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COSP 12 | UN headquarters | New York | June 11, 2019 | 9:45AM – 11:00AM
Ensuring Access to Community-based Mental Health Services for People with Psychosocial Disabilities -International Standards and Innovative Practices
CC link: https://www.enosh.org.il/en/un_cosp_12/ USISRA1106A
QualityRights, Mental Health Policy & Service Development Unit Dept of Mental Health & Substance Abuse, WHO Geneva
WHO QualityRights
Transforming services, policy and law using human rights based approach
WHO QualityRightsObjectives
Build capacity to combat stigma and discrimination and promote human rights and recovery
Create community based services and supports that respect and promote human rights
Support civil society movement to conduct advocacy and influence policy-making
Reform national policies and legislation in line with the CRPD and other international human rights standards
Core mental health, disability, human rights and recovery modules:
• Human rights
• Mental health, disability and human rights
• Recovery and the right to health in mental
health and social services
• Legal capacity and the right to decide in
mental health and social services
• Mental health and social services free from
coercion, violence and abuse
Specialized modules:
• Recovery practices for mental health
and well being
• Supported decision-making and
advance planning
• Strategies to end seclusion and
restraint
Content of training modules
Lessons (quizzes, short videos, fact sheets)
Gamification features (eg.challenges, leader’s board)
Discussion forums
Peer learning, sharing & coaching
Certificates
Foundation in Mental Health, Human Rights & Recovery
Quality Rights capacity building
E-training
Services –Assessment & transformative action toolkit to ensure quality & rights
Assessment
toolkit
Guidance - Improving &
transforming services
Services & supports- Good practice Guidance
Services & supports that:
• Operate without coercion
• Respond to people’s
needs
• Support recovery
• Promote autonomy &
inclusion
Evaluation of services & supports:
• Costs
• Outcomes
• Sustainability• Transferability
Categories of services by type according to different functions
1. Crisis response respite/residential Teams2. Non-crisis residential/community houses Short term Long term3. Recovery social spaces4. Community based mental heath servicesA. Centers• Day consultation• Day consultation & residential• Day consultation with mobile
outreachB. Community outreach• Mobile community outreach• Home community outreachC. Personal assistance
5. Primary care integrated mental health6. Hospital based services
Inpatient Outpatient Transition Outreach All inclusive
7. Peer support One-to-one Group support Drop-in support Both one-to-one and group8. Associations/provider groups
9. Regional network of services
10. Models
11. Programmes
9
Phases of Development
Review of literature and internet search for good practice
community based mental health services (English, Spanish,
Portuguese, French)
Online international consultation
Expert meetings
Korea (2-3 May 2019)
Trieste, Italy (23-26 September 2019)
Selection of services reflecting different service types & geographic
representation)
Drafting and international review (September 2019 – August 2020)
Finalization of guidance document
Launch – May 2021
Transforming services and promoting rights of people with psychosocial, intellectual or cognitive disabilities
WHO QualityRights
Zero ProjectFor a world without barriers
Thomas Butcher
CoSP 12: June 11, 2019
What is theZero Project?
• An initiative of the Essl Foundation
• Our Mission: “For a World without Barriers” by
exploring and communicating Innovative
Practices and Policies
• Report, Social Media, Zero Project Conference,
many active Conference Participations
• A network of over 4,000 disability experts from
180 countries
• Catalysts for others: foundations, funding
agencies, governments and municipalities,
NGOs and umbrella organizations, academics
and media, social entrepreneurs – and UN
Agencies
Innovative Practices
Community-Based Mental Health Services for People with Psychosocial
Disabilities
ISRAEL / ENOSH (THE ISRAELI MENTAL HEALTH ASSOCIATION) – SEEDS OF WELLNESS
Training on trauma and a trauma-informed housing model to support women with psychosocial disabilities who live with post-traumatic stress disorder (PTSD) as a result of sexual abuse.
Working as a contractor for local governments as well as in rural areas to provide personal ombudsmen
and a self-determination coordinator for people with psychosocial disabilities.
COLOMBIA / PROFAMILIA, ASDOWN COLOMBIA, LICA AND PAIIS
SWEDEN / PO-SKÅNE – PERSONAL OMBUDSMEN
Promoting and safeguarding the sexual and reproductive rights of people with intellectual and
psychosocial disabilities.
ROMANIA / PRO ACT SUPORT
Providing accommodation and support as a step between institutionalization and living independently in
the community.
Thank you
COSP 12 | UN headquarters | New York | June 11, 2019 | 9:45AM – 11:00AM
Ensuring Access to Community-based Mental Health Services for People with Psychosocial Disabilities -International Standards and Innovative Practices
Noa Hagiladi
Artist
Community-based Mental Health Services as a Process of Dual Impact
Sally Ross Bihari (MSW)Director of Professional Excellence
Enosh – The Israeli Mental Health Association
ENOSH – MULTI SECTORAL SUPPORTS
1,300 Family members | 5 Centers
454 Calls per month300 Participants
Supportive housing
Social & Recreation
Supportive employment
Family counseling centers
6,000+ Participants | 70 Centers | 800 Employees
Advocacy & Policy Youth center Call center Gome –Respite home
MAIN PRINCIPALS
Housing
Partnerships
and networks
Social activity and cultural life
Health & wellness
Financial management
Career and employment
Personal Support
Family andfamily life
MULTISECTORAL APPROACH
A person centered approach –supported decision making
Community based
Based on post traumatic growth to establish resilience
Holistic services and integrated approach
Lived experience is combined with professional expertise
CIRCLES OF CHANGE
Stigma reduction
person
Family
Community
Policies
Society
Resilience
Recovery
Trauma
Dr Manoj KumarMD; DPM; FRCPsychMental Health Action Trust, Kerala
Technology-Based Practices In Community Mental Health (India)
Technology is the Solution
Use of technology - MHAT experience
Huge population Limited resources Long Distances Lack of systems
4 key elements
Use of technology - MHAT experience
Decentralization Volunteering Task sharing Technology
Model
Use of technology - MHAT experience
Use existing health care infrastructure
A small team of professionals & lay workers
A bigger team of volunteers
Large number of patients
Evolution of a service
Use of technology - MHAT experience
>> 10 years56 centres
8 districts
Weekly Clinics > 4500 clients
Local Partners
FreeHigh Quality ComprehensiveCommunity based
Leveraging technology
Use of technology - MHAT experience
Telepsychiatry
Electronic database, mobile app
Round the clock telephone access
Ensuring quality
Illness management systems and practises
Early warning systems for relapse detection
Conclusion
Use of technology - MHAT experience
Reaching out
Lack of psychiatrists and
systems of aftercare
Continuous access and
constant monitoring
Every knows the great energies running amok cast terrible
shadows, that each of the so-called senseless acts has its thread
looping back through the world and into a human heart.”
-- Mary Oliver (Shadows)
TRAUMA INFORMED
MENTAL HEALTH CARE
“Trauma -informed care embraces a
perspective that highlights adaptation over
symptoms and resilience over pathology.”
(Elliot, Bjelajac, Fallot, Markoff, & Reed, 2005, p. 467)
Academy on Violence and Abuse
National Center for Injury Prevention and Control, Division of Violence Prevention
Statistics on Abuse in Individuals with Disabilities
Over 70 percent of people with disabilities reported that they had been
victims of abuse. More than 63 percent of family members said their loved
one with a disability had been an abuse victim. Focusing exclusively on
those with developmental disabilities, 62.5 percent of this group said they
had experienced abuse of one type or another.
Victims with disabilities reported
verbal-emotional abuse (87.2%) ,
physical abuse (50.6%), sexual abuse (41.6%),
neglect (37.3%)financial abuse (31.5%).
-- Disability and Abuse Project
