MENTAL HEALTH 2030: THE DECLARATION
Participants of the international conference Mental Health Policy in Lithuania and Europe 10 years after the Helsinki Conference: from ‘the vision of needed changes’ to ‘actual results’ held on 15th May 2015, agree with the Alternative Action Plan to the Mental Health Strategy developed by Lithuanian non-governmental organisations together with independent experts, and
Draw the attention of the President's Office, LR Parliament (Seimas), LR Government, Local Authorities, public and business organisations, professional groups and media to the following facts:
- Suicide indicators remain significantly high in Lithuania;
- Funds from the State budget, Health Insurance and EU Structural Funds are being used to support the existing flawed and irrational infrastructure of services;
- Important modern mental health principles that were approved by the Parliament, when implementing the Declaration of Helsinki Conference 2005 and publishing Mental Health Strategy 2007, are still not being fostered in practice;
- Analysis, which has revealed the flaws of the existing system, has been completed and calls for positive changes. However, the responsible authorities have not responded appropriately to this analysis as of yet. A lack of efficient and effective services remains, and this fails to address children's mental health problems, which in its turn poses a real threat to the future of the social, as well as economic burden on the country that is likely to continue to grow;
- It is crucial to initiate fundamental changes whilst implementing modern science and value-based mental health policy and principles in Lithuania;
- To mobilise and focus the efforts of State institutions and general public in order to fill key gaps in Lithuanian mental health care system and initiate a long awaited breakthrough in the field;
- To modernise this system and consistently implement contemporary mental health policy principles, as well as those outlined in the Declaration of Helsinki Conference 2005 and Lithuanian Mental Health Strategy 2007;
- To provide complex and effective community-based services for children and adults who have mental health, behaviour problems and/ or intellectual disabilities, whilst ensuring adequate accessibility, quality and funding of such services;
- To implement effective continuous preventive programmes in the field of mental health for children and adults;
- To create and apply independent monitoring mechanisms that correspond with modern methods and approaches in order to monitor human rights, systematic activities and results of this system;
- To aim that the following goals are achieved, whilst investing human and financial resources in relevant and efficient ways:
- For psychotherapy and other psychological counselling and treatment services to become accessible and be funded through the Health Insurance budget;
- For effective child and adolescent mental health care services to be developed and funded appropriately, increasing their volume as well as quality and accessibility every year;
- For an efficient model of support for persons, who had attempted suicide, to be created and applied;
- For capacity of local community staff to be built in order for them to be able to early identify and assess risks of potential suicide and respond appropriately;
- For accessibility of emotional help lines to increase;
- For all to have access to such psychological, social, housing and other services that would ensure the right of all society members to live safely.
- It would be possible to decrease the existing dependence on the infrastructure of current services, which is based on large residential care institutions, fosters human rights abuses and over-medicalised interventions, if investing in the implementation of measures proposed in the Alternative Action Plan and increasing the availability of new various services annually.
- The proposed Alternative Action Plan is based on the best practices from across the world and is directed at development of effective community-based services, strengthening of children’s mental health, effective suicide prevention and consistent independent monitoring of endeavoured results;
- The proposed Alternative Action Plan suggests options for filling the most obvious gaps in the existing system as follows: to reduce stigma and social exclusion, ensure access to effective services and substantially modernise the infrastructure of Lithuanian mental health care;
- According to preliminary estimates, approximately 25 million euros will be needed over the next 3 years to cover the costs during the transitional period;
- In the future this investment will pay for itself since following the proposed reform Lithuania will have a more effective mental health care system, as well as a more open, healthier and safer society;
- Consideration of this Plan is a great opportunity to mobilise active citizens and their organisations, politicians, service users and their families, carers, respective professionals, academia and media for the initiation and promotion of this crucial breakthrough.
The special adventures of Ramzidim and Radik
Deep into the mountainous heart of Central Asia lies Tajikistan, a poverty-stricken Islamic country with approximately 7,5 million inhabitants. It was part of the Soviet Union and after the collapse of the communist imperium the country sank into a civil war that lasted for five years and cost the lives of some 8 percent of the population. Ramzidin Juraev and Radik Troi live and work in this country. Ramzidin has a physical handicap, Radik a mental one. Radik pushes the wheelchair of Ramzidin and does various odd jobs for him. How they met is a special story.
In 1978, when Ramzidin was about one year of age, he was taken to hospital for an examination. An intern carried out a lumbar punction as a result of which his spinal cord was damaged and he became severely paralyzed. Not long after the mother of Ramzidin dies. According to him this was the result of the stress that was caused by what happened top her son. His father did not want to continue to care for him and brought him to a “dom-internat” (euphemistically called “social care home”). In the time of the Soviet Union some 1500 of these institutions existed in the country, many of them for handicapped children. These “internats” still exist. In the functional Soviet approach a hierarchy existed of “disabled” with a system of various privileges connected to it. At the top were war veterans and model workers who had become disabled during their jobs. At the bottom were those who were considered useless, such as children and adults with a learning disorder. The intelligent Ramzidin lived until his 16th among some 200 mentally handicapped children. The living conditions were horrendous. Callous personnel, lack of food, epidemics of scabies and diphtheria and endless boredom. Of the 200 children only 40 survived. “ It would have been better if you had died,” the doctors said. Regularly Ramzidin was refused food because he would only dirty himself and the caretakers didn’t feel like cleaning him afterwards. In the “internat” he met Radik Tsoi. Radik hardly remembers anything of his own history. His parents are Korean. During the Stalin era some six million people of ethnic minorities, including the Koreans that were living in Russia’s Far East, were deported to distant regions such as Tajikistan. They were called ‘enemies of the people”. Approximately one million and a half of them died in the process. The parents of Radik left him in an “internat” when it became clear that he was mentally handicapped, and they disappeared from his life. Radik helped Ramzidin with eating, going to the toilet, and by pushing his wheelchair. Ramzidin and Radik had no idea of what the world was like outside their “internat”. They never came outside. “Same people. Same doctors. Same food”. That was their life, an anonymous existence on the dustbin of history.
When they turned 18 they were transferred to an institution for adults. In 1995 aid workers of a foreign organization visited this institution and Ramzidin established contact with them. They were surprised by his intelligence and the organization offered him a job. As a result he learned to read and write and, as he calls it himself, “to behave himself”. He developed himself further and eventually earned enough money to leave the “internat” and to establish his own independent life. He took his faithful companion Radik along. By now Ramzidin is married and lives together with his wife, daughter and Radik in the north of Tajikistan. He is the owner of an expanding taxi firm and chairman of a local association for people with a disability. In that capacity he fights for better legislation and protection of people with a disability, and organizes trainings and workshops where people can learn skills such as sewing and other manual professions in order to be able to sustain themselves. His dream is to found a “social club” for people with a disability in the city where he lives. Deeply affected by his history Ramzidin was initially full of resentment and anger after he managed to escape from the inhuman conditions of life in “internats”. His aggression he gradually managed to turn into power to fight on behalf of his peers who continue to lead a marginalized life in poverty.
First winners of the new Jim Birley Scholarships
It is with great pleasure that the Netherlands-based international foundation “Human Rights in Mental Health-FGIP” announces the first winners of the new Jim Birley Scholarships. The Scholarship is shared in 2015 between two outstanding advocates for human rights in mental health. The winners of the 2015 Jim Birley Scholarships are Anka Jgenti from Georgia and Charlene Sunkel from South Africa