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Imitation of deinstitutionalization

Human rights activists consider the concept of institutionalization, with its segregation of people and barring them from access to society, an actual violation of human rights. The recent UN Convention on the Rights of Persons with Disabilities (CRPD) is the first legally binding instrument to give explicit recognition to the right of people with disabilities to live and participate in the community. Article 19 further requires States to ‘take effective and appropriate measures to facilitate full enjoyment by persons with disabilities of this right and their full inclusion and participation in the community’. The convention has been signed by Bulgaria and Romania, and even ratified by Serbia. “More than 1.2 million disabled in Europe are still segregated in residential institutions. Article 19 makes it clear that by putting disabled people in institutions, governments are violating our human rights. It is crucial that action is taken now to ensure that like other citizens, we can be a part of society and can regain control over our lives”, says John Evans, one of the founders of the European Coalition for Community Living that brings together a number of actors in the field.

The need for reform in the field has been a subject of international pressure for years. The main direction has been clear for some time already. It is called deinstitutionalization. In principle this process should work in two directions – it should develop a network of community-based services (such as day-care centres, protected housing, etc.) that could prevent people from entering institutions, or help when they leave them. At the same time it should prepare people in institutions for life outside – by providing them with adequate amount of care, therapy and social rehabilitation.

All three countries in question have clearly stated their commitments, and there have been efforts. But considering the appalling state, in which this investigation found the institutions’ residents, this is clearly not enough.

According to the Open Society Mental Health Initiative the problem is that “none of the new EU member states have concrete plans or financing mechanisms to develop networks of community-based alternatives”, even though “tens of thousands of people with mental disabilities are still living in institutions”.

The directors of community-based services – like “Nasa Kuca” day centre in Belgrade, Serbia, or the “Pentru Voi” foundation in Timishoara, Romania, say that the local government is far from doing enough to support alternatives to institutional care.

In a recent report the Bulgarian Helsinki Committee (BHC) talks about low quality and effectiveness of the social services in country’s specialized institutions; lack of sufficient funding and efficient management of the money; lack of community-based services, and lack of understanding of the purport of the reform by government.

The Bulgarian social ministry has stated that the reform will continue “by establishing more community based services, but also by relocating the current institutions in new, modernly equipped buildings, sufficiently staffed, in towns where care could be provided. Some institutions will be closed down, and some will have a decrease in their capacity”.

According to data from the social ministry, in 2009 ten people were taken out of institutions and placed in protected houses. However, 1,300 are on a waiting list for admission to institutions. The BHC calls government policy “imitation of deinstitutionalization” – the committee states that there is no “closing of the entry”, nor a “broad opening of the exit”. 

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