In the Action Plan 2015-2018 presented in Seoul, the proposed specific target areas are:
ACCESSIBILITY TO SERVICES:
Access to attention is a pendant issue in most places of the world, including many developed countries. According to WAPR-WHO Consensus Statement, the required services should include:
- Access to treatment and drugs if needed.
- Proper information and support to family carers.
- Consideration to housing and attention to basic needs (feeding, clothing).
- Proper opportunities for social inclusion: accessibility to transport, public social services –health care, justice, education and training, social protection, culture, leisure, etc.- ; job and vocational programmes.
Governments and policymakers are encouraged to design and implement Mental Health Plans and adequate budgets in the context of the public commitment with the health of populations. Scaling up resources is a compelling need in many regions.
QUALITY OF SERVICES.
Quality of services is a key feature of the requires services. In too many cases, the available services are of very poor quality. Under this perspective, the proposed Action Plan suggests:
- Insufficient resources to attend all health needs is a common problem everywhere. But Psychosocial Rehabilitation services are often of the cincerella of health services. However, citizens with mental illnesses deserve the same level of consideration as any other citizens, under the principle of equity. Hence, I any given area, the mentally ill deserve the same level of quality in services as in any other area of health care of the area.
- The “recovery perspective” is suggested as the way of assessing the quality of services: this means that services should: promote citizenship (the mentally ill as a citizen with full rights), should adapt to the users’ need (and not in reversal), promote the person’s self determination, and provide flexible support all time needed (adapted to the degree of disability that may be present in every stage of the recovery process).
- The Human Rights perspective is a way of assessing the quality of the available services. Collisions with Human Rights are common in psychiatric practice, and should be carefully addressed. A number of very extended practices usually may collide with human rights (seclusion and physical restriction, compulsive admissions of treatments, limitation of civil rights in case of legal incapacitation or guardianship, etc). Unfortunately, in some cases, collisions may involve also degrading practices, ill treatments, lack of legal control or guaranties, etc. This is a pending and heart-breaking aspect of quality in attention that needs permanent attention. There are tools of assessing Human Rights in health and mental health services that may be used to address this issue.
People labelled as with mentally ill are suffer from stigma, that is, a number of social false but extended attributions from society. They are usually wrongly considered as violent, unpredictable, irrecoverable… and treated accordingly. Stigma is a major barrier to access to services and social inclusion.
Stigma may be tackled in different ways:
- Social activism: User’s and carer’s organisations are good tool where people can gather, exchange, receive and provide peer support and find a friendly environment. There are many experiences in that direction that shows it is feasible and efficient. Users’ and carer’s organisations require some expertise, and leadership in order to remain active.
- Public Campaigns: where there is public commitment with mental health, public campaigns may be a tool to change social prejudices and attitudes. Some well-known celebrities and artist have publicly recognised their mental health problems and lent their image to campaigns.
- Social Networks: social networks are a very costless and powerful tool to disseminate a more accurate image of the people with mental illness, based on a increasing amount of social events of all kinds that show recovery from mental illness is possible. Music, theatre, arts, job environments; even daily living provides good stuff that feeds social network with proper information.