*First published in an internal newsletter of Inclusive Futures in January 2022*

In this Insights article, the OPD EO[1] in Kenya offers insights into support requirements for persons with psychosocial disabilities. In the first part she talks about identity, while in the second part, based on her experiences, she writes about peer support for persons with psychosocial disabilities to further their meaningful inclusion in society. 

Part 1: Identity and recognition

Very often, persons with psychosocial disabilities as an underrepresented group within the disability movement, face enormous barriers in realizing their rights to work and employment. The Inclusion Works (IW) program has endeavored to put measures in place to support the full and effective participation of persons with psychosocial disabilities within it. This, among others, included having organizations of persons with psychosocial disabilities as IW implementing OPD partners.

As one identifying as a woman with a psychosocial disability, I have often been faced with the question, who is the person with a psychosocial disability?

The World Network of Users and Survivors of Psychiatry developed an Implementation Manual for the United Nations Convention On the Rights of Persons with Disabilities (2008) where it noted that the word psychosocial refers to the interaction between psychological and social/cultural components of our disability. The psychological component refers to ways of thinking and processing our experiences and our perception of the world around us. The social/cultural component refers to societal and cultural limits for behavior that interact with those psychological differences/madness as well as the stigma that the society attaches to labeling us as disabled.

The manual noted that the term psychosocial disability was not yet (then) understood in most countries of the world, and therefore, at the end of the negotiations in the drafting of the CRPD, WNUSP agreed to use the more generally understood terminology of mental impairment in the text of the Convention. Persons with mental impairments include users and survivors of psychiatry who experience or have experienced madness and/or mental health problems and/or are using or surviving, or have used or survived psychiatry/mental health services, as well as those who are perceived by others as having a mental disability/impairment. Recalling also that the CRPD states that persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.

Over the years the CRPD Committee, the authoritative body interpreting the CRPD, has used the preferred term psychosocial disabilities. Indeed, the committee understands persons with “mental health conditions” to be persons with disabilities entitled to the guarantees of the Convention[2]. This therefore is the premise by which we claim the guarantees of the CRPD, in all that we do within our communities.

Part 2: On peer support for inclusion

In this part I share my experiences with peer support, as one tool that greatly supported me to be meaningfully engaged in my society, and in this sense, participate meaningfully in work and employment. I also add that IW has afforded me reasonable accommodation, offering me a space to utilise my peer support network to meaningfully execute my tasks as OPD EO. 

Due to barriers that I experienced, fully realising my rights to work and employment was not something obvious.  At some point, I thought that all I needed was medicine. My peers from my support group recall me looking for ‘a magic pill’. If only it would take away, completely, the distress and emotional turmoil that I could go through from time to time. There was a continued feeling that were it not for the mental impairment, maybe I would be a different person.

There was no magic pill. Did it mean then that, at that point there's nothing I could do, to improve my situation, with the mental distress? Did it mean that I was not capable to work?

For many years now, since these early experiences with trying to find solutions for the distress I would often go through, I found community, and solace in peer support. In basic terms, it was peers, persons who like me, had experienced mental distress in one way or another, who were coming in a space of 'peership'. Non-hierarchical, rather all of us, peers, as experts by experience!

Peer support for us then became a strong pillar in our lives. Within peer support as a form of social support, our psychosocial needs, our emotional needs also are a central concern, and we support each other in these dynamics too. In some of our peer support groups, we also began some income generating activities that also came in handy for members in different situations of their lives.

In speaking about social support systems,  it also means having a choice to come together as we may, in our own terms as peers, and deciding the best way that such support would benefit us and offer us tools to navigate life and our own experiences in the best way we can. Many studies have gone into benefits of peer support. We did our own informal studies under the membership organisation Users and Survivors of Psychiatry in Kenya. Some things that we found included reduced levels of involuntary treatment in psychiatric institutions; reduced relapses; a feeling of belonging to community, being involved for example; documenting and addressing issues of human rights abuses at community level with the involvement of government officers.

At personal levels, peers holding down jobs where initially it was not the case (I have held down a job a number of years now which was not always the case), and in other instances, the person with mental distress or the person with disability being supported to make their own informed choices as regards for example medication, or even which career to take. 

As one tool therefore that may support the inclusion of persons with psychosocial disabilities in their communities, disability inclusive development should be intentional about financing and supporting peer support models for persons with psychosocial disabilities. As an underrepresented group within the disability movement, there is need to continue to put focus on this group to find further ways to support their meaningful inclusion within the realm of work and employment.   

[1] Engagement Officer, Organizations of Persons with Disabilities

[2] CRPD Concluding Observations to Spain (2019), CRPD/C/ESP/CO/2-3, paragraphs 8-9.