CEELBAS Seminar

Mental Health and Intellectual Disability in Post-Socialist Eastern Europe: from Institutionalization to Integration?

26th October 2007

Wilkins Building, UCL

In Socialist Eastern Europe, state policy determined that all people with disabilities – including those with mental health problems and learning disabilities – were by and large institutionalised rather than integrated into society. In the post-Socialist period, disability continues to be a central aspect of social inequality, social exclusion, and human rights abuses in the region, both through the state policies which structure the lives of those with disabilities, and through the cultural perceptions which define their social position. Despite this, disability in Eastern Europe has received relatively little attention from academics and professional researchers working in the field of Russian and East European Studies.

This one-day seminar, the first in a series of CEELBAS events addressing social inequality, health and welfare in Eastern Europe, attempted to address this gap by bringing together a wide spectrum of user groups with an interest in mental health and intellectual disability in the post-Socialist space. Amongst the speakers and audience at the event were established and emerging academics, postgraduate students, representatives of national and trans-national non-governmental organisations, independent consultants, and government representatives, both from the UK and from a variety of Eastern European countries.

Key findings of the seminar

In total 8 presentations were made at the seminar. These, and the discussions which followed them, provided a wide range of perspectives on the problems facing mental health systems in Eastern Europe, and, more importantly, those whose lives are affected by such systems.

Amongst the key findings of these papers were the following points:

· That the deinstitutionalisation of mental health systems towards more community-based forms of care is taking place extremely slowly, if at all, in many Eastern European countries. Where this is taking place is most often due to the activities of NGOs than to government action, which tends only to exist ‘on paper’.

· That the slow pace of deinstitutionalisation results from a combination of factors, not least of which are a lack of political will and the embeddedness of mental health institutions in local economies.

· That a number of the laws governing the position of people with mental health problems undermine rather than underpin their human rights and other aspects of their citizenship (such as access to labour market opportunities).

· That there are, nevertheless, a number of arguments which can be made to influence Eastern European governments to bring about change in mental health care systems, not least of which the social, economic and demographic benefits of more inclusive policies.

· That, in order to make such arguments, there is a strong need for more wide-ranging academic research into mental health issues in the region, as well as for activities such as pilot programmes by NGOs.

Outcomes

In order to keep together the diverse audience which attended the seminar, a virtual network has been set up through the Jiscmail Listserv service. The network, entitled Disability and Mental Health in Eastern Europe and the Former Soviet Union, is open to anyone interested in the issues which framed the seminar. It serves as a forum for discussion, as well as a portal for news about forthcoming events, ongoing research and publication, and any other activities related to disability and mental health in Eastern Europe. To join the network, please visit www.jiscmail.ac.uk and search the list name DISABILITY-CEE-FSU (the abbreviated name of the network), or go straight to its homepage by visiting http://www.jiscmail.ac.uk/lists/DISABILITY-CEE-FSU.html. There, simply click on the link ‘join or leave the list’ and you will be prompted for your name and email address.

Presenters and Presentations from the Seminar

Dr. Stewart Britten (HealthProm, UK) – Dr. Britten, a former consultant child and adolescent psychiatrist, works with HealthProm, UK, and the Early Intervention Institute, St Petersburg, to reduce the flow of infants and children in Russia into institutions. He presented a paper entitled ‘Institutionalizing babies: the road to oblivion’, and screened a documentary film made in a 'baby home' in Russia by the St Petersburg Early Intervention Institute, HealthProm and EveryChild. The film will be shown across the Russian Federation in 2008 in order to raise awareness of the harm to small children of being placed in institutions.

Gabor Gombos (Mental Disability Advocacy Centre, Hungary) – Mr Gombos has been involved in the human rights advocacy of users and survivors of psychiatry in Eastern Europe for 15 years. He has worked for organisations ranging from grass-roots NGOs to the United Nations. He made two presentations at the seminar, the first of which provided a biographical perspective on mental health institutions in Eastern Europe. The second presentation was entitled ‘Core human rights violations in the institutionalized mental health care system in Hungary’.

Dr. Reima Ana Maglajlic Holicek (Swansea University, UK) – Dr Maglajlic Holicek has worked as a consultant for a number of international and local NGOs in South-Eastern Europe and has conducted research on mental health user-run organisations in countries such as Bosnia and Herzegovina. Dr.Holicek presented a paper entitled ‘International agencies and the development of community-based, user-led and user-run mental health initiatives in Eastern Europe'.

Natalija Jesenicnik (Association for Theory and Culture of Disability, Slovenia) – Natalija Jesenicnik is a social worker and sociologist working for a major disability-related NGO in Ljubljana. She has conducted research on disability and employment in Slovenia. Natalija presented a paper entitled ‘Being disabled in Slovenia: employment issues’.

Jo Lucas (Freelance Consultant, UK) – Jo Lucas has 14 years of experience working in various Central and Eastern European countries. She has been closely involved with the development of social work education in Ukraine and Georgia and has also spent 6 years working with mental health organisations across these countries. Jo presented an introductory paper entitled 'Setting the context – a brief overview of the social exclusion of people with mental health problems and intellectual disabilities'.

David McDaid (LSE, UK) – David McDaid is Research Fellow in Health Policy and Health Economics at LSE Health and Social Care and the European Observatory on Health Systems and Policies. He has published widely on the economics of mental health policy and has worked as a consultant for a variety of governmental and non-governmental bodies such as the WHO, the European Commission and Amnesty International. David presented a paper entitled ‘Barriers to the de-institutionalization of mental health care in Russia’. A published article on the same theme can be found here.

Professor Shula Ramon (Anglia University, UK) – Professor Ramon has conducted research, and published extensively, on community mental health in Europe and the former Soviet Union. Professor Ramon presented a paper entitled ‘Lay and professional approaches to people with mental illness in the former Soviet Union’.

Click here for full programme

---