MAPPING & UNDERSTANDING EXCLUSION IN EUROPE ABOUT MENTAL HEALTH EUROPE Mental Health Europe is a European non-governmental network organisation committed to the promotion of positive men- tal health, the prevention of mental distress, the improvement of care, advocacy for social inclusion and the protection of the rights of (ex)users of mental health services, persons with psychosocial disabilities, their families and carers. www.mhe-sme.org ABOUT THE TIZARD CENTRE The Tizard Centre at the University of Kent is one of the leading UK academic groups working in intellectual and develop- mental disability and community-based services. https://www.kent.ac.uk/tizard/ DISCLAIMER Although all efforts have been made to verify the accuracy of data presented in this report, this has not always been possible, and some inaccuracies or misinterpretations of the data, which was sometimes translated or provided in other languages, may remain. Mental Health Europe cannot be held responsible for any further use made of the in- formation in the report. Should you have any questions about the data found in this report, do not hesitate to contact Mental Health Europe. MAPPING AND UNDERSTANDING EXCLUSION: INSTITUTIONAL, COERCIVE AND COMMUNITY-BASED SERVICES AND PRACTICES ACROSS EUROPE Authors of the report: Ágnes Turnpenny, Gábor Petri, Ailbhe Finn, Julie Beadle-Brown, Maria Nyman Co-ordinator of the project: Laura Marchetti Proofread by: Prof Julie-Beadle Brown Design and layout: Pouce-Pied agency Published By: Mental Health Europe Mundo B- Rue d'Edimbourg 26, 1050, Bruxelles www.mhe-sme.org Printed in December 2017, Brussels 4 Acknowledgements ACKNOWLEDGEMENTS We would like to especially acknowledge the contributions of Charlotte Portier, the former Co-ordinator of the project, and Akiko Hart, former Acting Director of Mental health Europe, who worked on the project in its early stages. FINANCIAL SUPPORT We are grateful for the generous financial support from the Mental Health Initiative of the Open Society Foundations which made the publication of this report possible and from the European Union’s Equality, Rights and Citizenship programme which provides Mental Health Europe (MHE) with an operating grant. ADVISORY GROUP This report could have not been put together without the wisdom and experience contributed by an Advisory Group of re- presentatives of (ex) users and survivors of psychiatry, human rights experts, members of the disability movement, mental health professionals, and academics who provided invaluable comments and advice at all stages of the project and the draf- ting of the report. We would like to warmly thank the following experts who took part in the Advisory Group: · Maths Jesperson, PO-Skåne and founding member of the European Network of (ex-) Users and Survivors of Psy- chiatry (ENUSP) · Tone Vrhovnik Straka, representing the European Network of (ex-) Users and Survivors of Psychiatry (ENUSP) · Prof. Dr. Andrea Fiorillo, Board Member of European Psychiatric Association (EPA) · Christine Ogaranko, Program Officer with the Open Society Public Health Program’s Mental Health Initiative · Jamie Bolling, former Executive Director of the European Network on Independent Living (ENIL) and Co-chair until June 2017 of the European Expert Group on the Transition from Institutional to Community-based Care (EEG) · Milan Šveřepa, Executive Director of Inclusion Europe and Co-Chair as of June 2017 of the European Expert Group on the Transition from Institutional to Community-based Care (EEG) · Diane Kingston, former Deputy Director of CBM International and former member of the Committee on the Rights of Persons with Disabilities · Josée van Remoortel, Mental Health Europe Senior Policy Advisor on Human Rights · Kristijan Grdan, Chair of Mental Health Europe’s Committee on Mental Health and Human Rights · Prof Julie-Beadle Brown, Tizard Centre, University of Kent PERSONAL TESTIMONIES FOR UNDERSTANDING EXCLUSION The section on Understanding Exclusion could not have been put together without people with lived experience providing us with their stories. We are very grateful to everyone who shared their experiences both as named individuals, including Bea Jászberényi, Sabrina Palumbo and Guadalupe Morales, and anonymously. We recognise that for many people the decision to share their stories required substantial courage and trust. Acknowledgements 5 COUNTRY REPORTS This report is the result of dedicated work from the following Mental Health, Lille; Stephanie Wooley, Board Member individuals and organisations who kindly contributed their of Mental Health Europe, ENUSP (European Network of expertise, knowledge and time to the report through the (Ex-)Users and Survivors of Psychiatry), Advocacy-France provision of information and comments on draft versions of the Country Reports (Annex 1): Germany: Birgit Görres, Managing Director, and Peter Heuchemer, Referent, from Dachverband Gemeindepsy- chiatrie e.V. Armenia: Open Society Foundations – Armenia Kitty Mylonopoulou and Athina Frangouli from the Austria: Pro Mente Austria and Gesundheit Österreich Greece: GmbH Society of Social Psychiatry & Mental Health with the sup- port of Sofoulis Tataridis and Panagiota Fitsiou Belgium: Vlaamse Vereniging voor Geestelijke Gezondheid (VVGG) Georgia: Society of Georgian Psychiatrists and Eka Chko- nia, Head of Society of Georgian Psychiatrists Bosnia and Herzegovina: Haris Haverić, Director of SUME- RO (Union of Organizations for Support to the People with Hungary: Pszichiátriai Érdekvédelmi Fórum (Mental Health Intellectual Disability of Fbih) Interest Forum) and the Interministerial Committee on Di- sability, contributed by the Ministry of Human Capacities (State Secretariat for Social Affairs and Social Inclusion, Bulgaria: National Centre for Public Health and Analyses State Secretariat for Health), Ministry of Justice Croatia: Kristijan Grdan and NGO Susret Zagreb Ireland: Mental Health Ireland, the Health Service Exe- cutive, the Health Research Board and the Mental Health Cyprus: Elise Torossian and Kinisi Proaspisis Dikeomaton Psychika Asthenon (KI.PRO.DI.PS.A.)/Advocacy Group for Commission the Mentally Ill (A.G.M.I.). Information was also provided by the Social Welfare Services under Ministry of Labour Wel- Israel: Department of Mental Services, Ministry of Health fare & Social Insurance, the Office of the Law Commissio- State of Israel. Edited by Batya Leidner RN MA Senior Ma- ner and the Commissioner for Administration and Human nager, Housing Services Rights (Ombudsman) Italy: Donatella Miccinesi, Italian Association for Men- tal Health (Associazione Italiana per la Salute Mentale – Czech Republic: Fokus ČR and Národní ústav duševního zdraví (National Institute of Mental Health) AISME) and the Italian National Mental Health Platform (Piattaforma Nazionale Italiana della Salute Mentale) Denmark: Sind (Danish Association for Mental Health) and the Danish Health Authority Latvia: Ieva Leimane-Veldmeijere, Director of RC ZELDA : NGO Mental Health Perspectives (Karilė Le- Estonia: Ministry of Social Affairs of Estonia Lithuania vickaitė, Aurelija Auškalnytė, Ugnė Grigaitė, dr. Eglė Šumskienė) with the contribution by Prof. Dainius Pūras, Finland: National Institute for Health and Welfare Former Yugoslav Republic of Macedonia: Citizen Associa- the UN Special Rapporteur on the right to health and Dovilė tion for support of people with disabilities SOLEM – Skopje Juodkaitė Joseph Borg, Friends of Mount Carmel Hospital France: André Bitton, President and Co-Founder of CRPA Malta: (Cercle de réflexion et de proposition d’actions sur la psy- Society and Focus Point to MHE; Dr Anton Grech, Chair, chiatrie), former President of GIA (Groupe Information Mental Health Services; Ms Therese Runza, Manager Com- Asiles); Magali Coldefy, Magali Coldefy, Senior Research munity Mental Health Services Fellow, IRDES, French Institute for Research and Informa- tion in Health Economics; Dr. Philippe Leborgne, Bureau Netherlands: GGZ Nederland (the Dutch Association of Santé Mentale, Direction Générale de la Santé, French Mi- Mental Health and Addiction Care) nistry of Solidarities and Health; Simon Vasseur-Bâcle and Bérénice Staedel, WHO CC, French World Health Orga- Poland: Polish Institute of Open Dialogue, Institute of Psy- nization Collaborating Centre for Research and Training in chiatry Neurology in Warsaw and Adam Zawisny 6 Acknowledgements Portugal: Álvaro De Sarmento Afonso, Individual member Slovakia: Alexandra Brazinova, MD, PhD - League for Men- of Mental Health Europe tal Health Slovakia Republic of Moldova: Moldovan-Swiss project “MENSA- Slovenia: ŠENT - Slovenian Association for Mental Health NA - Support for the reform of mental health services in Moldova” Spain: Vicente Ibáñez-Rojo and Mikel Munarriz, Asociacion de Profesionales de Salud Mental AEN Romania: Gabriela Tanasan with the support of Dana Ha- rip, Psychologist; Asociatia Initiative Multidisciplinare AIM/ Sweden: Maria Nyman, Mental Health Europe Multidisciplinary Initiatives Association, Iasi; Simona Carmen Ionescu, Psychiatrist, Romanian Association of Forensic Turkey: Fatma Zenguin, Individual member of MHE and in- Psychiatry, Iasi; Raluca Sfetcu, Researcher, National School dependent living and recovery advocate, and Rusihak, Hu- of Public Health, Management and Professional Develop- man Rights in Mental Health Initiative ment, Bucharest; Leyla Safta-Zecheria, PhD Candidate in Political Science, Central European University, Budapest, Ukraine: Viktoriia Tymoshevska from the Public Health