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

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This Presentation will…….
 Explore Key Concepts
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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

Experience…….
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 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

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

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

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Capacity Building
Breaking the silence of mental illness in communities

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

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BasicNeeds Results

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

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

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BasicNeeds Results
Self-help groups District Associations National Association

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Some Key Conventions/Resolutions
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Declaration of Human Rights
Convention against torture, Cruel, Inhuman or
Degrading Treatment
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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…..
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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