High hopes for Croatia in mental health reform - Country must use knowledge and resources to fuel positive change
On July 1, Croatia became the 28th country to join the European Union (EU). Accession is a clear badge of honor, and Mental Health Europe will join those congratulating Croatia on becoming an EU member state, with the rights and responsibilities this status entails. However, once celebrations are over, Croatia should not breathe a sigh of relief – its work, particularly in mental health, has only just begun.
In the field of deinstitutionalization, things seemed to have been progressing. Croatia had set up a National Deinstitutionalization Strategy for the period 2011-2018. Although the strategy had significant limitations, as the Government had planned to move 30% of people with disabilities from institutions to community-based settings by 2016, but only 20% of mental health service users by 2018, it was still a sign of political will. However, MHE member Sto koluri has signaled some alarming recent developments. According to them, in the Croatian state budget, released in December 2012, more than 85% of the funds earmarked for social welfare will be allocated to existing residential institutions for people with disabilities. Community-based services are currently very limited in number, and the Government promotes foster care for adults with mental health problems. With Human Rights Watch reporting that up to 20 adults with disabilities are being assigned per “family home,” there is no denying that foster care for adults with disabilities is a completely inappropriate form of support and can be considered a new form of institutionalization.
Furthermore, contrary to the United Nations Convention on the Rights of Persons with Disabilities, which has been ratified by Croatia and signed and ratified by the European Union, there are legal forms of both plenary and partial guardianship for adults in the new member state. In 2011, 16,355 people were deprived of their legal capacity in Croatia. Also, while involuntary psychiatric treatment in Croatia is regulated by the Protection of Persons with Psychosocial Disabilities Act, according to reports from civil organizations, judicial control is not applied when it comes to people fully deprived of legal capacity. Therefore, in practice, when the guardian takes a decision on the need for treatment, the law considers the said treatment as voluntary. As a result, Human Rights Watch argues that between 70 and 100% of residents in some psychiatric institutions were institutionalized without their consent and with no means to challenge the decision.
However, on a positive note, Croatia did show commitment to acknowledging fundamental rights, as last year the Croatian Parliament approved a legislative amendment that allows people under guardianship to vote in elections.
EU accession is, at the same time, a sign of validation and a call for progress. It implies trust, but also accountability. “In the forthcoming years, I wish that Croatia invests in community-based services for people with mental health problems and psychosocial disabilities, uses the present resources and know-how already existing in the community, and commits to people, not buildings,” said Radmila Stojanović Babić, President of MHE Croatian member Susret.
Mental Health Europe believes it is time for Croatia to prove it can reform its mental health system, and can meet EU’s human rights standards. We trust that Croatia has the knowledge and ability to do so, and that positive change is on the way. No one would benefit from it more than the country itself.
For more information, please contact Silvana Enculescu, MHE Information and Communications Manager, at firstname.lastname@example.org