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Rehabilitation of the Mentally Ill: an International Perspective. INSTITUTION President's Committee on Employment of the Handicapped, Washington, D.C

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Rehabilitation of the Mentally Ill: an International Perspective. INSTITUTION President's Committee on Employment of the Handicapped, Washington, D.C DOCUMENT RESUME PD 204 615 CE 029 571 AUTHOR Schulman, Eveline D. TITLE Rehabilitation of the Mentally Ill: An International Perspective. INSTITUTION President's Committee on Employment of the Handicapped, Washington, D.C. PUB DATE [80] NOTE 68p. !DRS PRICE MF01/PC03 Plus Postage. DESCRIPTORS *Cross Cultural Studies: *Globh1 Approach; *International Educational Exchange: International Law: International Organizations; *Legislation: *Mental Disorders: Mental Health Programs; Psychiatry: Psychotherapy: *Rehabilitation Programs ABSTRACT This monograph is an international overview of available information about the current status of rehabilitation efforts for the mentally ill. It served as a springboard for discussion at the Special Interest Group session at the Fourteenth World Congress of Rehabilitation International in Winnipeg, Canada, on June, 1980. The first part of the monograph introduces the international context of rehabilitation of the mentally ill and outlines the scope of the problem. In Part 2, two areas of interest to those working in rehabilitation of the mentally ill are surveyed: laws about mental illness and mental patients, rights and responsibilities, in various countries of the world; and rehabilitation procedures for treating the mentally ill in various cultures and countries. Part 3 suggests prospects for the future--collaborative efforts that could be made among nations and international organizations 1t disseminating information about rehabilitation procedures: and a summary of the needs of rehabilitation programs. A list of references is included. (KC) ********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. ********************************************************************** Rehabilitation of the Contents Mentally Ill: Part One: Introduction An International Introduction 1 I. Acknowledgements 4 Perspective II. Scope of the Problem 5 Part Two: State of the Art I. The Law and Mental Illness 10 II. Transcultural Survey of Rehabilitation Procedures for the Mentally III 15 Part Three: The Future I. Collaborative EffortsInternational Organizations 54 II. In SummaryThe Dimensions of Rehabilitation 56 References 57 Eve line D. Schulman, Ed.D., Consultant President's Committee on Employment of the Handicapped 1.1) U.S. DEPARTMENT OF HEALTH. EDUCATION & WELFARE NATIONAL INSTITUTE OF EDUCATION THIS 00CUMENT HAS BEEN REPRO- DUCED EXACTLY AS RECEIVED FROM THE PERSON OR ORGANIZATION ORIGIN. 2 ATING IT POINTS OF VIEW OR OPINIONS STATED 00 NOT NECESSARILY REPRE- S SENT OFFICIAL NATIONAL INSTITUTE OF EDUCATION POSITION OR POLICY 3 2 Introduction The ever-growing realization of the importance of an ex- have been engaged in cooperative research and demonstration change of ideas on a national as well as an international scale is with a number of developing countries... under the Special written into the 1978 Rehabilitation, Comprehensive Services, Foreign Currency Program, authorized by Public Law 480, The and Developmental Disabilities Amendments to the Rehabilita- Agricultural Assistance Act of 1954, as amended (SRS and RSA, tion Act of 1973 in the United States of America. At the national 1976). level, a new Interagency Committee has been established as Recently, in order to implement the 1978 Amendment (Sec. follows: 204(b)(5)), the World Rehabilitation Fund (WRF) instituted the Sec. 203.(a)(1) In order to promote coordination and International Exchange of Information in Rehabilitation project cooperation among Federal departments and agencies con- designed to facilitate the sharing of rehabilitation information ducting rehabilitation research programs, there is establishedtransnationallyfocusing on the identified knowledge gaps in the within the Federal Government an Interagency Committee United States. Of particular pertinence to the interests of this on Handicapped Research...chaired by the Director and monograph is the fact that the second monograph in the WRF comprised of such members as the President may designate, series discusses rehabilitation procedures for chronic including the following...: the Director, the Commissioner, schizophrenics in Sweden (Dencker, 1980). the Commissioner of Education, the Administrator of These initiatives by the United States towards international Veterans' Affairs, the Director of the National Institutes of collaborative undertakings are prodded from still another direc- Health, the Administrator of the National Aeronautics and tionby identifiable gaps in the service system for the mentally ill Space Administration, the Secretary of Transportation and in both the developed and developing countries. From its incep- the Director of the National Science Foundation. tion, the concept of rehabilitation has been linked primarily to physical disabilities. Thus a serious void occurs in recognizing On the international scale, the Act focuses research, that for the mentally illcurative processes are not enough. Dr. demonstration and training efforts as follows: Gerald Klerman, Administrator, Alcohol, Drug Abuse and Men- Sec. 204.(b)(5) Conduct a program for international tal Health Administration, recently commented that in the 1950's rehabilitation research, demonstration, and training for the there were approximately 600,000 patients in public mental health purpose of developing new knowledge and methods in the hospitals. New forms of psychosocial technology plus the advent rehabilitation of handicapped individuals in the United of neuroleptics gave impetus to the release of institutionalized pa- States, cooperating and assisting in developing and sharing tients so that today there are less than 120,000 in the United information found useful in other nations in the rehabilita- States public mental hospitals. Thus the length of hospitalization tion of handicapped individuals in the United States, and in- has been shortened and the "patients are better but not well... we itiating a program to exchange experts and technical are suffering from partial success." assistance in the field of rehabilitation of handicapped in- It is not sufficient that psychopharmacology and other dividuals with other nations as a means of increasing the techniques have decreased (or masked) the vigor of the symptoms levels of skill of rehabilitation personnel. so that these patients are not dangerous to themselves or others. They must be helped to achieve, as close as possible, their poten- There are precedents for international exchange in many tial level of independencein community residential ar- areas of endeavor by the United States. For instance, the Interna-rangements, economic self-sufficiency, and, if desirable, return tional Research and Demonstration Projects of the Agricultural to a social place within their families. In other words, these Trade, Development and Assistance Act, as Amended P.L. 480. "restored" individuals must accomplish social integration within Since 1961, the Social and Rehabilitation Service (SRS), the the community. This goal suggests that there is a triad of Rehabilitation Services Administration (RSA), and their rehabilitation neededthe person, the family, and the commu- predecessor agencies, particularly the Welfare Administration, nity. The lack of recognition and emphasis on the significance of rehabilitation is often the crux of the problem for the mentally ill person. The literature about prevention, diagnosis, therapeutic 'The special Foreign Currency Program provides for financing of research and demonstration projects with U.S.-owned foreign currencies generated by the sale of U.S. agricultural commodities, which exceed amouitts needed by the U.S. government for meeting Embassy and other primary requirements. Thus participation by the developing countries in this program is designated by the U.S. Department of the Treasury. Addi- tional requirements are that applicants for funds under the program (governmental and private non-profit institutions) present sound research or demonstration proposals addressing problems of mutual concern to both the U.S. and applicant governments and that these proposals are of- ficially sanctioned by the respective governments (SRS and RSA, 1976). 3 measures J 'ant. However the mention of the fourth The three primary sources that provided particulars for the aspect, na.' 'in, is only beginning to seep through survey of international organizations and of countries are:1) In- discussions."' rent in the United States as well as in ternational Sources, 2) National (United States) sources, 3) A most other cour... eoretical foundations and practical literature search. Appreciation for assistance in this research can applications of rata i with the physically handicapped is only be partially expressed in a listing of acknowledgements. Ad- one source of inform ' lowever, there are many other world ditionally, there is always the fallacy of omission that besets the resources that can be mat..vailable. author's memory of all those individuals who have contributed. No one country has all of the answers. No one country can Therefore, the following list of acknowledgements is arranged in fulfill the perfect prow ype for other countries. (N. V.G.A., alphabetical order and does not represent the sequence' of ex- 1978). Both developedId developing countries would profit ploration nor the significance of the information. Moreover, the from an exchange of i.lrmation. Intensified efforts are emerg- author apologizes for any contacts that have been
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