Facilitating mental health lessons learned from monitoring of human rights in closed institutions
The paper describes experience of regular field study resulted in evidence-based recommendations for reforming a current mental healthcare system of Georgia; and the process facilitated by this evidence and proper lobbying.
The monitoring of human rights practices in closed psychiatric institutions of Georgia revealed the general fact that the degree of human rights protection is directly proportional to the quality of mental health care and the patients’ treatment merit; or, on the contrary, the more the rights of people having mental disorders are violated in the psychiatric hospitals, the less is the quality of medical service, treatment and care standards. Thus advancement of human rights of people with mental disorders (PMD) can foster the improved mental health care delivery.
The paper provides the data from international (CPT) and local monitoring studies (PDO + NPM), illustrates the additional traumata of inhuman conditions and treatment administered and describes the steps taken to change the situation.
Specifically, we demonstrate that, in general, the PMD have been under hard living conditions, the hospitals lack resources and competences to provide efficient treatment, the patients’ rights of getting information, communication with the outer world, lodging a complaint, and also the rights to be protected from inhuman and degrading treatment and forced labour are severely violated. It became obvious that this group of people because of their mental health problems represents especially vulnerable group in Georgian society.
The recent advancement toward the modern MH reform, de-institutionalization and balanced-care is discussed. The reform process encompassing a service-level, workforce capacity building and policy level is discussed; successes, challenges and barriers analysed and shared.
