Madrid, 16-19 April 1997

PRESENT SITUATION IN EUROPE

The 5th Mental Health Social Exclusion European Seminar allowed us to notice the general worsening of the exclusion situation , at the local, regional and European level, and to identify and underline the following phenomena.

1. Assessment of the phenomenon

We notice the increasing evolution of the number of people who live in a very diversified exclusion situation, as well as an increase of the mentally ill who live in a situation of exclusion and abandonment.

More and more, young people and women are part of this section of the population in the European metropolis. But we underline also that, next to the most visible marginalisation of the ones who live at the street, i.e. the "homeless", there is also the "invisible" condition of the people who are in a situation of abandonment in homes and institutions.

2. Factors and causes

The social and health precariousness can be seen in circumstances which appear most frequently as being the very immediate cause of exclusion:

• Loss / lack of housing/home (increase of the number of people who have no house, who have been put out of their houses, of the migration movements within and throughout the country, with its following uprooting...).
• Loss / lack of employment: non occupation, job losses, long time unemployment.
• Loss / lack of family links and social cohesion.
• Loss / lack of physical and psychic health (lack of: prevention and continuity of cares), added to "savage" dis-hospitalisation / institutionalisation.

We notice that the common features of the marginalised populations are the consequence of the devastating effects that they suffer from, because of these circumstances. However, there is no such a thing as an intrinsic identity of the "homeless", except that they are all victims of economic, social and cultural exclusion processes.

   3.The market laws

Among the factors in this general background, the most substantial one is the predominance of values and rules which are more and more openly at the mercy of the market laws, which do not include in their objective neither the universal human rights, nor the rights of citizenship.

It is increasingly clear that the situation of those people is not a priority in the political programming of the people who are in charge of the "public affairs".

   4.Statement and rights guardianship

Although the national constitutions and legislations recognise the rights to housing, employment, health, they do not establish any guarantee neither for giving access to these items nor for their full and permanent exercise (housing, employment, health, and so on).

   5.Needs and services

The services which are offered do not sufficiently meet the complexity of the demands and the needs, at the quality and quantity levels. Moreover, a great majority of the demands are not explicitly worded, and remain therefor "invisible and unnoticed" by the public administrations.

   6.Budget restrictions

Budget restrictions, generalised in Europe, are affecting most particularly the populations who live in the most precarious conditions (the "homeless") and who are the ones who are in the worse conditions for asking and making their rights prevail (the mentally ill).

   7.Programming and resources

We notice a lack of programming at the middle and long run, which limits the interventions to "emergency" cases and which is at the origin of the distortion between the social resources and health resources, in their conception and organisation. This leads to the great fragmentation of the services, which becomes practically a factor of reinforcement of the assistance and humanitarian "praxis": it keeps the marginalised persons in a state of ongoing dependency.

   8.Public and private

We notice a strict correlation on the one hand between the budget restrictions, the reduction of services, and on the other hand a very marked and generalised trend among the public authorities: getting away from the responsibilities about the voluntary organisations, charities and NGOs, generally speaking.

We notice a worrying increase of intolerance and an aggressive rejection of the populations who are different, more particularly against the populations who show signs of weakness and/or precariousness, and who are increasingly exposed to the masses' violence, who suffer from attitudes and behaviours of rejection, physical aggression and depreciation.

Our most energetic condemnation against these attitudes and behaviours.

PROPOSALS and RECCOMANDATIONS

In such a situation, marked by the abandonment of criteria/value of solidarity and justice, we urge the public authorities and society as a whole to:

1. Assume jointly (together) the responsibility.

2. Give priority to the needs linked to marginality and exclusion.

3. Make these issues theirs and give priority and find solutions to these serious problems.

We propose the following actions

1. Specificity of answers: defining specific proposals in order to meet the needs, well

defined, of this population, so that there is no risk of taking over by other groups who are more integrated and who are in better conditions to defend their rights.

2. Comprehensive answers: insuring to all the individuals an assistance/answer which is integrated in the public social and health system, as well as the rest of the population as a whole. In case of institutional intervention, implement dignified conditions, avoiding massification, cramming and de-personalisation.
3. Specific Programming: developing specific care/assistance with criteria of positive discrimination, so that they can be translated into:

• urgent implementation, where they do not exist,
• quantity and quality enhancement, for the services who showed themselves to be efficient,
• guaranteeing quality and continuity of the cares.

   4. Basic Rights and needs: to give specific attention to the needs of:

• housing: with immediate protection in case people are put out of their houses.
• minimum income: should be guaranteed as long as the situation of lack of income continues, so that nobody, in no moment, feels obliged to beg, or to accept to be exploited.
• regularising: facilitating the registration in the different offices which give citizens' rights: vote and public services.

   5. Suppressing the obstacles: suppressing all the bureaucratic steps which prevent people from
         using the services. A flexible and sufficiently diversified system has to be foreseen (according
         to age, sex and personal perspective...).

   6. Accompanying and guardianship: facilitating the availability of accompanying which guarantees
         the access and the better use of the available resources. We propose the building up of the
         person of "defender of the homeless" who would have enough social and legal authority in order
         to intervene for the direct defence of their rights and necessities.

   7. Protection of privacy: guaranteeing the right of intimacy protection, since there is a risk of
         morbid exhibition or manipulation of their situation by medias and others.

   8. Protection of physical integrity: because of the potential danger of prejudice, we proclaim the
         right of protection of their physical integrity.

   9. Liability of the politicians and citizens: avoiding forced normalisation as well as responsibility
         giving up at the social and political levels, in situations where protection and cares are demanded.

  10. Promoting training: facilitating the extended, ongoing and in depth formation of the operators
         (professionals and volunteers).

  11. Assistance to families: providing the families with economic, material, affective, pedagogical
         (general and health education) aid, prevention means and treatments means (interventions during
         crises and continuous treatment), and all the actions which are necessary for avoiding ruptures
         which hasten and worsen the exclusion.