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SI of mentally disabled people

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by

Ainur Shakenova

on 17 June 2015

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Transcript of SI of mentally disabled people

From paternalistic approach to policy of social inclusion: situation of people with mental health disabilities in Kazakhstan
General information

Population 16 000 000
More than 120 nationalities represented, Kazakhs – 63%, Russians – 25%, others  - 12%
Capital City Astana (825 000)
Languages Kazakh (official), Russian
Religion Muslim, Russian Orthodox
MAP
Who is the doctor?
Public servant
Socially unprotected
Low salary
Low prestige
No additional incentives for work

2 different historical approaches
I. Paternalistic approach
II. Social Inclusion

Special institutions in healthcare, education and
social protection settings,
and providing certain social benefits and welfare

Consequences –
• increased expenses of state budget,
• dependency of the beneficiaries,
• social segregation and exclusion
• lack of public awareness.

What was happening in mental health providing?
- General reforms
- The quantity of daily stationary, beds decreasing
-The amount of psycho therapy rooms in ambulance care from 63 (1995) to 35 (2012);
-Amount of psychiatrists was fluctuated, and deficiency led to substitute of doctors of other specialties
-Psychiatric emergency and specialized mobile brigades exist only in 65 districts
-The number of psychiatrists decreased to 699 (0,4 for 10 000)
-The average age 57-60 y.o.
- The amount of therapy occupational and workrooms from 20 to 2, amount of protected working placements from 2638 to 62 ( almost 43 times).





31 closed institution for adults and 22 for
children for 18 000 patients


What's for today?

POLICY
Legislation
U
N Conventions, treaties
Local legislation

National action plan
for improvement of the disabled people situation states new principles:
• Improvement of lives and quality of living for the disabled
• Social inclusion
• Deinstitualization
• Development of different alternative services,
directed for integration and care close the place of living

Public Board
for reforming of psychiatric care

Contradictions
Questionnaire 2015
Services provided by the NGOs


-Not enough information
-Difficult to get in
-Great personnel
-Great occupational therapy
Existing alternative services

Diminution of special institutions, creation
of additional alternative service, providing
some social benefits and welfare

Consequences –
decrease of expenses of state budget,
decreasing dependency of the beneficiaries,
social integration and inclusion
raised public awareness
Healthcare professionals
Public servant
Low salary, low prestige
Socially unprotected
No incentives
Social
Protection
Females over 50
Low salary
No additional education
No choice of field

Family
friends
social circle
Patient
Not enough base / distorted understanding of political will

examples,
Psychological, Medical and Pedagogical Commission (PMPC)
Individual Program of Rehabilitation
Medical Social Expertise
Contradictions

New institutions
Long queues to get there
Sometimes better conditions than at home
Much more money spent
Negative mass media


Quotes
They are isolated, no sport and occupational therapy, never go out

No art therapy, and our son is very talented, at home he paints

We can’t control anything.

How the institutions use our relatives’ pensions?

Here he stays forever. We said good bye forever...

Questionnaire 2015:
Long distance from home,
low quality of personnel, and services,
no occupational therapy,
no control of the situation, etc
1. Club Houses
2. Training cafe
3. Daily Centers
Policy
Education
Advocacy
Public
awareness
Personal
awareness
Further steps
Our goal -
to live,
study and
work without
isolation from the
society
Full transcript