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Words by Judith Klein, director of OSMHI

October 30, 2009

Foreword to the article “Institutions Remain Dumping Grounds for Forgotten People” in the newsletter of the European Coalition for Community Living, Issue No. 10, October 2009

By Judith Klein, Director of the Open Society Mental Health Initiative

Having worked for almost 15 years in Central and Eastern Europe supporting the development of community-based services for people with intellectual disabilities and mental health problems, I applaud Yana Buhrer Tavanier’s article on long stay institutions in this region. Buhrer Tavanier provides an in-depth look at an issue that governments in the region would prefer to ignore.

The Open Society Mental Health Initiative (MHI) has successfully supported the development of person centered, quality, cost effective community-based services such as supported housing, day programs, crisis intervention and supported employment in many Central and Eastern European countries. The target group for these programs is people with mental disabilities, including the most severely and multiply disabled people, and these programs are often held up as models of contemporary practice by national governments. Therefore, it is difficult to understand how governments can continue the unjustified and inappropriate life long institutionalization of people with mental disabilities when the community-based services offer viable and sustainable alternatives that respect the rights of the individuals receiving them.

I have two theories for why the segregation of people with mental disabilities, which is a very severe human rights violation in itself, is allowed to continue. One theory is that society as a whole fails to make the connection between the people incarcerated in institutions and what we expect for ourselves, our family, friends and fellow citizens. This is because, as Buhrer Tavanier’s article portrays so movingly, the residents of these institutions are systematically dehumanized. They are dehumanized by government practices, by staff in the institutions who have no time to treat them as individuals, and by the general public who prefer not to think about this issue. I think of this as the ‘us and them’ mentality. People with mental disabilities are regarded as ‘less than human’, an inferior form of being.  Couple this with the widespread and ingrained stigma and prejudice against them. The result: large, remote institutions where people spend their lives, dying of abuse and neglect, marginalized and forgotten. The bitter irony of this theory is that similar treatment of animals would be an immediate public scandal. This cannot be right.

The other theory is there is a lack of real political will in Central and Eastern Europe to take action necessary to end this appalling practice. At the global level, where deinstitutionalization has been successfully implemented on a large scale, there has, in every case, been strong political will from the central government to support it.

In Central and Eastern Europe, while ‘deinstitutionalization’ has become a popular turn of phrase in policy circles, the truth is that not one government in this region, including the new EU member states, has concrete plans or financing mechanisms to develop networks of community-based alternatives to institutions, which are an absolute prerequisite for successful deinstitutionalization. Alarmingly, new institutions for people with mental disabilities continue to be built across the region, often with European taxpayer funding.

Clearly, there is much work to be done. Thank you, Ms. Buhrer Tavanier for bringing people with mental disabilities in Central and Eastern Europe out of the shadows. MHI will continue its work to enable them to be reunited with their local communities, where they have always belonged.

Thank you.


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