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Alternatives to Institutionalization: The Right of Persons with Disabilities to

Live in the Community

Shoba Raja11 December 2007

OHCHR

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This Presentation will…….

Explore Key Concepts Brief Review- Recap of Situations to

establish needs and rights Review Alternatives – What is possible

through a case study of BasicNeeds Points to think about…..

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Two Key Concepts - associated ideas

Institutionalize – to place in a special location/house, lonely isolated but cannot live independently, lose individuality and ability to cope with life

Community - Group of people, socially interdependent, participate together, relationships, share practices, collective action

experientially – almost opposites

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In the context of Human Rights and Disability..…..

Current Situation : in Institutions

in Communities

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INSTITUTIONS

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Experience…….

Degrading treatment Neglect and lack of care

Inhuman conditions Stripped of Dignity

INDISPUTABLE NEED FOR ALTERNATIVE

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COMMUNITIES

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Experience for majority…..

Neglect Rejection

No access to treatment Poverty

Stressed families Ridicule, Taunts

Destitution

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Community as an alternative….

Is it possible?

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Case Study …..

BasicNeeds

An International Organization

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BasicNeeds

Map

Ghana Uganda Tanzania

Sri Lanka

India

Kenya

Laos PDR

Colombia

UKHead Office

Founded in 1999 by Chris Underhill

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Model Mental Health & Development

Sustainable Livelihoods

Community Mental Health

Capacity Building

Research & Policy

Management & Administration

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Capacity Building

Breaking the silence of mental

illness in communities

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Community Mental HealthEnsuring treatment for mentally ill people with the active involvement of their families, communities…..

….and using local resources, government facilities

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Sustainable Livelihoods

Supporting practical projects that help mentally ill people to

realise their potentials and contribute to their communities

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Research & Policy

Generate Evidence for influencing policy.

Evidence which has viewpoint of users

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Management & Administration

To ensure our work is efficient and professional

and……

satisfies the needs of mentally ill people, their families

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How we work

Community

Talk to community (Capacity Building)

Treatment

Self Help

Groups

Livelihoods

Acceptance

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BasicNeeds Results

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BasicNeeds Results

3/4People treated now productive

members of their communities

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BasicNeeds Results

1\3of caregivers now able to earn income

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BasicNeeds ResultsDistrict AssociationsSelf-help groups National Association

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Some Key Conventions/Resolutions

Declaration of Human Rights Convention against torture, Cruel, Inhuman or

Degrading Treatment Convention on Rights of persons with disabilities Resolution on The Protection of Persons with Mental

Illness and Improvement of their Mental health

Yet why does neglect, abuse, torture, humiliation continue to happen?

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To think about…..

– Approx. only 22% of mentally ill people remain chronically disabled. Majority are able to quickly mainstream

– Few community mental health aspects in government policy and budgets

– Where government policy/programme exists – no or ineffective implementation

– Poor quality of services – personnel shortages, shortages of medicines, lack of training

– Inadequate budget – Misconception and stigma – Excluded from poverty programmes – even from MDGs