I
New Uni e si y o Lisbon, Facul y o Medical Sciences; Wo ld Heal h
O ganiza ion, Depa men o Men al Heal h and Subs ance De iciency
A i udes o S a and Consume s owa d Human
Righ s o Pe sons wi h Psychosocial and Men al
Disabili ies
S uden : Abdelaziz Osman
This disse a ion is submi ed in pa ial ul illmen o he equi emen s o
he In e na ional Mas e s o Men al Heal h Policy and Se ices
Academic Supe iso : P o esso Ped o Ma eus
NOVA Medical School.
2017
II
1. Ti le
1.1 Desc ip i e, c oss sec ional s udy, o desc ibe ypes o a i udes o s a
and consume s owa d human igh s o pe sons wi h psychosocial and
men al disabili y, wi h emphasis on in eg a ion in o he communi y; he
e idence is om he h ee main psychia ic hospi als in Kha oum, he
capi al o Sudan.
1.2 A i udes o S a and Consume s owa d Human Righ s o Pe sons wi h
Psychosocial and Men al Disabili y
1.2.1 By:
D . ABDELAZIZ AWADELSEED ALHASSAN OSMAN
In e na ional Mas e in Men al Heal h Policy and Se ices
NOVA Medical School, Lisbon, Po ugal
1.2.2 Supe iso :
Ped o Ma eus
P o esso a NOVA Medical School, Lisbon, Po ugal
1.2.3 Moni o
Faculdade De Ciencias Medicas Da Uni e sidade No a De Lisboa
1.2.4 S udy si es
Tigani El-Mahi, Taha Baashe and Elid issi psychia ic hospi als in
Kha oum, he capi al o Sudan
1.3 P ojec de ails
P ojec submi ed in Pa ial Ful illmen o he Requi emen s o he Deg ee
o In e na ional Mas e in Men al Heal h Policy and Se ices in he Medical
School o New Uni e si y o Lisbon, Po ugal
2017
III
I would like o dedica e his s udy o my amily: my wi e Taysee , my sons
Ome and Ahmed and my daugh e s Leena and Deema.
Wi hou he commi men and s ead as suppo p o ided by my amily, I
would no ha e been able o ca y ou his endea o . Th oughou my
p o essional ca ee , my amily has been an abiding and sus aining sou ce o
s eng h, encou agemen , and inspi a ion o which I am e e nally g a e ul.
IV
I would like o exp ess my hanks o my supe iso P o esso s
Ped o Ma eus, o his guidance supe ision, help, aluable ad ices,
unlimi ed encou agemen and pa ience in spi e o his o he clinical and
academic commi men s.
I am g ea ly indeb ed o he s a o he Cen e o E hical Educa ion,
Uni e si y o No e Dame, U.S.A, o he pe mission o use pa o hei
in en o y (Guide o using he A i udes owa d Human Righ s In en o y
(ATHRI)), in de eloping my ques ionnai e.
I would like o acknowledge he unlimi ed e o s o my colleagues in Al-
Amal complex o men al heal h/ A a / KSA, o hei e o s in ansla ion
and back ansla ion o he ques ionnai e and hei e o s in conduc ing he
pilo s udy.
My hanks o he s a o Tigani El-Mahi, Taha Baashe and Elid issi
psychia ic hospi als in Kha oum, Sudan o hei g ea help and
pa icipa ion in his s udy.
I am g a e ul also o he pa ien s who pa icipa ed in his s udy.
My g a i ude o my iend D . Anas, consul an psychia is o helping me
in he s a is ical wo k and analysis
To all hose who con ibu ed o make his hesis come o ligh , I am mos
g a e ul.
V
Summa y
Backg ound: The new e a o Reco e y o ien ed men al heal h p ac ice is based on
human igh s and culmina ing by he con en ion on he igh s o pe sons wi h disabili ies
(CRPD, 2008) and WHO Quali yRigh s ToolKi , 212.
Objec i es: This s udy was designed o add ess a i udes o s a and consume s owa d
human igh s o pe sons wi h psychosocial and men al disabili ies and hei inclusion in o
communi y. Examining s a and consume s‘ a i udes will highligh de ici s in he
knowledge ega ding he magni ude o his p oblem and will in o m he in ended aising
o awa eness and aining in his a ea.
Me hods: A ques ionnai e was dis ibu ed o pa icipan s who we e 104 s a membe s
(psychologis , psychia ic nu ses, social wo ke s and doc o s) and 100 consume s a he
h ee main psychia ic hospi als in Sudan. Included in he ques ionnai e was he Human
Righ s o pe sons wi h psychosocial disabili y a i ude ques ionnai e (HRQ_6) which was
designed by he esea che based on (CRPD) as well as Communi y Li ing A i udes
Scale Men al Re a da ion - Sho Fo m (CLAS), demog aphic i ems ( o example, age,
gende , and ma i al s a us) and one ques ion abou eco e y in men al heal h. Sco es on
he HRQ_6 and he 4 CLAS subscales (Empowe men , Simila i y, Exclusion, and
Shel e ing) we e epo ed, and analyses o a iance we e pe o med o iden i y ac o s
associa ed wi h each subscale sco e. The consume s‘ sco es we e compa ed wi h s a ‘s
sco es. The HRQ_6 sco es we e co ela ed wi h he 4 CLAS subscales.
Resul s: Two hund ed and ou pa icipan s om s a and consume s ac oss he h ee
main psychia ic hospi als in Sudan. The pa icipan s‘ o bo h g oups had nega i e
a i udes owa ds human igh s o pe sons wi h psychosocial and men al disabili ies. Also
he pa icipan s‘ a i ude sco es a o ed Empowe men and Simila i y o e Exclusion
and Shel e ing. S a and consume s; Men and women; and doc o s and o he
p o essional g oups; esponded di e en ly. P e ious aining on human igh s had no
impac on he a i ude o he s a . The e was co ela ion be ween he HRQ_6 and he 4
CLAS subscales. The esea ch p o ided a much-needed window on he p ocess o
aining and aising awa eness wi h ega d o human igh s o pe sons wi h psychosocial
and men al disabili ies and hei inclusion in o he communi y.
Conclusion: S a and consume s hold a i udes owa d human igh s o pe sons wi h
psychosocial and men al disabili ies ha we e inconsis en wi h he eco e y o ien ed
men al heal h p ac ice. Mo e esea ches a e needed o unco e how a i udes owa ds
human igh s de elop in ou communi y, as well as how aining on human igh s can
in luence a i udes.

VI
Sumá io
In odução: A no a e a da p á ica de saúde men al, o ien ada pa a a Recupe ação, é
baseada em di ei os humanos, endo culminado na con enção sob e os di ei os das
pessoas com de iciência (CRPD, 2008) e no WHO Quali yRigh s ToolKi , 2012.
Objec i os: Es e es udo oi concebido pa a a alia as a i udes dos p o issionais e dos
u en es em elação aos di ei os humanos das pessoas com doenças men ais e
incapacidades psicossociais, e a sua inclusão na comunidade. A a aliação das a i udes
dos p o issionais e dos u en es i á des aca os dé ices de conhecimen o sob e a ampli ude
des es p oblemas e con ibui á pa a o aumen o da consciencialização e capaci ação nes a
á ea.
Mé odos: Um conjun o de ques ioná ios oi dis ibuído a 104 p o issionais (psicólogos,
en e mei os de saúde men al, assis en es sociais e médicos) e 100 u en es, nos ês
p incipais hospi ais psiquiá icos do Sudão. Es e conjun o incluiu um ques ioná io sob e
a i udes ace aos di ei os humanos das pessoas com incapacidade psiquiá ica, HRQ_6
(elabo ado pelo au o com base na CRPD), a Escala de A i udes sob e a Vida
Comuni á ia - Ve são Cu a (CLAS-Sho Fo m), dados sócio demog á icos (ex: idade,
gêne o e es ado ci il), e uma ques ão sob e ecupe ação em saúde men al. As pon uações
na HRQ_6 e as 4 subescalas CLAS (Empowe men , Simila i y, Exclusion e Shel e ing),
são desc i os, assim como a análise da a iância ealizada pa a iden i ica a o es
associados aos esul ados de cada subescala. As pon uações dos u en es o am
compa adas com as pon uações dos p o issionais e os esul ados do HRQ_6 o am
co elacionados com as 4 subescalas CLAS.
Resul ados: duzen os e qua o pa icipan es, en e p o issionais e u en es nos ês
p incipais hospi ais psiquiá icos do Sudão. Os pa icipan es de ambos os g upos i e am
a i udes nega i as em elação aos di ei os humanos de pessoas com incapacidades
psicossociais e men ais. Adicionalmen e, as pon uações sob e as a i udes a o ece am a
Capaci ação e a Simili ude quando compa ados com a Exclusão e o Ab igo. As espos as
o am di e en es en e os g upos de p o issionais e de u en es, homens e mulhe es e en e
médicos e ou os g upos p o issionais. A o mação p é ia em di ei os humanos não e e
impac o na a i ude dos p o issionais. Hou e co elação en e o HRQ_6 e as 4 subescalas
do CLAS. O es udo possibili ou uma isão mui o necessá ia pa a o p ocesso de
capaci ação e conscien ização em di ei os humanos de pessoas com doenças men ais e
incapacidades psicossociais, e sua inclusão na comunidade.
Conclusão: os p o issionais e os u en es man êm a i udes em elação aos di ei os
humanos das pessoas com doenças men ais e incapacidades psicossociais que são
incompa í eis com a p á ica de saúde men al o ien ada pa a a ecupe ação. É necessá ia
mais in es igação pa a descob i como es as a i udes em elação aos di ei os humanos se
desen ol em na nossa comunidade, bem como a o ma como a o mação sob e di ei os
humanos pode in luencia as a i udes.
VII
Resumen
In oducción: La nue a e a de la p ác ica de salud men al, o ien ada a la ecupe ación,
se basa en de echos humanos, culminando en la con ención sob e los de echos de las
pe sonas con discapacidad (CRPD, 2008) y en el WHO Quali yRigh s ToolKi , 2012.
Obje i os: Es e es udio ue concebido pa a e alua las ac i udes de los p o esionales y
de los usua ios en elación a los de echos humanos de las pe sonas con en e medades
men ales e incapacidades psicosociales, y su inclusión en la comunidad. La e aluación de
las ac i udes de los equipos y de los usua ios des aca á los dé ici s de conocimien o sob e
la ampli ud de es os p oblemas y con ibui á al aumen o de la concien ización y
capaci ación en es a á ea.
Mé odos: Se dis ibuyó un conjun o de cues iona ios a 104 p o esionales (psicólogos,
en e me os de salud men al, asis en es sociales y médicos) y 100 usua ios en los es
p incipales hospi ales psiquiá icos de Sudán. Es e conjun o incluyó un cues iona io sob e
ac i udes en e a los de echos humanos de las pe sonas con discapacidad (po ejemplo, la
edad, el géne o y el es ado ci il), y la p egun a sob e la ecupe ación de la calidad de ida
en salud men al. Las pun uaciones en la HRQ_6 y las 4 subescalas CLAS
(Empowe men , Simila i y, Exclusion y Shel e ing), se desc iben, así como el análisis de
la a ianza ealizada pa a iden i ica ac o es asociados a los esul ados de cada
subescala. Las pun uaciones de los usua ios se compa a on con las pun uaciones de los
p o esionales y los esul ados del HRQ_6 se co elaciona on con las 4 subescalas CLAS.
Resul ados: doscien os y cua o pa icipan es, en e p o esionales y usua ios en los es
p incipales hospi ales psiquiá icos de Sudán. Los pa icipan es de ambos g upos u ie on
ac i udes nega i as en elación a los de echos humanos de pe sonas con discapacidades
psicosociales y men ales. Adicionalmen e, las pun uaciones sob e las ac i udes
a o ecie on la Capaci ación y la Simili ud cuando compa adas con la Exclusión y el
Ab igo. Las espues as ue on di e en es en e los g upos de p o esionales y usua ios,
homb es y muje es y en e médicos y o os g upos p o esionales. La o mación p e ia en
de echos humanos no u o impac o en la ac i ud de los p o esionales. Hubo co elación
en e HRQ_6 y las 4 subescalas de CLAS. El es udio posibili ó una isión muy necesa ia
pa a el p oceso de capaci ación y concien ización sob e los de echos humanos de
pe sonas con en e medades men ales e incapacidades psicosociales, y su inclusión en la
comunidad.
Conclusión: los p o esionales y usua ios man ienen ac i udes hacia los de echos
humanos de las pe sonas con en e medades men ales e incapacidades psicosociales que
son incompa ibles con la p ác ica de salud men al o ien ada a la ecupe ación. Es
necesa ia más in es igación pa a descub i cómo es as ac i udes hacia los de echos
humanos se desa ollan en nues a comunidad, así como la o ma en que la o mación
sob e de echos humanos puede in lui en las ac i udes.
VIII
A es a ion
I decla e ha his wo k is o iginal excep whe e indica ed by special
e e ence in he ex and no pa o he disse a ion has been submi ed o
any o he deg ee. Any iews exp essed in he disse a ion a e hose o he
au ho .
The disse a ion has no been p esen ed o any o he uni e si y o
examina ion.
Signed: Abdelaziz Osman
IX
Con en s
Co e page............................................................................................................................I
UNIVERSIDADE NOVA DE LISBOA .............................................................................I
Faculdade de Ciências Médicas .........................................................................................I
A i udes o S a and Consume s owa d Human Righ s o Pe sons wi h Psychosocial
and Men al Disabili ies .......................................................................................................I
Ti le.....................................................................................................................................II
DEDICATION ......................................................………................................................III
ACKNOWLEDGMENTS..... …………...........................................................................IV
Summa y……….................................................................................................................V
Sumá io……………………………………………………………….………………….VI
Resumen…………….…………………………………..………………………………VII
A es a ion.......................................................................................................................VIII
Con en s..............................................................................................................................X
Lis o Tables and Figu es.................................................................................................XI
Abb e ia ions...................................................................................................................XII
1. Pa one..........................................................................................................................1
1.1.In oduc ion ...................................................................................................................2
1.2. Li e a u e e iew...........................................................................................................4
1.2.1. Sudan in B ie .........................................................................................................4
1.2.2. De ini ion o e ms...................................................................................................5
1.2.3. Li e a u e on a i ude..............................................................................................6
1.2.4. Li e a u e on human igh ........................................................................................9
1.2.5. Human igh s o pe sons wi h psychosocial and men al disabili ies.....................11
1.2.6. People wi h Men al Heal h Condi ions as a Vulne able G oup............................14
2. Pa wo........................................................................................................................18
2.1.Chap e one - G ounds, Objec i es and Hypo hesis....................................................19
2.1.1. G ounds.................................................................................................................20
2.1.1.1.In oduc ion............................................................................................................20
4
1.2. Li e a u e Re iew
1.2.1. Sudan in B ie :
Sudan, loca ed in no heas A ica. Na ional name: Jamhu ya as-Sudan.
To al a ea: 1,156,673 sq. mi (1,861,484 sq. km) measu es abou one- ou h
he size o he Uni ed S a es6. The cu en popula ion o Sudan is 40,986,180
as o Tuesday, Decembe 19, 2017, based on he la es Uni ed Na ions
es ima es7. Sudan popula ion is equi alen o 0.54% o he o al wo ld
popula ion. Sudan anks numbe 35 in he lis o coun ies (and
dependencies) by popula ion7. The popula ion densi y in Sudan is 23 pe
Km2 (59 people pe mi2). 35% o he popula ion is u ban (14,195,253
people in 2017)7. The median age in Sudan is 19 yea s7. Li e expec ancy in
Sudan 63.71 yea s6 .The e a e abou 19 majo e hnic g oups and a u he
597 subg oups8. In 2013, he o al adul li e acy a e and he emale adul
li e acy a e we e es ima ed a 74.24% and 66.40%, espec i ely9. I s
neighbo s a e Chad and he Cen al A ican Republic on he wes , Egyp and
Libya on he no h, E hiopia and E i ea on he eas , and Sou h Sudan on he
sou h6. The Red Sea washes abou 500 mi o he eas e n coas . I is a e sed
om no h o sou h by he Nile, all o whose g ea ibu a ies a e pa ly o
en i ely wi hin i s bo de s6. Sudan, once he la ges and one o he mos
geog aphically di e se s a es in A ica, spli in o wo coun ies in July 2011
a e he people o he sou h o ed o independence a e almos 50 yea s o
un es and a bad ci il wa 10. Jus as Sudan's ci il wa seemed o be coming
o an end, ano he wa in ensi ied in he no hwes e n Da u egion10.
Many people in he popula ion ha e been exposed o auma ic e en s and
huge iola ion o human igh s11. Repo ing o auma ela ed p oblems is
e y poo 11. The use s ea ed in men al heal h acili ies a e p ima ily
diagnosed wi h mood diso de s, schizoph enia and o he psycho ic diso de s
and anxie y diso de s12.
Majo heal h p oblems in Sudan -apa om men al heal h p oblems-
include: mala ia, measles, ube culosis, enal ailu e, malignancies and
malnu i ion13. In a eas wi h poo sani a ion o he sou h and wes , wa e -
bo ne diseases like chole a a e a h ea 13. The p oblems o ecei ing
adequa e heal h ca e a e pa icula ly high in u al egions, which lack ained
s a and acili ies. Howe e , spending on heal h is below he 9% le el
ecommended by he Wo ld Heal h O ganiza ion (WHO) 13.
Mos o Sudan‘s doc o s and medical s a wo k in he owns/ ci ies, whe e
he pay is highe . E en so, he e a e oo ew doc o s – only h ee o e e y
10,000 people – and hospi als can be o e c owded13.

5
The as majo i y o people wi h psychological p oblems and a subs an ial
numbe o people wi h physical p oblems ea ed by adi ional and ai h
heale s due o public belie e ha illness and in pa icula men al illness is
caused by a supe na u al powe such as de ils, e il spi i s, and magic14, 15.
1.2.2. De ini ion o e ms:
1.2.2.1. Human igh s (HR): a e he undamen al igh s ha humans ha e by
he ac o being human, and ha a e nei he c ea ed no can be ab oga ed by
any go e nmen 16.
1.2.2.2. Disabili y: is an umb ella e m, co e ing impai men s, ac i i y
limi a ions, and pa icipa ion es ic ions. An impai men : is a p oblem in
body unc ion o s uc u e; an ac i i y limi a ion is a di icul y encoun e ed
by an indi idual in execu ing a ask o ac ion; while a pa icipa ion
es ic ion is a p oblem expe ienced by an indi idual in in ol emen in li e
si ua ions (WHO de ini ion)5 .
1.2.2.3. A i ude: a p edisposi ion, owa d any pe son, ideas o objec s, i
con ains cogni i e, a ec i e and beha iou al componen s17.
1.2.2.4. Psychosocial and Men al disabili y (PMD): is an in e na ionally
ecognised e m unde he Uni ed Na ions Con en ion on he Righ s o
Pe sons wi h Disabili ies, used o desc ibe he expe ience o people wi h
impai men s and pa icipa ion es ic ions ela ed o men al heal h
condi ions. These impai men s can include a loss o abili y o unc ion,
hink clea ly, expe ience ull physical heal h, and manage he social and
emo ional aspec s o hei li es18.
1.2.2.5. Men al illnesses (MI): a e heal h condi ions in ol ing changes in
hinking, emo ion o beha io (o a combina ion o hese). Men al illnesses
a e associa ed wi h dis ess and/o p oblems unc ioning in social, wo k o
amily ac i i ies19.
1.2.2.6. S igma: is a combina ion o s e eo yped belie s, p ejudiced a i udes,
and disc imina o y beha io s owa d ou -g oups—bu anscending each
componen , gi en he global na u e o he aspe sions cas — esul ing in
educed li e oppo uni ies o hose who a e de alued20. S e eo ype: is a
cogni i e ―sho hand‖ o desc ibe a gi en social g oup, which may con ain a
ge m o u h bu which is likely o lead o igid cha ac e iza ions o g oup
membe s20. P ejudice: li e ally ―p ejudgmen ,‖ his e m e e s o nega i ely
inged a ec i e esponses o membe s o ou -g oups20. Disc imina ion: he
limi a ions on he igh s o ou -g oups o hose who a e socially cas iga ed;
he beha io al componen o s igma iza ion, beyond cogni i e s e eo ypes
and a ec i e p ejudices20.
6
1.2.3. Li e a u e on a i ude:
1.2.3.1. A i ude concep : Allpo de ined an a i ude as a men al o neu al
s a e o eadiness, o ganized h ough expe ience, exe ing a di ec i e o
dynamic in luence on he indi idual‘s esponse o all objec s and si ua ions
o which i is ela ed21. Acco ding o Schneide , ‗A i udes a e e alua i e
eac ions o pe sons, objec s, and e en s. This includes you belie s and
posi i e and nega i e eelings abou he a i ude objec 22. He also added ha
a i ude can guide ou expe iences and decide he e ec s o expe ience on
ou beha iou s22. Thus, indi idual‘s disposi ion becomes an a i ude i i
con ains in some pa s, aspec s o knowing and ac ing22. Mo eo e a ec i e
componen o ou a i ude consis s o a pe son‘s e alua ion o liking o
emo ional esponse o some objec s o pe son17. The cogni i e componen
e e s o he way he objec o pe son is pe cei ed. I is in ac he men al
pic u e o med in he indi idual‘s b ain. This includes he pe son‘s hough s,
belie s and knowledge abou he objec 17. The beha iou componen
in ol es he pe son‘s o e ac s di ec ed owa ds ano he pe son o g oup o
pe sons o objec s17. A simila de ini ions is adop ed by (Eagly & Chaiken)
‗A i udes a e e alua ions o a pa icula pe son, beha io , belie , o
concep . Fo example, you p obably hold a i udes owa d he U.S. p esiden
(a pe son), Abo ion (a beha io ), a i ma i e ac ion (a belie ), o
a chi ec u e (a concep ) 23.
A simple de ini ion o a i ude is a mindse o a endency o ac in a
pa icula way due o bo h an indi idual‘s expe ience and empe amen 22.
Ba on and By ne also ga e a simila de ini ion o a i ude which is,
‗A i udes can be de ined as las ing, gene al e alua ions o people (including
onesel ), objec s, o issues24. A i ude is las ing because i pe sis s ac oss
ime. A momen a y eeling does no coun as an a i ude24. This is simila o
a s a emen made by Vaughan & Hogg, ‗A i udes a e ela i ely pe manen -
pe sis ac oss imes and si ua ions25. A momen a y eeling in one place is no
an a i ude.‘ The e o e, i you encoun e ed a b ie eeling abou some hing, i
does no coun as an a i ude. Mo eo e , Vaughan & Hogg de ined a i ude
as, ‗A ela i ely endu ing o ganiza ion o belie s, eelings and beha iou al
endencies owa ds socially signi ican objec s, g oups, e en s o symbols o
a gene al eeling o e alua ion (posi i e/ nega i e) abou some pe son, objec
o issue‘25. In b ie , i could be said ha , a i ude is a posi i e o nega i e
e alua ions o eelings ha people ha e owa ds o he people, objec s, issues
o e en s, i.e. A i ude is he gene al way people eel owa ds socially
signi ican objec s and mos a i udes a e las ing25.
7
1.2.3.2. Componen s o A i ude:
Componen s o a i udes can be ca ego ized acco ding o he ABC model. In
he ABC model o a i ude, ‗A‘ ep esen s o he a ec i e componen s o
a i ude, ‗B‘ ep esen s o he beha iou al componen s and ‗C‘ ep esen s he
cogni i e componen o a i ude25.
The a ec i e componen o he a i ude e e s o how we eel abou ce ain
a i ude objec s. In o he wo ds, i e e s o ou emo ional eac ions owa ds
he a i ude objec 24, 25. I includes ou posi i e and nega i e eelings owa ds
he objec . The e o e, he a ec i e componen o an a i ude e lec s how
much we like o dislike an a i ude objec . Meanwhile he beha iou al
componen e e s o ou beha iou al in en ions, o how we ac acco ding o
he a i ude ha we ha e. This componen includes ou beha iou al endency
owa ds an a i ude objec . Basically, i e e s o how we a e inclined o ac
owa ds an a i ude objec 24, 25. The beha iou al componen o he a i ude
will de e mine how we ac owa ds an a i ude objec . On he o he hand, he
cogni i e componen e e s o wha ou knowledge o he a i ude objec . In
o he wo ds, he cogni i e componen e e s o wha we know abou he
a i ude objec and he p ocess ha goes on o o ming and using an
a i ude24. The cogni i e componen o an a i ude includes ou hough s and
ideas abou he a i ude objec 25. Fo example, a pe son‘s nega i e a i ude
owa ds a pe son wi h psychosocial disabili y could be di ided in o he h ee
ollowing componen s. Fi s ly, he a ec i e componen could be he
pe son‘s nega i e eelings o ea owa ds he pe son wi h psychosocial.
Then, he beha iou al componen could be he pe son‘s endency o mo e
away om ha pe son o be gua ded suspicious when he o she is nea such
pe son. Finally, he cogni i e componen could be he pe son‘s knowledge
ha pe sons wi h psychosocial disabili ies a e dange s and hey can
endange people‘s li es.
1.2.3.3. A i ude o ma ion and a i ude change:
An a i ude is o med by he exci a ion o a need in he indi idual. This need
may a ise wi hin he indi idual o be igge ed by a ele an cue in he
en i onmen . To induce a i ude change he exp ession o an old a i ude o
i s an icipa ed exp ession mus be seen o gi e sa is ac ion no longe 24.
One way o changing people is o change hei a i udes and opinions.
A i udinal change o opinion change is a ype o change in which he
change agen exe cises social in luence23. This p ocess o changing a i udes
is called pe suasion, one o he cen al concep s in social psychology. The
ease wi h which a i udes can be changed depends on a numbe o ac o s,
including:
8
Message sou ce: a i ude communica o who is physically and socially
a ac i e p oduce g ea e a i ude change han hose who a e less a ac i e;
cha ac e is ic o he message: o example, wo sided messages
(communica ion ha p esen s wo poin s o iew and hen p esen s
a gumen s o coun e he opposing iew) also called wo-sided appeal, a e
mo e pe suasi e han one sided messages and cha ac e is ic o he a ge : o
example in elligen people and men a e mo e esis an o pe suasion23.
Types o a i udes owa d pe sons wi h psychosocial disabili y esul in
s igma iza ion o hese people. S igma has nume ous nega i e e ec s on
pe sons wi h psychosocial disabili y such as di icul ies ob aining housing,
disc imina ion among employe s ‗hi ing p ac ices, loss o amily and social
suppo , and sel -s igma26. The amoun o s igma expe ienced is so powe ul
ha some consume s epo i is mo e debili a ing han he illness i sel 27.
Essen ially, he way people pe cei e and ea men al heal h clien s is wo se
han he psychia ic symp oms hey expe ience3. We need o be awa e abou
he elemen s o a i ude change o change a i udes owa ds pe sons wi h
psychosocial and men al disabili ies. I ‘s ime o look a he ac s and dispel
some o he my hs su ounding men al illness.
1.2.3.4. Wha can we do abou s igma and disc imina ion?
I is i s impo an o ha e ongoing educa ion ega ding men al illness so
people can unde s and wha men al illness is and how i migh impac hose
su e ing o be os acized and ejec ed. This educa ion should be conduc ed
by p o essional who a e commi ed o he human igh s, knowledgeable
ega ding men al illness and socially a ac i e and in elligen . We need o
use cen al ou e p ocessing a he han he pe iphe al ou e p ocessing, o
comp ehend ou messages ega ding men al heal h issues because cen al
ou e p ocessing gene ally leads o s onge , mo e las ing a i ude change23.
I is also impo an o o e suppo o hose who migh be ying o cope and
deal wi h men al illness o le hem know ha i is no a weakness o admi o
expe iencing men al illness, a he s eng h o ask o help1. This will also
help hose who a e dealing wi h men al illness o come o wa d o ecei e
he help hey need.
1.2.4. Li e a u e on human igh s:
Human igh s a e almos a o m o eligion in oday's wo ld. They a e he
g ea e hical ya ds ick ha is used o measu e a go e nmen 's ea men o i s
people. A b oad consensus has eme ged in he wen ie h cen u y on he o ic
9
ha ames judgmen o na ions agains an in e na ional mo al code
p esc ibing ce ain bene i s and ea men o all humans simply because
hey a e human and wi hin many na ions poli ical deba es age o e he
denial o abuse o human igh s28.
1.2.4.1. Theo y o human igh s:
(1)Human igh s can be seen as p ima ily e hical demands. They a e no
p incipally ―legal,‖ ―p o o-legal‖ o ―ideal-legal‖ commands. E en hough
human igh s can, and o en do, inspi e legisla ion, his is a u he ac ,
a he han a cons i u i e cha ac e is ic o human igh s29.
(2) The impo ance o human igh s ela es o he signi icance o he
eedoms ha o m he subjec ma e o hese igh s. Bo h he oppo uni y
aspec and he p ocess aspec o eedoms can igu e in human igh s. To
quali y as he basis o human igh s, he eedoms o be de ended o
ad anced mus sa is y some ― h eshold condi ions‖ o (i) special impo ance
and (ii) social in luence-abili y28.
(3) Human igh s gene a e easons o ac ion o agen s who a e in a posi ion
o help in he p omo ing o sa egua ding o he unde lying eedoms. The
induced obliga ions p ima ily in ol e he du y o gi e easonable
conside a ion o he easons o ac ion and hei p ac ical implica ions,
aking in o accoun he ele an pa ame e s o he indi idual case. The
easons o ac ion can suppo bo h ―pe ec ‖ obliga ions as well as
―impe ec ‖ ones, which a e less p ecisely cha ac e ized. E en hough hey
di e in con en , impe ec obliga ions a e co ela i e wi h human igh s in
much he same way as pe ec obliga ions a e. In pa icula , he accep ance
o impe ec obliga ions goes beyond olun ee ed cha i y o elec i e
i ues28.
(4) The implemen a ion o human igh s can go well beyond legisla ion, and
a heo y o human igh s canno be sensibly con ined wi hin he ju idical
model in which i is equen ly inca ce a ed. Fo example, public ecogni ion
and agi a ion (including he moni o ing o iola ions) can be pa o he
obliga ions—o en impe ec —gene a ed by he acknowledgmen o human
igh s. Also, some ecognized human igh s a e no ideally legisla ed, bu a e
be e p omo ed h ough o he means, including public discussion, app aisal
and ad ocacy (a basic poin ha would ha e come as no su p ise o Ma y
Wolls onec a , whose A Vindica ion o he Righ s o Woman: wi h
S ic u es on Poli ical and Mo al Subjec s was published in 1792)28.
(5) Human igh s can include signi ican and in luenceable economic and
social eedoms. I hey canno be ealized because o inadequa e
ins i u ionaliza ion, hen, o wo k o ins i u ional expansion o e o m can

10
be a pa o he obliga ions gene a ed by he ecogni ion o hese igh s. The
cu en un ealizabili y o any accep ed human igh , which can be p omo ed
h ough ins i u ional o poli ical change, does no , by i sel , con e ha
claim in o a non- igh 29.
(6) The uni e sali y o human igh s ela es o he idea o su i abili y in
unobs uc ed discussion—open o pa icipa ion by pe sons ac oss na ional
bounda ies. Pa isanship is a oided no so much by aking ei he a
conjunc ion, o an in e sec ion, o he iews espec i ely held by dominan
oices in di e en socie ies ac oss he wo ld (including e y ep essi e
ones), bu h ough an in e ac i e p ocess, in pa icula by examining wha
would su i e in public discussion, gi en a easonably ee low o
in o ma ion and uncu bed oppo uni y o discuss di e ing poin s o iew.
Adam Smi h‘s insis ence ha e hical sc u iny equi es examining mo al
belie s om, in e alia, ―a ce ain dis ance‖ has a di ec bea ing on he
connec ion o human igh s o global public easoning29.
1.2.4.2. The His o ical O igins o Human Righ s:
In 539 B.C., he a mies o Cy us he G ea , he i s king o ancien Pe sia,
conque ed he ci y o Babylon. Bu i was his nex ac ions ha ma ked a
majo ad ance o Man. He eed he sla es, decla ed ha all people had he
igh o choose hei own eligion, and es ablished acial equali y. These and
o he dec ees we e eco ded on a baked-clay cylinde in he Akkadian
language wi h cunei o m sc ip 30.
Known oday as he Cy us Cylinde , his ancien eco d has now been
ecognized as he wo ld‘s i s cha e o human igh s. I is ansla ed in o
all six o icial languages o he Uni ed Na ions and i s p o isions pa allel he
i s ou A icles o he Uni e sal Decla a ion o Human Righ s30.
1.2.4.3. The Sp ead o Human Righ s:
F om Babylon, he idea o human igh s sp ead quickly o India, G eece and
e en ually Rome. The e he concep o ―na u al law‖ a ose, in obse a ion o
he ac ha people ended o ollow ce ain unw i en laws in he cou se o
li e, and Roman law was based on a ional ideas de i ed om he na u e o
hings31.
Documen s asse ing indi idual igh s, such as he Magna Ca a (1215), he
Pe i ion o Righ (1628), he US Cons i u ion (1787), he F ench Decla a ion
o he Righ s o Man and o he Ci izen (1789), and he US Bill o Righ s
(1791) a e he w i en p ecu so s o many o oday‘s human igh s
documen s31.
11
The Magna Ca a, o ―G ea Cha e ,‖ was a guably he mos signi ican
ea ly in luence on he ex ensi e his o ical p ocess ha led o he ule o
cons i u ional law oday in he English-speaking wo ld31.
By 1948, he Uni ed Na ions‘ new Human Righ s Commission had cap u ed
he a en ion o he wo ld. Unde he dynamic chai manship o Eleano
Roose el , he Commission se ou o d a he documen ha became he
Uni e sal Decla a ion o Human Righ s. Roose el , c edi ed wi h i s
inspi a ion, e e ed o he Decla a ion as he ―in e na ional Magna Ca a o
all mankind.‖ I was adop ed by he Uni ed Na ions on Decembe 10, 194830.
In i s p eamble and in A icle 1, he Decla a ion unequi ocally p oclaims he
inhe en igh s o all human beings. A icle 1 ―All human beings a e bo n
ee and equal in digni y and igh s32. They a e endowed wi h eason and
conscience and should ac owa ds one ano he in a spi i o b o he hood.32‖
Human igh s ad oca es ag ee ha , six y yea s a e i s issue, he Uni e sal
Decla a ion o Human Righ s is s ill mo e a d eam han eali y. Viola ions
exis in e e y pa o he wo ld. Fo example, Amnes y In e na ional and
o he sou ces show ha indi iduals a e:
To u ed o abused in a leas 81 coun ies
Face un ai ials in a leas 54 coun ies
Res ic ed in hei eedom o exp ession in a leas 77 coun ies
No only ha , bu ulne able g oups such as women, child en, e hnic
mino i ies and pe sons wi h disabili ies in pa icula a e ma ginalized in
nume ous ways, he p ess is no ee in many coun ies, and dissen e s a e
silenced, oo o en pe manen ly. While some gains ha e been made o e he
cou se o he las six decades, human igh s iola ions s ill plague he wo ld
oday31.
1.2.5. Human igh s o pe sons wi h psychosocial and men al disabili ies
1.2.5.1. In oduc ion:
People wi h men al illness ha e long been subjec ed o c uel y, neglec ,
idicule, disc imina ion, ma ginaliza ion, and s igma. The s igma associa ed
wi h hese condi ions means ha people expe ienced exclusion and ejec ion
by he socie y33. S igma has been ound o be a p ima y de e en o
indi iduals who need men al heal h se ices as well as impac ing hose
al eady ecei ing se ices20. Wo ld heal h o ganiza ion (WHO) s a ed ha :
(All people wi h men al diso de s ha e he igh o ecei e high quali y
ea men and ca e deli e ed h ough esponsi e heal h ca e se ices. They
should be p o ec ed agains any o m o inhuman ea men and
disc imina ion3. Abou 15% o he wo ld's popula ion li es wi h some o m
12
o disabili y, o whom 2-4% expe ience signi ican di icul ies in
unc ioning34.
Al hough in he las wo decades, he wo ld has wi nessed a signi ican
change in he quali y o li e and social pa icipa ion o pe sons wi h
psychosocial and men al disabili ies, based on he issues o human igh s,
s ill he e is a huge iola ion o he igh s o his ulne able g oup, in low
and middle-income coun ies35. Sudan is one o he low income g oup
coun ies36.
In Sudan, no na ional human igh s e iew body exis s. Re iew/inspec ion o
human igh s p o ec ion o pa ien s in men al hospi als is spo adic and
inconsis en . None o he men al heal h s a wo king in men al hospi als
ecei ed any o mal aining on human igh s12.
The en y in o o ce o he UN Con en ion on he Righ s o Pe sons wi h
Disabili ies (CRPD) in May 2008 ma ked he beginning o a new e a in he
e o s ― o p omo e, p o ec and ensu e he ull and equal enjoymen o all
human igh s and undamen al eedoms by all pe sons wi h disabili ies, and
o p omo e espec o hei inhe en digni y‖4. Mo eo e CRPD adop ed he
social model o disabili y, in which he disabili y is ecognized as he
consequence o he in e ac ion o he indi idual wi h an en i onmen . Also
psychia ic disabili ies a e included among o he disabili ies o he i s
ime4.
1.2.5.2. Con en ion on he Righ s o Pe sons wi h Disabili ies (CRPD)
Wha is (CRPD)?
The Con en ion on he Righ s o Pe sons wi h Disabili ies is an in e na ional
human igh s ea y o he Uni ed Na ions in ended o p o ec he igh s and
digni y o pe sons wi h disabili ies. Pa ies o he Con en ion a e equi ed o
p omo e, p o ec , and ensu e he ull enjoymen o human igh s by pe sons
wi h disabili ies and ensu e ha hey enjoy ull equali y unde he law. The
Con en ion has se ed as he majo ca alys in he global mo emen om
iewing pe sons wi h disabili ies as objec s o cha i y, medical ea men and
social p o ec ion owa ds iewing hem as ull and equal membe s o
socie y, wi h human igh s4.
The Con en ion adop s a social model o disabili y, and de ines disabili y as
including hose who ha e long- e m physical, men al, in ellec ual o senso y
impai men s which in in e ac ion wi h a ious ba ie s may hinde hei ull
and e ec i e pa icipa ion in socie y on an equal basis wi h o he s. The ex
was adop ed by he Uni ed Na ions Gene al Assembly on 13 Decembe
2006, and opened o signa u e on 30 Ma ch 2007. Following a i ica ion by
13
he 20 h pa y, i came in o o ce on 3 May 2008124. Cu en ly, Sudan is a
pa y coun y o bo h he con en ion and he op ional p o ocol37. The
Con en ion ollows he ci il law adi ion, wi h a p eamble, in which he
p inciple ha "all human igh s a e uni e sal, indi isible, in e dependen and
in e ela ed‖ o Vienna Decla a ion and p og amme o Ac ion is ci ed,
ollowed by 50 a icles. Unlike many UN co enan s and con en ions, i is
no o mally di ided in o pa s4.
Summa y o he con en ion:
A icle 1 de ines he pu pose o he Con en ion: o p omo e, p o ec and
ensu e he ull and equal enjoymen o all human igh s and undamen al
eedoms by all pe sons wi h disabili ies, and o p omo e espec o hei
inhe en digni y
A icles 2 and 3 p o ide de ini ions and gene al p inciples including
communica ion, easonable accommoda ion and uni e sal design.
A icles 4–32 de ine he igh s o pe sons wi h disabili ies and he
obliga ions o s a es pa ies owa ds hem. Many o hese mi o igh s
a i med in o he UN con en ions such as he In e na ional Co enan on
Ci il and Poli ical Righ s, In e na ional Co enan on Economic, Social and
Cul u al Righ s o he Con en ion Agains To u e, bu wi h speci ic
obliga ions ensu ing ha hey can be ully ealized by pe sons wi h
disabili ies.
Righ s speci ic o his con en ion include he igh s o accessibili y including
he in o ma ion echnology, he igh s o li e independen ly and be included
in he communi y (A icle 19), o pe sonal mobili y (a icle 20), habili a ion
and ehabili a ion (A icle 26), and o pa icipa ion in poli ical and public
li e, and cul u al li e, ec ea ion and spo (A icles 29 and 30).
In addi ion, pa ies o he Con en ion mus aise awa eness o he human
igh s o pe sons wi h disabili ies (A icle 8), and ensu e access o oads,
buildings, and in o ma ion (A icle 9).
A icles 33–39 go e n epo ing and moni o ing o he con en ion by
na ional human igh s ins i u ions (A icle 33) and Commi ee on he Righ s
o Pe sons wi h Disabili ies (A icle 34).
A icles 40–50 go e n a i ica ion, en y in o o ce, and amendmen o he
Con en ion. A icle 49 also equi es ha he Con en ion be a ailable in
accessible o ma s.
Guiding p inciples o he Con en ion:
The e a e eigh guiding p inciples ha unde lie he Con en ion:
20
Chap e I - GROUNDS, OBJECTIVES AND HYPOTHESIS
2.1.1. G ounds
2.1.1.1. In oduc ion:
Men al heal h in Sudan as in o he s A ican coun ies was exclusi ely
monopolized by ai h heale s, Za conduc o s, exo cis s, and shee quacks
un il he mid- wen ie h cen u y14. Nei he he Ki chene a my in ading
Sudan in 189839, no he subsequen colonial adminis a ion, con empla ed
in oducing any men al heal h componen in hei Mili a y Medical Co ps o
in hei la e Sudan Medical Se ice40. Nei he had he es ablished 1924
Ki chene School o Medicine (KSM) include any didac ic o clinical
ins uc ion in men al heal h14. No wonde ha none o he i s gene a ion o
Sudanese g adua es om KSM exp essed any in e es in dealing wi h
pa ien s wi h men al heal h p oblems14. The singula excep ion was a 1935
g adua e who s unned his ela i es and colleagues by his c azy decision (a
ha ime) o choice men al heal h as a ca ee . His o y o psychia y in Sudan
is closely ela ed o P o esso Tigani El-Mahi (1911-70) who was he i s
Sudanese and na i e A ican psychia is . He in oduced he i s psychia ic
acili y in Sudan. He la e became he i s Men al Heal h Ad iso in he
Eas Medi e anean Regional O ice o he Wo ld Heal h O ganiza ion. He
was he i s p o esso o psychia y in Sudan. His disciple, Taha Baashe
(1922-2008), sha ed and ca ied o wa d El-Mahi‘s isions and plans. Thei
join con ibu ions cons i u ed he ene s o wha has become known as he
El-Mahi-Baashe he i age14, 41. Whene e he his o y o Psychia y in he
Sudan is discussed, i would be app op ia e o men ion El-Mahi and Baashe
he i age.
El-Mahi ounded he i s Psychia y clinic in Al Amlak dis ic in Bah i ci y
and in 1950 he co- ounded Kobe Men al Asylum41. Baashe ounded many
men al heal h ins i u es including Bah i psychia y clinic in 1959, Kha oum
Psychia y clinic in 1962 and Tigani El-Mahi Teaching Hospi al in197141.
He is igh ully he genuine a he o he so called ―open-doo psychia y
ea men policy‖, as he adop ed accep ing pa ien s and hei amilies o
inpa ien s ea men , and en ed houses nea he clinic o ha pu pose41.
Baashe also ounded psychia ic uni s in all p o inces o he Sudan. He and
his colleagues s a ed om he e y beginning o b idge he gap be ween
adi ional healing and psychia y14, 41.
Tene s o El-Mahi-Baashe he i age as s a ed by P o esso Sheikh Id is14, 41:
a. De elop men al heal h se ices s a ing om he base o he py amid
o he communi y, h ough ou pa ien acili ies, o gene al hospi al

21
wa ds, o small-size sho -s ay psychia ic hospi als, o la ge size
longe -s ay he apeu ic ehabili a ion hospi als.
b. Rec ui , ain, and coo dina e mul i-disciplina y men al heal h eams
c. In ol e, psycho-educa e, and suppo he amily as an essen ial
pa ne in he p e en ion, ea men , and ehabili a ion.
d. Inco po a e men al heal h se ices in he gene al heal h p og am
s a ing om he p ima y heal h ca e cen e .
e. Collabo a e wi h espec able adi ional heale s, especially in
epu able and ime-hono ed ai h- he apeu ic illages.
. Encou age scien i ic esea ch wi h emphasis on epidemiology,
psychopa hology, he apeu ics, socio-cul u al and mul idisciplina y
s udies.
g. T ain and quali y u u e gene a ions o men al heal h p o essionals in
unde g adua e, pos -g adua e, and con inuous p o essional
de elopmen .
h. C ea e and main ain ac i e pa icipa ion in local, egional and global
p o essional o ganiza ions and ac i i ies.
2.1.1.2. S a emen o he p oblem
Despi e he ad anced iew o he pionee s in psychia y a a e y ea ly ime,
un o una ely many obs acles p e en ed he achie emen o wha hey
wan ed o men al heal h in Sudan. The e we e a subs an ial numbe o
ba ie s o implemen hese p inciples in o de o de elop a good men al
heal h sys em in he coun y. These ba ie s include s igma, human igh s
iola ions, lack o poli ical well, p o essional ba ie , lack o awa eness, lack
o ained men al heal h ca e p o ide , b ain d ainage, po e y and many
o he heal h p oblems ha we e conside ed as p io i ies by he
s akeholde s12.
In Sudan, men al heal h sys em has h ee ypes o men al heal h acili ies;
classical psychia ic hospi als, psychia ic uni s in gene al hospi als and
asylums. The as majo i y o he iny inancial esou ces and a subs an ial
pa o human esou ces ha a e a ailable a e di ec ed owa ds hese
acili ies12. Psychia ic hospi als and psychia ic uni s a e un by he
minis y o heal h. Asylums con ain mos o he ch onic pa ien s, homeless
pa ien s and pa ien s wi h c iminal esponsibili ies, a e un by police and
look like p isons. Howe e mos o hese acili ies need o be s eng hened
22
and de eloped u he in e ms o s a , ea men acili ies and li ing
acili ies12. None o hese acili ies p o ide ac i e ollow-up ca e in he
communi y and almos no p o essional communi y men al heal h se ice.
P ima y heal h ca e s a aining on men al heal h issues is weak, as is
in e ac ion be ween he p ima y heal h and men al heal h sys em. The e is an
imbalance in a o o men al hospi al inpa ien ca e. Few acili ies a e
de o ed o child en and adolescen s12.
Up o he momen o conduc ing his s udy, he asylums we e he main
acili ies all o e he coun y excep Kha oum - he capi al- o pe sons wi h
psychosocial and men al disabili ies who we e kep in e y na ow cells in
an inhumane manne , wea ing di y clo hes o no clo hing a all. Ve y ew
medica ions we e a ailable as we e ained s a membe s and i a pa ien
becomes exci ed, hen unmodi ied elec ocon ulsi e he apy (ECT) is he
only op ion!.
Since he a i ude can p edic beha io 42, he esea che hypo hesized ha he
s a and consume s a i udes owa d human igh s o pe sons wi h
psychosocial and men al disabili ies a ec he ex en o which he inclusion
philosophy becomes eali y.
The issues o human igh s o people wi h psychosocial and men al
disabili ies wo ldwide a e lagging behind. The e is no na ional men al heal h
legisla ion is in 25% o coun ies wi h nea ly 31% o he wo ld‘s popula ion.
In he Eas e n Medi e anean Region only 57% ha e such legisla ion 3.
Sudan's men al heal h policy was e o mula ed in 2006-2008. The las
e sion o men al heal h legisla ion da es back o 1998 and equi es
upda ing12 and he cu en men al heal h ac d a which is unde app o al
con ains a icles wi h majo human igh s iola ions. Up o he esea che
knowledge un il now he e is no s udy add essing he a i ude owa d human
igh s o pe sons wi h psychosocial disabili ies in Sudan. The e a e many
s udies o a i ude owa d pe sons wi h men al diso de s we e done in Sudan
by many colleagues in he ield o men al heal h, o ins ance Anas, 2011
and Khalid, 2015 among medical s uden s and p ima y heal h ca e p o ide s
espec i ely. They e ealed nega i e a i udes owa d pe sons wi h
psychosocial disabili ies. Bu no one add ess he a i udes o men al heal h
23
ca e p o ide s owa d hei pa ien s o he a i udes o he consume s owa d
hemsel es o men al illness.
2.1.1.3. Signi icance o he s udy:
This s udy explo ed some o he majo ba ie s ha a e p e en ing pe sons
wi h psychosocial disabili ies o expe ience hei human igh s (especially
ull inclusion and pa icipa ion in he communi y), by examining he s a
membe s' and consume s' a i udes owa d his popula ion's human igh s.
The esul s o his s udy will in o m aining o s a and consume s on
human igh s issues.
2.1.2. Objec i es:
2.1.2.1. Gene al Objec i e:
This s udy was designed o desc ibe he a i udes o s a and consume s
owa d human igh s o pe sons wi h psychosocial and men al disabili ies
and hei in eg a ion in o he communi y, wi hin Kha oum he capi al ci y
o Sudan.
2.1.2.2. Speci ic Objec i es:
2.1.2.2.1. To b ing o a en ion he issues o human igh s o pe sons wi h
psychosocial disabili ies by examining s a 's and consume s' a i udes
owa d hese igh s.
2.1.2.2.2. To p o ide in o ma ion on he gene al a i udes o s a 's and
consume s' owa d human igh s.
2.1.2.2.3. To desc ibe ypes o a i udes o s a and consume s owa d
human igh s o pe sons wi h psychosocial and men al disabili y and hei
in eg a ion in o he communi y.
2.1.2.2.4. To explo e he possible p edic o s o a i udes o s a and
consume s owa d human igh s o pe sons wi h psychosocial and men al
disabili y and hei in eg a ion in o he communi y.
24
2.1.2.2.5. To see he di e ence be ween s a 's and consume s' a i udes
owa d human igh s o pe sons wi h men al and psychosocial disabili y.
2.1.2.3. Subsidia y objec i e:
2.1.2.3.1. A s ep in he cons uc ion and he s anda diza ion o Human
Righ s o pe sons wi h psychosocial and men al disabili y a i ude
ques ionnai e (HRQ_6).
2.1.3. S udy hypo heses:
2.1.3.1. S a and consume s ha e nega i e a i udes owa d he human igh s
o pe sons wi h psychosocial and men al disabili ies which will a ec he
p ocess o in eg a ion in o he communi y.
Null hypo hesis: S a and consume s ha e neu al a i udes owa d human
igh s o pe sons wi h psychosocial and men al disabili ies
2.1.3.2. S a membe backg ound a iables including age, gende ,academic
discipline, senio i y, ma i al s a us, his o y o men al diso de , con ac wi h
psychia ic se ices as a use and he ole, may ha e an e ec on his/he
a i udes owa d human igh s o pe sons wi h psychosocial and men al
disabili ies.
Null hypo hesis: s a membe backg ound a iables ha e no e ec on
his/he a i udes owa d human igh s o pe sons wi h psychosocial and
men al disabili ies.
2.1.3.3. Consume backg ound a iables including age, gende , ma i al
s a us, numbe s o yea s using he se ice, diagnosis, le el o educa ion and
sel -es eem may ha e an e ec on his/he a i udes owa d human igh s o
pe sons wi h psychosocial and men al disabili ies.
Null hypo hesis: consume backg ound a iables ha e no e ec on his/he
a i udes owa d human igh s o pe sons wi h psychosocial and men al
disabili ies.
25
2.1.3.4. Consume s' a i udes owa d human igh s o pe sons wi h
psychosocial and men al disabili ies will be mo e posi i e han he s a
a i udes.
Null hypo hesis: The e will be no di e ence be ween he consume s'
a i udes and he s a a i udes owa d human igh s o pe sons wi h
psychosocial and men al disabili ies.

26
2.2. CHAPTER TWO: METHODOLOGY
27
CHAPTER 2: METHODOLOGY
This chap e will desc ibe he p ocedu e upon which he esea ch is based.
A su ey is de ised and conduc ed in o de o assess he a i udes o s a
and consume s owa d human igh s o pe sons wi h psychosocial and
men al disabili ies and hei in eg a ion in o he communi y .The main
objec i e behind his su ey was o guide and in o m he aining and aising
he awa eness ha would be ca ied ou amongs s a and consume s in
Sudan, o be e iden i y, accep and deal wi h pa ien s o men al illness.
2.2.1. S udy design:
This s udy was a non-expe imen al, c oss-sec ional desc ip i e, hospi al
based s udy.
2.2.2. S udy popula ion:
The pa icipan s o his s udy was consis o s a p o essionals (social
wo ke s, nu ses, psychologis and doc o s) and hei pa ien s.
The sample Numbe = 204, was consis o 100 consume s and 104 s a
membe s. Pa icipan s we e selec ed h ough con enience sampling.
In o med consen was ob ained om all he pa icipan s. To ensu e
con iden iali y, pa icipan names we e no aken and he samples we e
iden i ied only by a numbe code. All o he s in ol ed in he p ojec we e
old ha no in o ma ion would be eleased abou indi idual pa icipan s.
2.2.2.1. C i e ia o pa icipa ion in his s udy we e including:
1. P o essional s a membe o consume in one o he main h ee
psychia ic hospi als in Kha oum.
2. Wo king a leas o h ee mon hs in men al heal h ield (s a ).
3. Accep ing o pa icipa e in he s udy.
2.2.2.2Exclusion c i e ia we e including:
1. S a membe s who spen less han h ee mon hs in men al heal h ield.
2. Re usal o con inue in he s udy a any ime du ing he da a collec ion.
2.2.3. S udy a ea:
The s udy was ca ied ou be ween May 2016 and Feb ua y 2017 in
Kha oum ci y, he capi al o Sudan. I is a ci y o 8 million popula ion6, 7
and h ee main psychia ic hospi als wi h a ound 400 beds and e y busy
ou pa ien s (OPD) and eme gency(ER) clinics wi h a ound 200 consume s
28
pe day. The h ee main psychia ic hospi als in Kha oum, Sudan, whe e
his s udy was conduc ed a e:
(1) Tigani El-Mahi Teaching Hospi al o Men al Heal h (EETHMH): his is
he la ges ci il men al heal h in Sudan, was buil in 1971 and named a e
P o esso El-Mahi (Fa he o A ican Psychia y). , ounded in Omdu man
(Kha oum wes ), and con ains 100 beds15.
(2) Baashe hospi al Psychia ic Hospi al: is an ex ension o he i s
psychia y acili y in Sudan which ounded by El-Mahi in 1950 and enewal
by Baashe in 1959, in Bah i (Kha oum no h), and con ains 50 beds15.
(3) Elid issi Psychia ic Hospi al (EPH): is he s a e hospi al o ea ing
pa ien s wi h men al illness and c iminal esponsibili ies and pa ien s who
a e dange ous o hemsel es o o he s, ounded in Bah i (Kha oum no h),
and con ains 250 beds15.
These hospi als a e he majo public psychia ic hospi als in Sudan, ecei e
pa ien s om all o e he coun y and om di e en social classes .They ac
as he main e ia y hospi als o men al heal h in he coun y, al hough hey
can ecei e pa ien s di ec ly h ough OPD o ER, also hey a e he main
hospi als o men al heal h aining in Sudan.
The a e age o admission pe day a ies om h ee pa ien s in Baashe
hospi al o en pa ien s in Tigani El-Mahi and Elid issi15.
2.2.4. Sampling and ec ui men :
Sampling was con enien sampling. A e we ha e ecei ed pe mission, he
ques ionnai e was dis ibu ed o he s a and he consume s who we e
sa is y he c i e ia, be ween May 2016 and Feb ua y 2017. E e y pa icipan
was me pe sonally and gi en his/he ques ionnai e o ensu e ha he/she is
esponded o i . Pa icipan was gi en A abic language e sion o a
ques ionnai e ha ook app oxima ely 25 minu es o comple e. The
ques ionnai e included he Communi y Li ing A i udes Scale Men al
Re a da ion - Sho Fo m (CLAS). The esponden s we e asked o indica e
he ex en o which hey ag eed o disag eed wi h he s a emen s in he
Communi y Li ing A i udes Scale Men al Re a da ion - Sho Fo m
(CLAS), 17 i ems and Human Righ s o pe sons wi h psychosocial and
men al disabili ies a i ude ques ionnai e which is de eloped by he
esea che based on CRPD (included some ques ions no ound in he
29
CLAS). Each s a emen was sco ed by he esponden using a 6-poin
Like -like scale.
2.2.5. Va iables:
Two se s o da a we e collec ed:
2.2.5.1. a. Dependen a iables:
Communi y Li ing A i udes Scale (MR)-Sho Fo m (CLAS), 17 i ems
(Hen y e al., 1996), Human Righ s o pe sons wi h psychosocial and men al
disabili ies a i ude ques ionnai e de eloped by he esea che based on
CRPD, 25 i ems and one ques ion ega ding eco e y (a ainable o no ).
2.2.5.2. b. Independen a iables:
Gende
Age
Ma i al s a us
Child en (consume s)
The esponsibili y owa ds sel (consume s)
The esponsibili y owa ds o he s (consume s)
Academic discipline o le el o educa ion
Role o job
Numbe o yea s (wo king in o using he se ice)
His o y o men al illness (s a only) (HMI)
Close pe son his o y o men al illness (CPHMI)
P e ious con ac wi h men al heal h se ices as a use (s a only)
T aining on human igh s
36
a ainable o e e yone; while (11%) o he consume s belie e ha eco e y
is no a ainable a all om men al illness, none o he s a membe s
belie es so; he majo i y o bo h g oups (54% om he consume s and
63.5% o he s a membe s) belie e ha eco e y is a ainable only o
some clien s. Some consume s we e spen mo e han en yea s wi h men al
illness (5%) and mo e han one hal (53%) su e om men al illness o less
han i e yea s. Twen y se en consume s (27%) indica ed ha hey ca ied
he ull esponsibili y owa d sel and eigh een (18%) epo ed ha he
esponsibili y owa d onesel was ca ied ou ully by o he s. Fo y i e
consume s Less han one-hal (45%) epo ed ha hey we e looking a e
o he people such as child en o pa en s.
Figu e 1: Pe cen age o he esponden s acco ding o hei age:

37
Table 1: Selec ed Demog aphics o he esponden s:
Va iable
F equency
Pe cen
Hospi al
El-Mahi
67
32.8
Baashe
51
25.0
El-Ed isi
86
42.2
To al
204
100.0
Type
Consume
100
49.0
S a
104
51.0
To al
204
100.0
Gende
Male
96
47.1
Female
106
52.0
To al
202
99.0
Ma i al s a us
Ma ied
69
33.8
Single
97
47.5
Widowed
13
6.4
Di o ce
22
10.8
To al
201
98.5
38
Figu e 2: Pe cen age o he consume s acco ding o hei occupa ion:
39
2.3.2. Pa icipan s’ A i udes:
As measu ed by he a i ude owa d Human Righ s o pe sons wi h
psychosocial and men al disabili ies Ques ionnai e (HRQ_6) and he
Communi y Li ing A i ude Scale-sho o m (CLAS), he esponden s‘
iews owa d human igh s o pe sons wi h psychosocial and men al
disabili y can be cha ac e ized as nega i e a i ude ha was below o jus a
he minimal esponse ha in a o o basic human igh s o hose people,
which was (4.00 o HRQ_6, Empowe men and Simila i y and 2:00 o
Isola ion and Shel e ing). HRQ_6 mean was (3.76) and SD was (0.44),
CLAS subscales empowe men (a i udes owa d sel -ad ocacy and
empowe men ) and simila i y ( he pe cei ed simila i y o pe sons wi h
psychosocial and men al disabili ies o onesel ) we e as ollows:
empowe men mean was (4.00) and SD was 0.78 and simila i y mean was
4.36 and SD was 0.76. CLAS subscales exclusion ( he desi e o he
esponden o exclude pe sons wi h psychosocial and men al disabili ies
om communi y li e) and shel e ing ( he ex en o which he esponden
belie es ha pe sons wi h psychosocial and men al disabili ies need o be
shel e ed o p o ec ed) we e as ollows: exclusion mean was (2.40) and SD
was 1.00 and shel e ing mean was (3.83) and SD was 0.83.
The esponden s we e a o ing Empowe men and Simila i y o e Exclusion
and Shel e ing
Table (2) p o ides he mean o he HRQ_6 i em sco es:
The ques ion
N
Min
i
Max
Mean
SD
1. In Sudan no need o men al heal h legisla ion o p o ec
he igh s o pe sons wi h psychosocial and men al
disabili ies.
204
1.00
6.00
4.5098
1.47053
2. All na ions should wo k owa d libe y and jus ice o all
including pe sons wi h psychosocial and men al
disabili ies
204
1.00
6.00
4.6029
1.27275
3. Pe sons wi h psychosocial and men al disabili ies should
be able o ha e a oice in how hey deal wi h hei own
204
1.00
6.00
4.5147
1.17644
40
physical well-being, wi h hei heal h and wi h hei
illnesses
4. Pe sons wi h psychosocial and men al disabili ies should be
able o lead, con ol, exe cise choice o e , and de e mine hei
own pa h o eco e y
204
1.00
6.00
4.1324
1.16903
5. Occasionally i is easonable o deny he igh o o e o some
g oups o pe sons wi h psychosocial and men al disabili ies; o
ins ance o pe sons wi h se e ypes o schizoph enia
204
1.00
6.00
3.1814
1.29472
6. Teenage s wi h psychosocial and men al disabili y should be
allowed o ecei e all ypes o medical and psychosocial
ea men s wi hou pa en al consen
204
1.00
6.00
3.3088
1.54974
7. I is legi ima e o au ho i ies o cu ail he ac i i ies o pe sons
wi h psychosocial and men al disabili ies which a e socially
unaccep able; o ins ance wande ing along he s ee wi h di y
clo hes
204
1.00
6.00
3.2402
1.51060
8. All ci izens should be gi en ull cons i u ional igh s bu
ci izens wi h psychosocial and men al disabili ies should no
expec o be gi en all hose igh s
204
1.00
6.00
3.6814
1.47606
9. Pe sons wi h psychosocial and men al disabili ies should
no ha e o wo y abou unwa an ed in usions by he
go e nmen , amily and iends in o hei p i a e li es
204
1.00
6.00
3.2598
1.39533
10. Books should be banned i hey a e w i en by pe sons
wi h psychosocial and men al disabili ies who ha e been
in acu e psycho ic s a e du ing he ime o w i ing.
204
1.00
6.00
3.7451
1.42245
11. Police should no ha e o ge sea ch wa an s when hey
a e pu suing suspec s wi h known se e e men al illness.
204
1.00
6.00
3.4902
1.50366
12. Disc imina ion agains because o psychosocial and men al
disabili y is jus i iable some imes
204
1.00
6.00
3.2304
1.25194
13. We should no was e ime o suppo pe sons wi h psychosocial
o men al disabili ies o ake hei decisions abou sel , when
we a e 100% su e hey a e no able o make decisions
204
1.00
6.00
3.5931
1.39180
14. Pe sons wi h psychosocial and men al disabili ies should ha e
he igh o in ol e he adi ional heale s in hei managemen
plan
204
1.00
6.00
3.8725
1.26079
15. Pe sons wi h psychosocial and men al disabili ies p obably
shouldn' be hi ed o jobs equi ing conside able con ac wi h
he public since hey could beha e in a s ange way
204
1.00
6.00
3.6765
1.43950
16. As soon as a pe son shows signs o men al dis u bance, he
should be hospi alized
204
1.00
6.00
2.6127
1.25240
17. Counselo s should encou age pe sons wi h psychosocial and
men al disabili ies o conside aining o become doc o s,
pilo s, ca pen e s, mili a y o ice s and o he occupa ions ha
i wi h hei po en ials ega dless o hei illness
204
1.00
6.00
3.7843
1.40462
18. Fo pe sons wi h psychosocial and men al disabili ies is be e
o gi e wel a e assis ance a he han o encou age employmen
in o de o p o ec hem
204
1.00
6.00
3.4167
1.37103
19. F eedom o speech should be a basic human igh excep o
pe sons wi h psychosocial and men al disabili ies because hey
can emba ass hei amilies and iends
204
1.00
6.00
3.8529
1.53384
41
20. The en i onmen should be adap ed o he needs o pe sons
wi h psychosocial and men al disabili ies e en i doing so is
expensi e
204
1.00
6.00
4.2990
1.28032
21. The Con en ion on he Righ s o Pe sons wi h Disabili ies
(CRPD) could dis up socie y wi h i s emphasis on ea ing
pe sons wi h psychosocial and men al disabili ies like o he s
204
1.00
6.00
3.7647
1.27249
22. Teache s wi h psychosocial and men al disabili ies can be good
ole models o ou child en, jus like anyone else.
204
1.00
6.00
4.0686
1.37364
23. Publishe s, speake s, p o essionals and o he s since hey a e no
in ending s igma can use s igma izing e ms such as psycho ic,
schizoph enic and demen ed ins ead o usual e ms such as
pe sons wi h psychosis, wi h schizoph enia and wi h demen ia.
204
1.00
6.00
3.7696
1.38281
24. Pe sons wi h psychosocial and men al disabili ies should enjoy
legal capaci y on an equal basis wi h o he s in all aspec s o
li e.
204
1.00
6.00
3.7941
1.31560
25. Pe sons wi h psychosocial and men al disabili ies should no be
dep i ed o hei libe y unlaw ully o a bi a ily, and ha any
dep i a ion o libe y is in con o mi y wi h he law, and ha he
exis ence o a disabili y shall in no case jus i y a dep i a ion o
libe y.
204
1.00
6.00
4.2353
1.28789
N
Mini
Max
Mean
SD
Human Righ s o pe sons wi h psychosocial and men al
disabili ies a i ude Ques ionnai e (HRQ_6)
204
2.46
5.28
3.7648
.43954

42
Figu e (3) p o ides he HRQ_6 means dis ibu ion:
Table 3 p o ides he means and s anda d de ia ions o he CLAS i ems and
subscales.
The ques ions
N
Mini
Max
Mean
SD
1. Pe sons wi h psychosocial and men al disabili ies should no be
allowed o ma y and ha e child en
203
1.00
6.00
4.487
7
1.3692
5
2. A pe son would be oolish o ma y a pe son wi h psychosocial and
men al Disabili y
204
1.00
6.00
4.465
7
1.3182
3
3. Pe sons wi h psychosocial and men al disabili ies can plan mee ings
and con e ences wi hou assis ance om o he s
201
1.00
6.00
4.487
7
1.2102
2
4. Pe sons wi h psychosocial and men al disabili ies can be us ed o
handle money esponsibly
201
1.00
6.00
4.465
7
1.2496
6
5. The opinion o a pe son wi h psychosocial and men al disabili y
should ca y mo e weigh han hose o amily membe s and
p o essionals in decisions a ec ing ha pe son
204
1.00
6.00
3.776
1
1.1490
8
6. Shel e ed wo kshops o pe sons wi h psychosocial and men al
disabili ies a e essen ial
204
1.00
6.00
3.671
6
1.2332
8
43
7. Inc eased spending on p og ams o pe sons wi h psychosocial and
men al disabili ies is a was e o ax dolla s
203
1.00
6.00
3.568
6
1.2116
4
8. Homes and se ices o pe sons wi h psychosocial and men al
disabili ies downg ade he neighbo hoods hey a e in
202
1.00
6.00
3.965
7
1.3229
1
9. Pe sons wi h psychosocial and men al disabili ies a e a bu den o
socie y
203
1.00
6.00
2.275
9
1.1539
1
10. Homes and se ices o pe sons wi h psychosocial and men al
disabili ies should be kep ou o esiden ial neighbo hoods
203
1.00
6.00
2.707
9
1.3608
7
11. Pe sons wi h psychosocial and men al disabili ies need someone o
plan hei ac i i ies o hem
203
1.00
5.00
2.172
4
1.2113
2
12. Pe sons wi h psychosocial and men al disabili ies do no need o make
choices abou he hings hey will do each day
203
1.00
6.00
2.443
3
1.2509
4
13. Pe sons wi h psychosocial and men al disabili ies can be p oduc i e
membe s o socie y
202
2.00
6.00
3.886
7
1.0660
7
14. Pe sons wi h psychosocial and men al disabili ies ha e goals o hei
li es like o he people
202
1.00
6.00
3.443
3
.97154
15. Pe sons wi h psychosocial and men al disabili ies can ha e close
pe sonal ela ionships jus like e e yone else
203
1.00
6.00
4.673
3
1.0910
6
16. Pe sons wi h psychosocial and men al disabili ies should li e in
shel e ed acili ies because o he dange o li e in he communi y
203
1.00
6.00
4.683
2
1.2944
3
17. Pe sons wi h psychosocial and men al disabili ies usually should be in
g oup homes o o he acili ies whe e hey can ha e he help and
suppo o s a
203
1.00
6.00
4.645
3
1.2915
7
Subscale
N
Mini
Max
Mean
SD
Empowe men
197
2.20
5.80
4.0030
.78180
Exclusion
200
1.00
5.00
2.4050
1.00675
Shel e ing
203
1.50
5.75
3.8313
.82776
Simila i y
201
2.50
6.00
4.3570
.75730
The s a s‘ mean sco es di e ed om hose o he consume s (mo e
posi i e) on he HRQ_6 and he CLAS subscales Empowe men , Exclusion,
Shel e ing and Simila i y subscales.
S a had mo e posi i e a i udes han he consume s in HRQ_6 (mean 3.92
s 3.60, = 5.32, d 202, P <0.000); and in he ou CLAS ac o s,
Empowe men (mean 4.15 s 3.85, = 2.68, d 195, P <0.008), Simila i y
(mean 4.65 s 4.05, = 6.09, d 199, P <0.00), Exclusion (mean 1.96 s
2.87, = 7.22, d 198, P <0.000) and Shel e ing (mean 3.66 s 4.01, = 3.14,
d 202, P <0.002).
44
Table 4 epo s (HRQ_6) & CLAS subscale means o he compa ison be ween s a
and consume s.
HRQ_6:
Consume o S a
Mean
N
S d.
Consume
3.6079
100
.34177
S a
3.9156
104
.47078
To al
3.7648
204
.43954
CLAS subscales:
Consume o
S a
Empowe men
Exclusion
Shel e ing
Simila i y
Consume
Mean
3.8505
2.8724
4.0125
4.0530
N
95
98
100
99
S d. De ia ion
.87809
.94518
.62802
.71898
S a
Mean
4.1451
1.9559
3.6553
4.6520
N
102
102
103
102
S d. De ia ion
.65289
.85046
.95430
.67501
To al
Mean
4.0030
2.4050
3.8313
4.3570
N
197
200
203
201
S d. De ia ion
.78180
1.00675
.82776
.75730
45
Figu e (4) p o ides compa ison be ween s a and consume s on CLAS subscale
sco es:
Female pa icipan s had mo e posi i e a i udes han male pa icipan s in
h ee ac o s: exclusion, shel e ing and simila i y and P alues we e (P
<0.015, P <0.002 & P <0.014 espec i ely.
Pa icipan s om Eled isi psychia ic hospi al in compa ison wi h he
pa icipan s om he o he wo hospi als had mo e nega i e a i udes in
HRQ_6 (P <0.006).
While he consume s om Eled isi psychia ic hospi al had mo e posi i e
a i udes in empowe men ac o (P <0.002), he consume s om El-Mahi
psychia ic hospi al had mo e nega i e a i udes in exclusion ac o (P
<0.000).
52
men al heal h se ices in Sudan), samples showed ha bo h g oups had
nega i e a i udes owa d human igh s o pe sons wi h psychosocial and
men al disabili y. These nega i e a i udes a e consis en wi h WHO epo
on men al heal h in Sudan which e ealed ha human igh issues in Sudan
a e spo adic and inconsis en 12. This pa e n o a i udes is pa allel o he
nega i e a i udes owa d igh s o pe sons wi h psychosocial and men al
disabili y wo ldwide3, 34, 35 and 43
The esponden s gene ally we e a o ing Empowe men and Simila i y o e
Exclusion and Shel e ing. This ela i ely posi i e a i ude may be explained
in pa by he inna e desi e o jus ice and equali y44 and he e ec o
di e en ypes o media a e A ab Sp ing.
The s a sample had posi i e a i udes han he consume s sample on he
HRQ_6 and all CALS ou subscales and his con i m ou hypo hesis ha
s a will ha e mo e posi i e a i udes owa d human igh s o pe sons wi h
men al heal h p oblems han he consume s. This esul is in con as wi h
(Du de any) who ound ha he consume s' a i udes we e mo e posi i e in
ela ion o empowe men han hose o hei s a 45. Bu in he exclusion,
simila i y and shel e ing ac o s, no di e ences we e ound be ween s a
and consume s. This di e ence could be explained by he ac ha
consume s sample in Du de any s udy, we e a communi y sample; mo e
o e he consume s awa eness in Is ael ega ding hei igh s migh be was
much be e han ha in Sudan.
Sex di e ences in a i ude we e no ed; emale pa icipan s had mo e posi i e
a i udes han male pa icipan s owa d inclusion o pe sons wi h men al
heal h p oblem in he communi y.
This pa e n o indings may be consis en wi h a p e ious s udy by C oss
SE & Madson L om USA ha sugges s women a e mo e o ien ed owa d
ela ionships, in e dependence, and empa hy han a e men46.
The nega i e a i udes owa d human igh s o he pa icipan s om Eled isi
hospi al on HRQ_6 may be explained by he ac ha his hospi al is un by
police and includes pa ien s wi h c iminal cases.

53
In Sudan since he medical model o disabili y is p edomina ed, doc o s a e
he only di ec ly in ol ed s a who make decisions ega ding assessmen
and managemen , o he p o essionals in he eam play mino oles and hey
a e in ol ed only when he doc o asks hem o do some so o in e en ion,
e.g. doc o s gi e o de o o al medica ions in inpa ien as well as in
ou pa ien se ing di ec ly o he amily membe s who nu se he pa ien
h oughou he illness and no o he nu se who is in ol ed only in pa en e al
medica ions and elec ocon ulsi e he apy (ECT)!. Ou indings suppo he
p e ious wo k o Al ed Ngi ababyeyi om Rwanda (Ngi ababyeyi. A,
2012) who e ealed ha , di ec ly in ol ed s a showed mo e posi i e
a i udes owa d inclusion o pa ien s wi h men al diso de ; doc o s in ou
s udy had mo e posi i e a i udes han he o he p o essional g oups
(psychologis s, social wo ke s and nu ses).
The abo e esul (doc o s ha e mo e posi i e a i udes owa d pe sons wi h
psychosocial disabili y) coupled wi h ou inding ha , ( hose om he s a
membe s who had ecei ed lowe educa ional le el (Diploma) had nega i e
a i udes owa d simila i y ac o han hose who ecei e highe educa ional
le els) could con i m p e ious s udies om Is ael (Du de any, 2000;
Hen y, Keyss, Balacaza , & Jopp, 1996). In hese s udies he highe he s a
membe s' posi ion, he mo e libe al and humanis ic a e hei a i udes. They
end o be less au ho i a i e, es ic i e and less s igma ic owa d pe sons
wi h men al disabili y. In ac , in Sudan he men al heal h s a membe s
who ecei e only diploma (mos o hem a e nu ses) a ely hey expose o
aining o educa ional subjec ega ding men al heal h issues. The e o e
hese esul s could con i m a p e ious s udy om USA by Hun Cou ney
Shel on & Hun B andon in 2004. In his s udy hey ound ha he
educa ional in e en ion had a signi ican impac on bo h pa icipan s'
knowledge le els and hei a i udes, e en a e con olling o gende and
p io expe ience wi h people wi h disabili ies
Those om he s a membe s who we e wo king mo e han 10 yea s in
men al heal h ield had mo e nega i e a i ude owa d simila i y ac o , his
esul con i m p e ious s udies om Is ael such as (Du de any, 2008)
which con i m he p e ious s udies (Du de any, 2000; Hen y e al., 1996b;
McReynold, Wa d, & Singe , 2002) and s a ed ha young pe sons ha e
54
mo e posi i e a i udes han olde people. They a e mo e ole an and libe al
han olde membe s o s a . As hey acqui e g ea e senio i y in he ield,
hey end o keep mo e o a dis ance and iew psychia ic disabili ies mo e
scien i ically han humanis ic ally.
Those om he consume s who had o he people unde hei di ec
esponsibili y e ealed mo e posi i e a i udes owa d empowe men and
simila i y ac o s, his esul can con i m a p e ious s udy om USA (Ryan
D. Kme , 2013) who e ealed he posi i e e ec o al uism on sel -es eem
and cogni ion.
F om he s a , hose who had expe ienced di ec psychosocial o men al
heal h ouble wi h one o he close ela i es o iends e ealed signi ican
posi i e a i udes in Exclusion ac o . This esul may con i m he
in e na ional s udies which showed ha con ac wi h people wi h men al
illness can esul in posi i e a i udes owa d hose people, as well as
inc eases he le el o com o in in e ac ing wi h hem (e.g., Ge hing
&Wheele , 1992; A ens, 1993; Beckwi h & Ma hews, 1994; Nikolaos
Kazan zis , 2009).
In his s udy s a aining on human igh s didn‘ e eal any mo e posi i e
a i udes; his may explained ha he aining didn' ha e he desi ed e ec .
I can be due o poo ly designed p og ammes, an ine ec i e aine s o
inadequa e ime o aining.
In e es ing enough we ound ha , doc o s in his s udy had mo e posi i e
a i udes owa d eco e y om men al illness han o he p o essional g oups.
This esul ecalls op imism ega ding he u u e o e o m o men al heal h
in Sudan, because mos o he men al heal h p og ams a e led by doc o s.
The posi i e a i udes ega ding eco e y showed by consume s who we e
ully esponsible owa ds sel , may con i m he impo ance o Responsibili y
as one o he 10 undamen al componen s o Reco e y47.
The e we e signi ican co ela ions be ween (HRQ_6) and CLAS subscales.
This esul achie ed ou subsidia y objec i e which was o pu a s ep in he
55
cons uc ion and he s anda diza ion o Human Righ s o pe sons wi h
psychosocial and men al disabili y a i ude ques ionnai e (HRQ_6).
In sum, his s udy ep esen s one o he i s o explo e he a i udes o s a
and consume s owa d human igh s o pe sons wi h psychosocial and
men al disabili ies and hei in eg a ion in o he communi y in Sudan and in
he egion.
This s udy e ealed he huge gap in human igh s aining in men al heal h
ield coupled wi h lack o knowledge ega ding eco e y o ien ed men al
heal h se ices.
The pas e a o medical model o disabili y domina ing he pic u e in men al
heal h se ices in Sudan, he e o e he gene al heme o hinking in his
s udy was in line wi h his ac . T aining and knowledge can make he
di e ence in a o o social model o disabili y is suppo ed by he
ollowing:
-S a a i udes owa d human igh s o pe sons wi h psychosocial and
men al disabili ies we e much be e han he consume s.
-Among he s a doc o s had mo e posi i e a i udes owa d human igh s o
pe sons wi h psychosocial and men al disabili ies han o he s a membe s
in men al heal h ield. The e o e wi h sui able aining hey can lead he
e o m in men al heal h se ices.
2.4.2. Limi a ions o his s udy:
Se e al conside a ions ecommend some cau ion in in e p e ing hese
indings. Fi s , Al hough HRQ_6 is based on con en ions on he igh s o
pe sons wi h disabili y, s ill is no s anda dized ool o assess a i udes
owa ds human igh s o pe sons wi h psychosocial and men al disabili ies.
Also he CLAS has no p e iously been used wi h a Sudanese sample.
Second, all he p oblems o ansla ion we e he e when we ansla ed CLAS
and HRQ_6 and will s ill emain beside he in luence o cul u al ac o s, so
some concep s migh no be accu a ely iden ical due o cul u al ac o s.
56
Thi d, compa ison g oups om he same cul u e and backg ound we e no
a ailable due o lack o s udies in his a ea.
Fou h, he pa icipan s may no be e y accu a e in answe ing he
ques ionnai es.
Fi h, he sample is a con enien sample, so bias esul s and
mis ep esen a ion o da a a e expec ed o some ex en .
Finally, some ac o s in his s udy could in luence he e ec o each o he .
e.g., mos o he nu ses had lowe educa ional le el han he o he
p o essional g oups and we e wo king o mo e han 10 yea s in he ield o
men al heal h.
57
2.5. CHAPTER FIVE: CONCLUSION AND RECOMMENDATIONS

58
Chap e 5 - Conclusion and Recommenda ions
2.5.1. Conclusion
In sum, in his s udy, we a emp ed o examine he a i ude o s a
and consume s owa d human igh s o pe sons wi h men al heal h
p oblems and he di e ences be ween he wo g oups. The esul s in
gene al showed nega i e a i ude o bo h g oups consis en wi h
backg ound o human igh s issues in ou communi y. S ill he e
we e signi ican di e ences be ween he wo g oups wi h he s a
had mo e posi i e a i ude han he consume s. The di e ences in
a i udes among he s a we e mainly a esul o hei educa ion and
p o essional ole. Mos o he s a had been educa ed on he medical
model, and hei belie s s ill e ained some o he ba ie s.
The p ac ical applica ion o he con en ion on igh s o pe sons wi h
disabili ies (CRPD) in men al heal h ield s ill is a away especially
in low income coun ies!
This s udy ep esen s one o he i s o explo e s a and consume s‘
a i udes owa ds human igh s o pe sons wi h men al heal h
p oblems. I is hoped ha his wo k will highligh human igh s
aining gap in men al heal h ield as well as in ou communi y.
All he s akeholde s in men al heal h ield should be commi ed o
espec ing all human igh s o he consume s including hei igh s o
inclusion in o he communi y.
The concep o eco e y o ien ed men al p ac ice among bo h g oups
no well o med ye .
Finally, his s udy demons a es ha human igh s‘ aining in men al
heal h se ices is no a p io i y in Sudan.
59
2.5.2. Recommenda ions
i. P o ec ion o Human igh s is he back bone o he e ec i e men al
heal h se ices. Based on he esul o his s udy, s akeholde s in
men al heal h in Sudan should design e ec i e p og ammes wi h
adequa e ime o human igh s aining h oughou all men al
heal h p og ams in Sudan.
ii. S ill he e a e many a eas o explo e wi hin he ield o human
igh s when add essing men al heal h se ices in Sudan. The WHO
Quali yRigh s ool ki can be used o assess quali y o men al
heal h se ices in Sudan.
iii. G ass oo s ad oca es a e needed o aise he le el o awa eness
ega ding human igh s o pe sons wi h psychosocial and men al
disabili y in ou communi y and among men al heal h ca e
p o ide s.
i . The e is a need o u he esea ch on he a i udes owa ds igh s
o pe sons wi h men al heal h p oblem among public g oups,
communi y leade s, ai h heale s, non-psychia ic heal h ca e
p o ide s and o he s akeholde s in men al heal h ield.
. The e is u gen need o men al heal h policies and laws in Sudan
o imp o e condi ions o people wi h men al disabili ies.
i. Communi y-based se ices and suppo s as al e na i es o
ins i u ional ca e should be adop ed by s akeholde s in men al
heal h se ices.
60
2.6. CHAPTER SIX: REFERENCES
61
CHAPTER 6 - REFERENCES
Lis o e e ences
1. The Wo ld Heal h Repo : 2001: Men al Heal h: New Unde s anding, New Hope.
Gene a, Wo ld Heal h O ganiza ion, 2001.
2. WHO, Men al Heal h Policy and Se ice Guidance Package, he Men al Heal h
Con ex book, 2003
3. WHO, Resou ce book on men al heal h, human igh s and legisla ion, 2005.
4. UN, Con en ion on he Righ s o Pe sons wi h Disabili ies, 2006.
5. WHO, Wo ld epo on disabili y, 2011.
6. Wikipedia, Sudan, A ailable a : h ps://en.wikipedia.o g/wiki/Sudan
7. Wo ldome e s, Popula ion, Sudan, 2017. A ailable a :
h p://www.wo ldome e s.in o/wo ld-popula ion/sudan-popula ion
8. And ew Mwanik, E hnic G oups o Sudan, 2017.
A ailable a : h ps://www.wo lda las.com/a icles/ he-e hnic-g oups-in-sudan.h ml
9. Uni ed Na ions Educa ional, Scien i ic, and Cul u al O ganiza ion (UNESCO)
Ins i u e o S a is ics, 2013. A ailable a :
h p://www.indexmundi.com/ ac s/sudan/li e acy- a e
10. B.B.C NEWS, Sudan Coun y P o ile, 2017. Web: h p://www.bbc.com/news/wo ld-
a ica-14094995
11. Repo o he In e na ional Commission o Inqui y on Da u o he Uni ed Na ions
Sec e a y-Gene al, Gene a, 2005. Web:
h p://www.un.o g/news/dh/sudan/com_inq_da u .pd
12. WHO-aims epo on men al heal h sys em in Sudan, 2009.
13. Po e y and heal h, Ou A ica. Web: h p://www.ou -a ica.o g/sudan/po e y-
heal hca e
14. Sheikh Id is A Rahim; he Mahi-Baashe He i age; he Sudanese jou nal o
psychia y; Volume 1 – Issue 2, Ap il, 2011.
15. His o y o psychia y in Sudan, Sudanese psychia ic associa ion. A ailable a :
h p://www.sudanesepsychia is s.o g/index.h m
16. Uni e sal decla a ion o human igh s, 1948.
17. Zimba do, P. G., & Ebbesen, E. B., In luencing A i udes and Changing Beha io .
Reading, MA: Addison Wesley Publishing Co,1960. [Re ised, 1977].
18. Na ional Disabili y Insu ance Scheme, 2014. A ailable a :
h ps://mhaus alia.o g/gene al/ge ing-ndis- igh -people-psychosocial-disabili y.
19. Ame ican psychia ic associa ion, wha is men al illness 2015. Web:
h ps://www.psychia y.o g/pa ien s- amilies/wha -is-men al-illness
20. S ephen P. Hinshaw and And ea S ie ., S igma as Rela ed o Men al Diso de s.
Annu. Re . Clin. Psychol. 2008. 4:367–93
21. Allpo , G. W, A i udes, Handbook o Social Psychology, Cla k Uni e si y P ess,
Wo ces e , Mass, 1935.
22. Je ey Pickens, A i udes and Pe cep ions, chap e 3, 2005.
23. Robe S. Fledm,an, unde s anding psychology, eigh h edi ion, 2008
68
36. Pe sons wi h psychosocial and men al disabili ies should enjoy legal capaci y on an equal basis wi h
o he s in all aspec s o li e.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
37. Pe sons wi h psychosocial and men al disabili ies should no be dep i ed o hei libe y unlaw ully o
a bi a ily, and ha any dep i a ion o libe y is in con o mi y wi h he law, and ha he exis ence o a
disabili y shall in no case jus i y a dep i a ion o libe y.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
38. Pe sons wi h psychosocial and men al disabili ies should no be allowed o ma y and ha e child en
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 39. A pe son would be oolish o ma y a pe son wi h psychosocial and men al Disabili y
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 40. Pe sons wi h psychosocial and men al disabili ies can plan mee ings and con e ences
wi hou assis ance om o he s.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 41. Pe sons wi h psychosocial and men al disabili ies can be us ed o handle money
esponsibly.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 42. The opinion o a pe son wi h psychosocial and men al disabili y should ca y mo e weigh
han hose o amily membe s and p o essionals in decisions a ec ing ha pe son.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
43. Shel e ed wo kshops o pe sons wi h psychosocial and men al disabili ies a e essen ial.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
44. Inc eased spending on p og ams o pe sons wi h psychosocial and men al disabili ies is a was e o ax
dolla s.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 45. Homes and se ices o pe sons wi h psychosocial and men al disabili ies downg ade he
neighbo hoods hey a e in.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 46. Pe sons wi h psychosocial and men al disabili ies a e a bu den o socie y.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 47. Homes and se ices o pe sons wi h psychosocial and men al disabili ies should be kep ou
o esiden ial neighbo hoods.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 48. Pe sons wi h psychosocial and men al disabili ies need someone o plan hei
ac i i ies o hem.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
49. Pe sons wi h psychosocial and men al disabili ies do no need o make choices abou he hings hey
will do each day.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 50. Pe sons wi h psychosocial and men al disabili ies can be p oduc i e membe s o
socie y.

69
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 51. Pe sons wi h psychosocial and men al disabili ies ha e goals o hei li es like o he
people.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee.
52. Pe sons wi h psychosocial and men al disabili ies can ha e close pe sonal ela ionships jus like
e e yone else
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 53. Pe sons wi h psychosocial and men al disabili ies should li e in shel e ed acili ies because
o he dange o li e in he communi y.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 54. Pe sons wi h psychosocial and men al disabili ies usually should be in g oup homes o o he
acili ies whe e hey can ha e he help and suppo o s a .
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
Glossa y
Con en ion on Righ s o Pe sons wi h Disabili ies (CRPD): is an in e na ional human igh s ea y o
he Uni ed Na ions. Pa ies o he Con en ion a e equi ed o p omo e, p o ec , and ensu e he ull
enjoymen o human igh s by pe sons wi h disabili ies and ensu e ha hey enjoy ull equali y unde he
law.
Reco e y: Reco e y in men al heal h is o egain meaning ul li e in spi e o se ious men al illness
Men al heal h legisla ion: In Sudan, cu en ly a new e sion o men al heal h ac is eady o
implemen a ion. The las e sion da es back o 1998
Shel e ed wo kshops: e e s o an o ganiza ion o en i onmen ha employs people wi h disabili ies
sepa a ely om o he s.
70
The In e na ional Mas e in Men al Heal h Policy and Se ices
No a Medical School
New Uni e si y o Lisbon
Po ugal
Ques ionnai e o assess he A i udes o S a and Consume s owa d Human Righ s o Pe sons wi h
Psychosocial and Men al Disabili ies (S a )
D . Abdelaziz Osman ca ies ou his s udy as a inal yea p ojec o he In e na ional Mas e o Men al
Heal h Policy and Se ices, he Uni e si y o New Lisbon, Po ugal.
The aim o he s udy is o assess he a i ude owa d human igh s o pe son wi h psychosocial and men al
disabili ies, o ecommend he ypes o aining equi ed in his a ea in o de o imp o e men al heal h
se ices in ou coun y and egion. We app ecia e so much you pa icipa ion in his s udy.
Iden i y will be anonymous and in o ma ion will be used o esea ch pu poses only.
Kindly, ill he ollowing ques ions: (pu a √).
Filling in he ques ionnai e akes abou 15 minu es.
Please ead he ins uc ions, be o e illing in he ques ionnai e, ead each ques ion, including he answe ing
op ions, be o e gi ing an answe , choose he answe ha is mos applicable o you si ua ion, and choose
only one answe , unless s a ed di e en ly.
Please ill in his ques ionnai e only o you sel and you si ua ion.
The ques ionnai e will be collec ed by ou eam du ing no mal wo king hou s.
Feel ee o wi hd aw om he s udy a any pa o he p ocedu e.
Feel ee o con ac D . Abdelaziz a his email add ess wede [email p o ec ed]m o azza[email p o ec ed]om .
6. Numbe s o yea s wo king in MH: less han 5 yea s 5 o 10 yea s mo e han 10 yea s
6. Las deg ee: Diploma Bachelo Pos g adua ion s udies in men al heal h ield
7. Ha e you expe ienced you sel any psychosocial o men al oubles/p oblems? Yes No
8.Ha e you di ec ly expe ienced any psychosocial o men al oubles/p oblems wi h one o you
ela i es/close iends? Yes No
9. Did you ha e any con ac o a men al heal h se ices as a use ? Yes No
10. Numbe s o yea s wo king in Men al Heal h: less han 5 5 o 10 mo e han 10
11. Wha do you hink abou Reco e y om men al illness?
Is a ainable o e e yone Is a ainable o some people Is no a ainable a all
12. Ha e you ecei ed any aining on human igh s? Yes No
Following a e a couple o s a emen s abou he igh s o pe sons wi h men al disabili ies. We would like
o know whe he you ag ee wi h he s a emen o no and in wha deg ee. I you do no ha e a s ong
opinion, please y o ind ou i i is mo e like ‗ag ee o mo e like ‗disag ee. I you eally do no know, you
can selec one o he wo op ions ―somewha disag ee o somewha ag ee‖, ha you a e com o able wi h.
3. Ma i al s a us
Single
Ma ied
Di o ce
Widowed
2. Hospi al
Elmahi
Baeshe
Elid eisi
2. Gende
Male
Female
No answe
4. Age (
yea s
)
5. Cu en p o essional job
Doc o
Nu se
Psychologis
Social wo ke
71
13. In Sudan no need o men al heal h legisla ion o p o ec he igh s o pe sons wi h psychosocial and
men al disabili ies.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
14. All na ions should wo k owa d libe y and jus ice o all including pe sons wi h psychosocial and
men al disabili ies
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
15. Pe sons wi h psychosocial and men al disabili ies should be able o ha e a oice in how hey deal wi h
hei own physical well-being, wi h hei heal h and wi h hei illnesses.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
16. Pe sons wi h psychosocial and men al disabili ies should be able o lead, con ol, exe cise choice o e ,
and de e mine hei own pa h o eco e y.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
17. Occasionally i is easonable o deny he igh o o e o some g oups o pe sons wi h psychosocial and
men al disabili ies; o ins ance o pe sons wi h se e ypes o schizoph enia
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
18. Teenage s wi h psychosocial and men al disabili y should be allowed o ecei e all ypes o medical and
psychosocial ea men s wi hou pa en al consen .
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
19. I is legi ima e o au ho i ies o cu ail he ac i i ies o pe sons wi h psychosocial and men al
disabili ies which a e socially unaccep able; o ins ance wande ing along he s ee wi h di y clo hes
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
20. All ci izens should be gi en ull cons i u ional igh s bu ci izens wi h psychosocial and men al
disabili ies should no expec o be gi en all hose igh s.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
21. Pe sons wi h psychosocial and men al disabili ies should no ha e o wo y abou unwa an ed
in usions by he go e nmen , amily and iends in o hei p i a e li es.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
22. Books should be banned i hey a e w i en by pe sons wi h psychosocial and men al disabili ies who
ha e been in a se e psycho ic s a e du ing he ime o w i ing
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
23. Police should no ha e o ge sea ch wa an s when hey a e pu suing suspec s wi h known se e e
men al illness
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
24. Disc imina ion agains because o psychosocial and men al disabili y is jus i iable some imes
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
72
25. We should no was e ime o suppo pe sons wi h psychosocial o men al disabili ies o ake hei
decisions abou sel , when we a e 100% su e hey a e no able o make decisions.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
26. Pe sons wi h psychosocial and men al disabili ies should ha e he igh o in ol e he adi ional heale s
in hei managemen plan
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
27. Pe sons wi h psychosocial and men al disabili ies p obably shouldn' be hi ed o jobs equi ing
conside able con ac wi h he public since hey could beha e in a s ange way
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
28. As soon as a pe son shows signs o men al dis u bance, he should be hospi alized
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
29. Counselo s should encou age pe sons wi h psychosocial and men al disabili ies o conside aining o
become doc o s, pilo s, ca pen e s, mili a y o ice s and o he occupa ions ha i wi h hei po en ials
ega dless o hei illness
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
30. Fo pe sons wi h psychosocial and men al disabili ies is be e o gi e wel a e assis ance a he han o
encou age employmen in o de o p o ec hem
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
31. F eedom o speech should be a basic human igh excep o pe sons wi h psychosocial and men al
disabili ies because hey can emba ass hei amilies and iends.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
32. The en i onmen should be adap ed o he needs o pe sons wi h psychosocial and men al disabili ies
e en i doing so is expensi e.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
33. The Con en ion on he Righ s o Pe sons wi h Disabili ies (CRPD) could dis up socie y wi h i s
emphasis on ea ing pe sons wi h psychosocial and men al disabili ies like o he s.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
34. Teache s wi h psychosocial and men al disabili ies can be good ole models o ou child en, jus like
anyone else.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
35. Publishe s, speake s, p o essionals and o he s since hey a e no in ending s igma can use s igma izing
e ms such as psycho ic, schizoph enic and demen ed ins ead o usual e ms such as pe sons wi h
psychosis, wi h schizoph enia and wi h demen ia.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
36. Pe sons wi h psychosocial and men al disabili ies should enjoy legal capaci y on an equal basis wi h
o he s in all aspec s o li e.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
73
37. Pe sons wi h psychosocial and men al disabili ies should no be dep i ed o hei libe y unlaw ully o
a bi a ily, and ha any dep i a ion o libe y is in con o mi y wi h he law, and ha he exis ence o a
disabili y shall in no case jus i y a dep i a ion o libe y.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
38. Pe sons wi h psychosocial and men al disabili ies should no be allowed o ma y and ha e child en
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 39. A pe son would be oolish o ma y a pe son wi h psychosocial and men al Disabili y
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 40. Pe sons wi h psychosocial and men al disabili ies can plan mee ings and con e ences
wi hou assis ance om o he s.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 41. Pe sons wi h psychosocial and men al disabili ies can be us ed o handle money
esponsibly.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 42. The opinion o a pe son wi h psychosocial and men al disabili y should ca y mo e weigh
han hose o amily membe s and p o essionals in decisions a ec ing ha pe son.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
43. Shel e ed wo kshops o pe sons wi h psychosocial and men al disabili ies a e essen ial.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
44. Inc eased spending on p og ams o pe sons wi h psychosocial and men al disabili ies is a was e o ax
dolla s.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
45. Homes and se ices o pe sons wi h psychosocial and men al disabili ies downg ade he
neighbo hoods hey a e in.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
46. Pe sons wi h psychosocial and men al disabili ies a e a bu den o socie y.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 47. Homes and se ices o pe sons wi h psychosocial and men al disabili ies should be kep ou
o esiden ial neighbo hoods.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 48. Pe sons wi h psychosocial and men al disabili ies need someone o plan hei
ac i i ies o hem.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
49. Pe sons wi h psychosocial and men al disabili ies do no need o make choices abou he hings hey
will do each day.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
50. Pe sons wi h psychosocial and men al disabili ies can be p oduc i e membe s o socie y.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
51. Pe sons wi h psychosocial and men al disabili ies ha e goals o hei li es like o he people.

74
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
52. Pe sons wi h psychosocial and men al disabili ies can ha e close pe sonal ela ionships jus like
e e yone else.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
53. Pe sons wi h psychosocial and men al disabili ies should li e in shel e ed acili ies because o he
dange o li e in he communi y.
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee 54. Pe sons wi h psychosocial and men al disabili ies usually should be in g oup homes o o he
acili ies whe e hey can ha e he help and suppo o s a .
S ongly disag ee. Disag ee. Somewha disag ee. Somewha ag ee. Ag ee. S ongly
ag ee
Glossa y
Con en ion on Righ s o Pe sons wi h Disabili ies (CRPD): is an in e na ional human igh s ea y o
he Uni ed Na ions. Pa ies o he Con en ion a e equi ed o p omo e, p o ec , and ensu e he ull
enjoymen o human igh s by pe sons wi h disabili ies and ensu e ha hey enjoy ull equali y unde he
law.
Reco e y: Reco e y in men al heal h is o egain meaning ul li e in spi e o se ious men al illness
Men al heal h legisla ion: In Sudan, cu en ly a new e sion o men al heal h ac is eady o
implemen a ion. The las e sion da es back o 1998
Shel e ed wo kshops: e e s o an o ganiza ion o en i onmen ha employs people wi h disabili ies
sepa a ely om o he s.