1 Alternatives to Institutionalization: The Right of Persons with Disabilities to Live in the Community Shoba Raja 11 December 2007 OHCHR

2 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…..

3 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

4 In the context of Human Rights and Disability..….. Current Situation : in Institutions in Communities

5 INSTITUTIONS

6 Experience……. Degrading treatment Neglect and lack of care Inhuman conditions Stripped of Dignity INDISPUTABLE NEED FOR ALTERNATIVE

7 COMMUNITIES

8 Experience for majority….. Neglect Rejection No access to treatment Poverty Stressed families Ridicule, Taunts Destitution

9 Community as an alternative…. Is it possible?

10 Case Study ….. BasicNeeds An International Organization

11 BasicNeeds Map Ghana Uganda Tanzania Sri Lanka India Kenya Laos PDR Colombia UK Head Office Founded in 1999 by Chris Underhill

12 Model Mental Health & Development Sustainable Livelihoods Community Mental Health Capacity Building Research & Policy Management & Administration

13 Capacity Building Breaking the silence of mental illness in communities

14 Community Mental Health Ensuring treatment for mentally ill people with the active involvement of their families, communities….. ….and using local resources, government facilities

15 Sustainable Livelihoods Supporting practical projects that help mentally ill people to realise their potentials and contribute to their communities

16 Research & Policy Generate Evidence for influencing policy. Evidence which has viewpoint of users

17 Management & Administration To ensure our work is efficient and professional and…… satisfies the needs of mentally ill people, their families

18 How we work Community Talk to community (Capacity Building) Treatment Self Help Groups Livelihoods Acceptance

19 BasicNeeds Results

20 BasicNeeds Results 3/4 People treated now productive members of their communities

21 BasicNeeds Results 1\3 of caregivers now able to earn income

22 BasicNeeds Results District AssociationsSelf-help groupsNational Association

23 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?

24 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