Monday, 17 August 2009

Community-based Rehabilitation and Mental Health

An international workshop on "CBR and Mental Health" was organised just before the First Asia-Pacific CBR Congress held in Bangkok in February 2009. 50 persons coming from 20 different countries had participated in this workshop.

The full report on CBR and Mental Health can be downloaded from AIFO website in Word and PDF formats.

The main conclusions of this workshop were as follows:

Persons with mental illnesses are often surrounded by strong stigma and prejudice. Persons with mental illness and their families are often marginalised. Their human rights are often violated, they may be put into prisons like criminals and many countries have laws that violate their human rights. Some times, persons with mental illness are closed in old institutions and kept in inhuman conditions.

There are few mental health referral services and professionals in many developing countries. Similarly, community mental health programmes are very few and limited. Often persons with mental illness lack access to mental health services and face barriers including difficulties of accessing regular medication.

Many CBR programmes do not include persons with chronic mental illness in their work. There is lack of understanding, knowledge and skills about management of mental illnesses.

There are positive examples of CBR programmes showing great deal of convergence with community mental health programmes. Both are based on human rights approach. CBR is an effective and empowering approach for reaching persons with disabilities including persons with chronic mental illnesses.

There is need to develop capacities of persons with mental illness, their families, communities, primary health care workers and CBR workers about mental illnesses and how can persons manage them more efficiently at community level. CBR can be the vehicle to extend and support the community mental health services. CBR programmes have to make efforts to promote inclusion of persons with mental illness in their work.

CBR programmes work through active participation of persons with disabilities, who are supported to form user groups, self-help groups, peer groups and DPOs. Supporting and promoting user groups of persons with mental illness is an effective way to promote their active participation in the CBR programme. If user groups can play decision making role in all stages of CBR programme from planning, to implementation, monitoring and evaluation of activities, programmes can answer their real needs and it is empowering.

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