OBSERVATIONS AND PROPOSALS
as a conclusion of the 5th MHSE European Seminar
"CITIZENSHIP AND HEALTH"
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.
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.
The social and health precariousness can be seen in circumstances which appear most frequently as being the very immediate cause of exclusion:
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.
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.
9.Intolerance and aggression
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
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.
4. Basic Rights and needs: to give specific attention to the needs of:
5. Suppressing the obstacles: suppressing all the
bureaucratic steps which prevent people from
6. Accompanying and guardianship: facilitating the
availability of accompanying which guarantees
7. Protection of privacy: guaranteeing the right of
intimacy protection, since there is a risk of
8. Protection of physical integrity: because of the
potential danger of prejudice, we proclaim the
9. Liability of the politicians and citizens:
avoiding forced normalisation as well as responsibility
10. Promoting training: facilitating the extended, ongoing
and in depth formation of the operators
11. Assistance to families: providing the families with
economic, material, affective, pedagogical
12. Convivial planning of the urban space: the local
political authorities, as well as urban planning