By IDA

 - November 28, 2017

The right and opportunity to have a whole life: Best practices for empowerment, self-determination, community resilience, wellbeing and human rights.

Franca and Franco Basaglia International School, Trieste, Italy

The Trieste Conference on mental health took place from the 15 to the 18 November 2017 at the Franca and Franco Basaglia International School, in Trieste, organised by the Department of Mental Health of the Italian region of Trieste. The Conference was attended by several lead activists with psychosocial disabilities from Latin America, Asia, Europe and Africa, supported by World Network of Users and Survivors of Psychiatry (WNUSP), Transforming Community for Inclusion-Asia, with financial support from OSF and DFID.

The conference gathered many mental health practitioners, academics and few Self-advocates from over 36 countries. The conference content tackled the extent to which mental health policies and services have evolved in recent years and if this evolution was framed by human rights and inclusion.  There was obviously a strong focus on the deinstitutionalization of mental health services.

Structured around study visits to services and programmes, interactive plenary sessions, short classes, masterclasses, working groups and expert meetings, speakers shared best practices for empowerment, self-determination, community resilience, well-being and human rights. Among others, speakers advocated for: a shift of focus of health care services to the individual; the reformulation of the concept of justice for persons with disability from object to subject of the law; a community based inclusive development; and the humanization of Psychiatrics’ terminologies. One speaker highlighted that “no one should act instead of the person on the point of best interest”. 

Bhargavi Davar, from Bapu Trust and convenor of TCI Asia, was main speaker in three panels: “Recovery and Rights” on Day 1 (16 November 2017), “Global Mental Health and social rights” on Day 2 (17 November 2017), and ¨Declaration and Conclusion: towards a rights-based care” on Day 3 of the Conference (18 November 2017).  Drawing from her experience in the Global South, Ms Davar underlined the importance of involving the whole community when providing support to persons with psycho social disability. She also shared the BAPU Trust vision experience, which offers alternative health care services through peer support, strong dialogue systems, crisis support and being well and staying well strategies.

 Bhargavi Davar’s presentation for the panel “Recovery and Rights”, 16 November 2017, Trieste, Italy

Picture above: Bhargavi Davar’s presentation for the panel “Recovery and Rights”, 16 November 2017, Trieste, Italy.  

In the closure panel, Jolijn Santegoeds, co-chair of WNUSP, acknowledged the evolution and experience of Trieste services and welcomed the efforts and attempts made to reform mental health services within a rights-based framework. While highlighting the openness to dialogue promoted by the Conference, Jolijn nevertheless called for a greater participation of persons with psychosocial disabilities. To ensure in-depth and informed dialogue, there should be a parity between persons with lived experience and services providers or academics. In addition, Jolijn highlighted the remaining limitation and the urgency to move further towards full CRPD compliance. She ended her presentation by emphasising the key role that persons with psychosocial disabilities and their representative organisations can play in such required reforms.

After the conference, representatives of organisations of persons with psychosocial disabilities from Latin America, Asia, Europe and Africa gathered for a one and half day strategic planning workshop. The aim of the workshop was to share experiences, identify key advocacy issues, as well as activities required to strengthen the self-advocacy movement within and across regions.

BACKGROUND* 

Since 1980, the city of Trieste has closed psychiatric hospitals and set up a network of 24-hour community mental health centres. These offer a wide range of services, such as community mental health centres, small units in general hospitals, day-care centres, and community residential solutions for supported housing. The practice was recognised as an experimental pilot area of mental health de-institutionalisation by the World Health Organization in 1974, became a WHO Collaborating Centre in 1987 and is reconfirmed as such until 2018.

Because de-institutionalisation was successful in Trieste, the community-based approach has been implemented in the whole Friuli Venezia Giulia region and is acting as inspiring model for services, organisations and countries in more than 30 countries.  

*Taken from the website: https://zeroproject.org/practice/mental-health-department-whocc-italytrieste/

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