Professional Conference
Deinstitutionalization* in Serbia
Belgrade, January 28-29, 2014
Recommendations to the Serbian government and relevant ministries for efficient deinstitutionalization process >>>
On January 28-29, 2014, at the close of two
compatible projects – “Strengthening NPM and Advocacy for the Rights
of Institutionalized Persons” and “Prison Reform Monitoring” –
realized with the assistance of Civil Rights Defenders and the Royal
Netherlands Embassy respectively – the Helsinki Committee convened
yet another two-day professional conference under the title
“Cooperation between the Civil Society and the Government in the
Process of Deinstitutionalization.”
The purpose of the conference was to initiate the
dialogue between governmental officials, independent regulatory
bodies, managements of psychiatric and social care institutions
catering for beneficiaries, NGO activists and formerly
institutionalized beneficiaries on the challenges facing Serbia in
the process of deinstitutionalization of psychiatric patients and
persons with mental/developmental disabilities.
The conference assembled representatives of
ministries of healthcare, education, labor and social policy, the
Republican Bureau for Social Protection, Citizens’ Ombudsman and
Provincial Ombudsperson, and, above all, professionals from
specialized hospitals and social care homes from Vršac, Kovin, Novi
Kneževac, Novi Bečej, Padinska Skela, Kragujevac, Tutin and
Sremčica. Associations of former psychiatric patients, physicians,
psychologists and other independent experts, and civil society
organizations concerned with this complex problematic were also
represented in the conferences. All of them actively participated in
the proceedings, contributed to deeper insights into the problem of
deinstitutionalized and helped organizers to formulate guidelines
for future activities.
Welcoming the participants, Chairwoman of the
Helsinki Committee Sonja Biserko underlined that the ongoing
practice of institutionalization and treatment of persons with
mental and developmental disorders seriously breached their
fundamental human rights, and reminded of Serbia’s commitment to
deinstitutionalization. Such a commitment is the more so important
since the Chapter 23 of the accession negotiations with EU examines
the level of protection of fundamental human rights of candidate
states, she said. To meet the conditions laid down in the Chapter
Serbia must undertake reformist moves that would positively affect
citizens’ everyday lives, especially those coming from vulnerable
groups of population, added Biserko.
According to Deputy Ombudsman Miloš Janković the
Ministry of Healthcare and the Ministry of Labor and Social Policy,
as crucial factors in the process of deinstitutionalization, were
not cooperating at all. The state of Serbia must clearly define its
concept of deinstitutionalization, adopt relevant laws and bylaws,
develop an action plan and designate implementers so as not to allow
poorly capacitated local self-government to independently cope with
this delicate problem, he explained.
Dr. Vladimir Jović - psychiatrist, psychoanalyst,
NPM expert and co-founder of the International Aid Network – said
that medical officers were the biggest stumbling bloc in the way of
deinstitutionalization. The so-called political will is not only
weak but practically non-existent: as it seems, the relevant
authorities are interested in maintaining the existing system of
institutionalization of psychiatric patients, which contradicts
contemporary methods of psychiatric treatment. Some progress has
been made within the social care system but that is insufficient
considering the strong resistance to deinstitutionalization of its
counterpart – the healthcare system. This resistance is probably
best illustrated by the recently adopted Rules for the Use of
Physical Restraint and Isolation of Psychiatric Patients, he said.
Participants in the conference discussed the
situation of institutions catering for persons with mental disorders
and the problems inherent to relevant ministries, but also tackled
many challenges to deinstitutionalization (current procedures for
depriving persons of earning ability, education and employment,
community-based medical care and other services to support persons
with mental disorders, etc.), inadequate professional capacity of
institutional personnel, the existing strategy, the newly
established centers for mental health, the activities to promote
community-based care and overcome resistance to it, etc. Focusing on
the models of good practice such as special psychiatric institutions
in Kneževac and Vršac, as well as the Kragujevac-based Medical
Center and the Mental Health Counseling Service, the participants
concluded these were nevertheless isolated cases relying on
individual enthusiasms rather than on a systemic process.
The conference was the follow-up to the
Committee’s years-long advocacy for the promotion and protection of
human rights of all citizens of Serbia, especially those coming from
marginalized and vulnerable groups. On the basis of its experience
in on-site scrutiny of social care institutions catering for
beneficiaries and psychiatric patients, the conference proceedings,
as well as the exchanges with independent regulatory bodies,
concerned NGOs and associations of former beneficiaries, the
Committee has developed recommendations to the Serbian government
and ministries aimed at speeding up the process of
deinstitutionalization.
* Deinstitutionalization is the process of
replacing long-stay psychiatric hospitals and social care
institutions with less isolated community mental/social care
services for those diagnosed with mental disorders or developmental
disabilities.
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