Promoting Social Inclusion of People with Mental Health Problems : a challenge for the European Union (2000-2001)
Social exclusion is a painful reality for millions of people. It is an offence against human dignity and fundamental human rights. Certain groups are particularly at risk of social exclusion : disabled people, refugees and asylum seekers, ethnic minorities, older people, single parent families, women, unemployed people, and specifically people with mental health problems.
An invisible issue
Most people do not realise the impact of mental health / illness on modern society, and too often mental health issues are too low on the list of policy priorities.
In Europe, one person in ten is known to have a mental illness and more than 60 percent of these have psychoses, depressions and other major psychological problems. According to the World Health Organisation, by the year 2020 major depression will take the second place among the 10 leading causes of the global burden of disease.
About 90 percent of people with mental health problems live in the community and need a place to live, opportunities to work and adequate conditions to develop relationships.
Improving social inclusion
In his address to the "European Conference on Promotion of Mental Health and Social Inclusion" in Tampere in October 1999, Mr David Byrne, Commissioner for Health and Consumer Protection, stated : "We have to escape from the past tendency to deal with mental health within the narrow confines of our healthcare systems. Of course, our healthcare systems have a critical role to play, especially in addressing mental illness. But, as you know, the real gains are often to be made in our education systems, in housing provision, in employment policies and perhaps most of all in how society perceives mental health".
Project description
The project "Promoting social inclusion of persons with mental health problems : a challenge for the European Union !" aims to raise awareness about the exclusion of people with mental health problems, and to provide guidelines to policy makers and service providers to foster social inclusion of these people.
The project is partly supported by the European Commission and is part of a larger European Union programme : 'Preparatory Actions to Combat and Prevent Social Exclusion'.
Mental Health Europe was responsible for the general co-ordination of the project and provided a secretariat to the project. The project was conducted in four countries : Austria (pro mente Kärnten), Finland (the Finnish Association for Mental Health), France (Advocacy France) and the United Kingdom (Mind). The European Network of (ex-)Users and Survivors of Psychiatry was associated with the co-ordination of the project and provided useful expertise in terms of user participation and the legislative framework for social inclusion practice.
Social exclusion - social inclusion
"Social inclusion must come down to somewhere to live, something to do, someone to love. It's as simple - and as complicated - as that. There are all kinds of barriers to people with mental health problems having those three things".
This statement was made by Charles Fraser, one of the witnesses of an inquiry entitled 'Creating Accepting Communities' performed by Mind regarding the social exclusion experienced by people who use mental health services.
It indicates clearly where the focus of the social inclusion project is, namely in :
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housing
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employment, training and social benefit
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daily living
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media
The sector of media is added to the other three since the media more often portrays negative images and reinforces stigmas and fears.
Each country took responsibility for exploring one sector. Reference groups were set up in each country. Those groups were composed of people who have an expertise in the issue of social exclusion of people with mental health problems together with a majority of users, ex-users or their representatives.
In concrete terms the project was developed in three steps :
Step 1 : identifying indicators of social exclusion
Step 2 : identifying practices which combat exclusion and promote inclusion in the society
Step 3 : preparing guidelines and a handbook to support the social inclusion of people with mental health problems.
Guidelines
At the end of the project, Mental Health Europe, after consulting groups of (ex-)users of mental health services and representatives of organisations working in the field of the rehabilitation of people with mental health problems, prepared guidelines for policy makers and service providers. The guidelines offer practical solutions for a more inclusive society in the framework of the European initiative on social exclusion and the National Action Plans for combating social exclusion and poverty.
The guidelines can be downloaded here in English, Finnish, French and German.
Mental Health Europe also produced a Handbook with examples of national practices promoting the social inclusion of people with mental health problems. The Handbook can be downloaded here in English, French and German.
Employment
| Among the persons with serious mental health problems who wish to work, only 10% obtain employment. Among employees with mental health problems, more than 30% are forced to resign from their jobs. | Every effort to maintain and improve the employability of people with mental health problems should be taken at national and European level. Actions need to be taken to adjust the workplace to the mental health needs of people as well as to make sure that employers, employees and Unions are well aware of mental health issues. |
Housing
| Over half of the people with mental health problems feel afraid of attack or of harassment. They also live in precarious situations as they may lose their accommodation because they cannot afford to pay both treatment and rent. Access to mainstream housing might also be particularly difficult for users and ex-users of mental health services because of the possible protective reaction of the neighbourhood (NIMBY - not in my backyard reaction). | Affordable, adequate and decent housing should be made available for all, respecting the different needs of people (sheltered housing, supported accommodation, mainstream accommodation). |
Education and training
| People with mental health problems, as others with disabilities, have difficulties in accessing adequate education and training. | When taking into consideration the accessibility of an education or a training programme the focus should be on the needs of students with mental health problems, on an equal basis with those suffering from physical disabilities. |
Daily life
| Discrimination and social exclusion of persons with mental health problems are universal problems in our communities. They may be denied access to insurance coverage, some leisure centres may not accept them, they may lose their voting rights, etc. | Access to transport services, to leisure activities, to insurance services should be granted on a normal basis without any hindrance. |
Health services
| Access to certain types of mental health treatments may depend on the age, gender and the race of the patients. 50 percent of people with mental health problems feel that they are treated unfairly by general health care services. | Every type of treatment should be made available to all people regardless of their age, gender, race, disability, sexuality, etc. Doctors and medical staff should have to inform the users about conditions and consequences of any treatment and measures of rehabilitation. |
Partners
ADVOCACY France
Claude DEUTSCH
Martine SOLA
8 rue Thureau Dangin
F - 75015 Paris
Tel / Fax : +33-1-45.32.22.35
E-mail : advocacy.france@erenis.fr
FINNISH ASSOCIATION FOR MENTAL HEALTH
Pirkko LAHTI
Maistraatinportti, 4 A
FIN - 00240 Helsinki
Tel : +358-9-61.55.16
Fax : +358-9-61.55.17.70
Email : pirkko.lahti@mielenterveysseura.fi
Web : http://www.mielenterveysseura.fi
EUROPEAN NETWORK OF (EX-)USERS AND SURVIVORS OF PSYCHIATRY
Clemens HUITINK
Gabor GOMBOS
Meerhoethof 50
Postbus 645
NL - 3500 AP Utrecht
Fax :+31-30-254.11.57
Email :enusp@wxs.nl and gombosg@mail.matav.hu
Web : www.enusp.org/
MIND - National Association for Mental Health
Madie CHAPMAN
15-19 Broadway
Stratford
UK - London E15 4BQ
Tel : +44-208-215.22.10
Fax : +44-208-522.17.25
Email : m.chapman@mind.org.uk
Web : http://www.mind.org.uk
PRO MENTE AUSTRIA
Eva Leutner
C/o Pro Mente Kärnten
Hoffmanngasse 12
A - 9020 Klagenfurt
Tel : +43-463-55.112
Fax : +43-463-50.12.56
For more information, please contact info@mhe-sme.org
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