TO THE LOCAL AND EUROPEAN
SOCIAL AFFAIRS AND HEALTH CARE OFFICIALS
"From Exclusion to Participation: an impossible challenge
Conclusion of the 3rd European Seminar
Paris 18-20 May 1995
"All human beings
have the right of access to the best mental health care available, in the framework of
health system and welfare. (Resolutions 46/119,1.1, Gen. Ass.
"Poverty is the most lethal decease of the world..." (Report on the world health, WHO, May 1995)
People who live in social precariousness (poverty/extreme poverty) and health
precariousness (illness/mental illness) and who are already installed in, or who might
undergo a marginalisation and exclusion process "could take part" fully in
citizenship, if a radical change of aptitude towards them could allow a step further,
going beyond a mere "charity assistance".
Two fundamental conditions for meeting this challenge are:
- the poorest become THE priority in the political programmes' elaboration,
- the poorest find their place as active subjects in the initiatives and projects.
Therefor we recommend
- General objectives: implementing all the measures for receiving, supporting and
accompanying, so that:
- the assisted, disqualified, vulnerable people can find back their identity, their
specific and active place,
- the people still integrated, in spite of their poverty situation and precarious health,
stop being isolated and above all maintain their housing,
- the homeless who do not have their own house do not worsen their health condition.
2. Comprehensive prevention and accompanying policy:
- crisis: in case of loosing their housing and/or emergency hospitalisation, preventing
the "crisis" situation to be tranformed into a "permanent and
- continuity / duration in the time: guaranteeing the continuity of the health care
(treatment) and the accompaniment (support) to the disadvantaged people,
- discharge / de-institutionalisation: insure that once discharged of an institution
(psychiatric or not) all the necessary conditions are filled in for re-insertion:
preparation for discharge, guaranteeing an "adapted" housing, continuity of the
health care, accompaniment, specific intervention and accompaniment programs outreach
(going and meeting) and welcome (receiving) the people who live in "chronicity",
(ill and at the street).
3. Defending the human rights which requires the access right
to information to the rights, vigilance
for their implementation, and court
in case of denial:
- right of "living" in dignity,
- right to health, accessible to all within a hospital and oustsite,
- right to emergency shelter, but mainly to housing, even if specific and differentiated,
- right to employment according to the possibility and situation of each one.
FEATURES OF THE ACTIONS
- Involvement and reliability of the "users" so that they themselves become
"actors" of a society project,
- Personalisation, adeguation and continuity of "follow up, accompanying" of the
person, in his/her environment,
- Coherence with other actions - projects:
- articulation between the social and the health sectors;
- integration on the territory (community care),
- Involvement of civil society,
- Involvement of the institutional and political officials.
MEANS at the local and European level for implementing those recommendations
- Partnership between public administrations and private institutions / associations,
- Networking giving incentive to synergies of specific skills between:
- the public and private sectors, health and social sectors,
- voluntary associations and professional institutions,
3. Assessment which is above all a state of mind
(questioning), but also a technique which facilitates
the adequation between the
"services" and the "needs", through research-action.