued me from the burning house without being scathed, but I received a beating that I will never forget. I thought I would die, because it was the mob and my family combined beating me. There is also this time that I had been unlocked and went out to bask in the sun. So when it was time to get into the room so that I can be locked again, I refused. My father could hear none of my pleas of wanting more sunshine. He came with his usual rod and gave me a thorough beating that left me writhing with pain for days. The beatings are so severe that each day I keep hoping that my father will have a change of heart and refrain from beating me.

DESERTION BY SPOUSE This study showed that persons with psychosocial disabilities were deserted upon the partners learning of their impairment I had been married to a wonderful man. We got two children and we lived as a happy family. I however developed depression and was constantly sick. I could be taken to hospital where I incurred heavy expenses on medication. My needs started being many, and this led to lack of adequate money to cater for all my needs. My husband could not handle this, and he decided to leave. We had started having disagreements and arguments because of the expenses we incurred at the hospital every time I was taken. One day he just woke up and left. He left me with my two children whom I could not support, as I was not working. It was a very difficult time for me because I expected him to understand me as my husband. Again, before he married me, I had fallen sick, and this he knew and had married me despite the sickness. I could not understand why he had turned his back on me. My mother traced where his parents lived, and took my children there so that they could be supported. I have tried to reconcile with my husband, but now it is almost impossible because he is married to another woman. My children come to visit me once in a while and I am always happy to have them around.

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MISDIAGNOSIS Cases of misdiagnosis were also revealed as cited in the following experience My mother noticed of my mental illness while I was in college and asked me to seek psychiatric attention. I have not yet been diagnosed of any specific psychosocial disorder because every time I see a psychiatrist, each gives me a different diagnosis. Recently, I could not sleep for days and was getting highly irritated. I could not keep a job and relationships became a nightmare. I therefore decided to seek medical attention and went to a highly recommended psychiatrist. To start with, from the minute I got to her office to the time I left, she never looked at me even once. She just kept scribbling on her note pad as I talked and this made me feel as if I was having a conversation with a wall. She treated me like a statue or a robot. She did not look up to listen to me, ask me questions or even show interest in what I was telling her. After I had finished sharing my experience, she tore a page from her notepad with a prescription and handed it to me and asked me to take it to the pharmacy and get the drugs prescribed. She never bothered with explaining to me what medication it was or why I needed it. I am still very bitter with her by the way. So off I went to the pharmacy and got the medication. 2 days after beginning the dose, I started shaking. My hands could not hold anything, my neck could not hold my head, and the head kept shaking. This continued even while I lay in bed. It was a very horrible experience. I stopped taking that medication and vowed not to go back to the psychiatrist again.

DEPRIVATION OF LIBERTY Liberty is the ability of individuals to have agency (control over their own actions). The right to liberty means that, in general, a person has a right not to be locked in a room, kept in any place or confined to any area against the persons will. The deprivation of the right to liberty is something that is also likely to have a direct and adverse effect on the enjoyment of many of the other rights, ranging from the right to family and private life, through the right to freedom of assembly, association and expression to the right to freedom of movement. Furthermore, any deprivation of liberty will invariably put the person affected into an extremely vulnerable position, exposing him or her to the risk of being subjected to torture and inhuman and degrading treatment. Hence, in order for the guarantee of liberty to be meaningful, any deprivation of it should always be exceptional, objectively justified and of no longer duration than absolutely necessary.
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Article 18 of the CRPD recognizes the right of persons with disabilities to liberty of movement. Some of the respondents shared how their right to liberty and movement had been curtailed more so by their close family members I am usually not allowed to go visit friends. My mother tells me that I should not leave our home because I will go to disturb other people. When there are ceremonies in the neighbourhood, I dont attend because my mother will not let me. I always have this feeling of being in bondage but I have learnt to live the way she wants. I am not that social so I do not have many friends. Once in a while a neighbour invites me to her house to help her in cooking, but my mother will not let me. I studied cookery in college and was working in a big hotel but left the work after I got married. Therefore my neighbours know that my cookery skills are really good and at times they ask me to cook for occasions, then I can earn some income. So these are the times that my mother refuses me to go out. Since she provides anything that I require, including paying for my medication, I have decided to leave how she wants me to. Today she allowed me to attend the support group meeting. Am happy she knows the importance of the support group and that she encourages me to attend it.

Another respondent shared her experience of what she went through every time she was locked up. When I become very sick, I go around beating women who wear trousers. At such times, the sickness escalates because I refuse to take medicine. It is at these times that my family locks me up in my room. They lock me up all day though they give me food. My room only has a mattress; the bed was removed because I could jump on top of it to an extent of breaking it. I have a very big problem in being locked because my room does not have a washroom. So every time am locked up, I have nowhere to use as my washroom so I end up using the floor. Sometimes the smell of the waste is usually so much to bear that I hit the door so that I can wash the mess. I usually suffer so much and I have even informed my family but they hear none of it. Last week, I was having my menstrual flow and I did not have any sanitary pad. You can imagine for the 3 days the agony I went through. Now all my petticoats are discoloured and am still wearing them because I have no choice. FORCED STERILIZATION Article 23(1)(c) of the CRPD, provides that persons with disabilities, including children, should retain their fertility on an equal basis with others.
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One of the respondents narrated the following I had two children previously before I got married then after getting married I got two other children. Afterwards, I started having problems with my health and developed a mental illness, my family decided that I should be taken to hospital for tubal ligation to be carried out so that I would not conceive and get more children. My elder sister therefore, paid for the procedure to be carried out. All this time, nobody asked for my opinion. I had never heard about tubal ligation before and even the medics did not explain to me what the procedure involved. Much later, I learnt that I could not get pregnant due to the permanent sterilization that was carried out and I was very devastated. Unfortunately, it cannot be reversed and I have to live like that. At least am happy I have my four children whom I love very much.

CONCLUSION
It is from these findings that we come to terms with the various forms of human rights violations that are meted to persons with psychosocial disabilities. The following were the most common forms of human rights violations that were revealed during the study Stigma and discrimination Child custody Rape Exploitation Involuntary treatment Physical and verbal abuse Desertion Misdiagnosis Deprivation of liberty
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Forced sterilization

Most of these violations are perpetrated by the family of the person with psychosocial disability or the community. As noted in the study, most of the violations go unreported to the local authorities and even when the perpetrators are known no measures to seek justice are sought. Hence, Article 13 of the CRPD, on access to justice, remains empty for persons with psychosocial disabilities in Kenya. According to the CRPD Article 16, it provides for freedom from exploitation, violence and abuse which was prevalent in the community. Article 15 provides for freedom from torture or cruel, inhuman or degrading treatment or punishment. It is clear that the policy and legislation of laws concerning persons with disabilities are in place but implementation of these laws remains a hurdle that the stakeholders in the cross disability movement will need to address.

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RECOMMENDATIONS
Based on the above findings, USPKenya wishes to make the following recommendations that will assist in the protection and realization of the human rights of persons with psychosocial disabilities as envisioned in the CoK 2010 and the CRPD. 1. Stigma and discrimination a) Work Place. With regard to employment, employers should be required to provide reasonable accommodation to their employees. There is also a need to define the denial of reasonable accommodation as a form of discrimination. Ensure that all legislation prohibiting discrimination in employment is strongly enforced at all levels and in all forms of employment. b) Education Develop accountability mechanism needed to monitor school registration and completion by children with disabilities. Provide training to teachers so that they can respond to classroom diversity. 2. Child custody The state should avail free legal aid most persons with disabilities cannot fight back when their children are taken away because they cannot afford legal advice. Create viable options for rendering appropriate assistance to persons with disabilities in the performance of child rearing responsibilities 3. Rape

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 That police, investigators and other actors in the justice system should be trained on the rights of persons with disabilities Accommodations should be provided during all stages of a case to ensure that persons with disabilities access justice on an equal standing with others, an example, there should be persons trained in communication at the police stations to take evidence in cases where a person may communicate in unique ways. DPOs of persons with psychosocial disabilities should reach out to mainstream women NGOs which have a lot of experience in representing women victims of rape in court 4. Exploitation The public should be made aware about the rights of persons with disabilities. This may be a first step towards their treating them as equals. 5. Involuntary treatment Develop alternatives to medical model Train families and persons with disabilities on their rights Train health care professionals on the rights of persons with psychosocial disabilities Use public interest litigation to address issues of forced treatment and arbitrary deprivation of liberty. Amend the Mental Health Act Develop advance planning tools 6. Physical and verbal abuse Educate families and public on the inherent dignity of users and survivors of psychiatry Empower persons with psychosocial disabilities to stand up for themselves
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7. Desertion Amend the Matrimonial Causes Act, to no longer allow the presumption of unsound mind as a ground of divorce in marriage Train families and public on the human rights of persons with disabilities 8. Misdiagnosis Empower persons with psychosocial disabilities to develop a treatment plan in conjunction with medical professionals 9. Deprivation of liberty and movement Educate families on the human rights of persons with psychosocial disabilities Empower persons with disabilities financially and provide social protection programs to their families. 10. Forced sterilization Educate hospitals on the rights of persons with disabilities Empower persons with disabilities Sue doctors for malpractices Create viable options for rendering appropriate assistance to persons with disabilities in the performance of child rearing responsibilities 11. Access to justice Establish justice advisory centers at the ward level whose key functions would include but not limited to: coordinate legal advice and awareness within the Ward; refer cases in need of legal aid services to the local County Service office; facilitate and conduct legal aid clinics within the location;
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 encourage the settlement of disputes by way of negotiation, mediation, and conciliation;

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