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2016 04 30

Two years of intensive mental health and human rights advocacy: Growing civil society


Since the declaration of independence, Lithuania has been walking on a windy road towards a modern mental health awareness, respect for human rights and consolidation of modern mental health services development. Although, in 2007 was adopted to modern mental health care principles corresponding Lithuanian Mental Health Strategy and in 2010 ratified the United Nations Convention on the Rights of Persons with Disabilities, initial enthusiasm to get rid of the perverse legacy of the Soviet system weakened in the face of deeper than expected cultural trauma, lack of political will and inertia of the system itself. So during the past decade mental health questions were not prioritized in the state and members of the society quietly made peace with reforms that were not being implemented, low-quality services, human rights violations, public health emergencies that no one was dealing with (suicide, alcohol use problems), and the responsible authorities that did not experienced strong push for urgent reforms.

In response to this situation at the end of 2014 “Mental Health Perspectives” started implementing a project called "Towards mental health and human rights advocacy in Lithuania: The role of NGOs". With this project it was aimed to move stagnated mental health system modernization processes, contribute to democracy and social justice development. In order to implement all these goals, first of all, was decided to strengthen civil society.

At the end of this project, it was estimated that one of the biggest achievements was non-governmental organizations and experts coalition activities. Coalition for Childs’s Rights in Lithuania and Coalition “Mental Health 2030” brought together experts and nongovernmental organizations working in the field united by the modern approach to mental health and human rights. In this way, not only a space for sharing of ideas and discussions was created but the role of civil society itself was strengthened. During the project “Mental Health Perspectives” together with coalition polished their positions and took coordinated action by engaging in the political process. They prepared and sent dozens of letters to decision-makers, executed several meetings with various representatives from ministries, the Presidency of Lithuania, European Parliament, Vilnius city government and participated in work groups organized by Lithuanian ministries. In these meetings was represented NGOs position and defended people with mental and psychosocial disabilities, as well as, mental health service users and rights of children. All Lithuanian parties were addressed as well, in order, to encourage them to include mental health priorities to the new electoral programs and they also were offered the necessary expertise to do that.

One part of coalition activities were determined by the aim to promptly respond to political or social issues, the other part was coherent and targeted towards long-standing problems. Although in Lithuania necessary legal steps were carried out and EU structural funds were used to implement social care homes reform, its results are not yet visible, while transparency and the quality are questionable. “Mental Health Perspectives” a year ago, carried out monitoring of the reform that showed the same result as 10 years ago, stagnant approach to the right of the people to live in the community. Adults and children are still separated from the public in institutions, which do not guarantee human dignity, deny freedom of choice and opportunities for growth. In the absence of alternative community-based services, people that have mental or psychosocial disabilities still fall within the residential care system and even worse – are forced to wait in long queues to get into these flawed institutions. In isolated cases, into the public horizon burst information about serious violations of human rights in social care homes (For example, “Mental Health Perspectives” publicized the case of the use of restraining measures) but even the goodwill of employees or the renewed buildings do not change the human rights violation culture. During the project, it was aimed to inform the public about these issues, which recently were highlighted by UN Committee on the Rights of Persons with Disabilities that assessed the situation of people with disabilities in Lithuania.

Another important achievement of the project is "Lithuanian strategy on mental health and suicide prevention alternative action plan 2016-2018” which was prepared together with coalition “Mental Health 2030” and presented to the public and decision-makers in May of 2015, during the conference held in Lithuanian republic parliament. In the publicly presented and for discussion submitted plan were named concrete and realistic steps, which were necessary to carry out to strengthen children’s mental health, develop community-based services, transform primary mental health care system and implement suicide prevention. Although the political will to carry out the proposals was lacking at the time, the achievement could be considered consolidation of proposed solutions and intense discussion in the public discourse. Preliminary expectations surpassed huge public interest and after the conference emerged debate in the public space.

To involve civil society into the debate on mental health and reveal why these issues are relevant is as important as other goals raised during the implementation of the project. “Mental Health Perspectives” by constantly publicizing the positions of international organizations and reactions to Lithuanian actualities almost ten times increased the number of news followers in social networks. In the media appeared more than 100 articles, related to project activities or intended to deepen public understanding of mental health. Communicated with journalists themselves, in pursuance that mental health topics would be properly represented without discrimination of vulnerable persons. Thanks to established contacts, some journalists constantly ask for competent comments. In order to continue to develop the training of mental health topics related sales, a virtual platform was created that facilitated the organization of such training.

It is safe to say that the project strengthened the “Mental Health Perspectives” organization which had the opportunity to refine its strategy and goals. Needed advocacy skills acquired and strengthened expert and public organizations coalitions. Slowly but consistently the public discourse about mental health questions is changing and the signs start to appear that stagnation can be set in motion, and those changes not only necessary but also possible.

The project "Towards mental health and human rights advocacy in Lithuania: The role of NGOs" funded by the European NGO program “EEA Grants”

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2015 05 14

Lithuanian mental health system: the search for the best solution

 

For the first time in Lithuania an NGO initiated and together with the Ministry of Health, Committee on Health Affairs of the Parliament and Vilnius University organized international conference „Mental Health Policy in Lithuania and Europe 10 years after the Helsinki Conference: from ‘the vision of needed changes’ to ‘actual results’ will be held on the 15th of May. Lithuanian and international experts will discuss mental health policy devepolments and will present an Alternative Lithuanian Mental Health Strategy and Suicide Prevention Alternative Action Plan 2016 – 2018.

The World Health Organisation (WHO) approved the Mental Health Declaration and Action Plan for Europe 2005-2010 at the Conference of the Health Ministers for the European Region in Helsinki in the year 2005. This policy document set out evidence and fundamental values-based principles for strengthening and safeguarding mental health in Europe. This was intended to provide guidelines, which could be used to improve society‘s mental health indicators and address mental health problems more effectively. One of the most important conditions for this to become reality, was a firm decision needed by all member states to review and redistribute the quantity and quality of investment in mental health; redirecting national resources towards such prevention, treatment and rehabilitation services, that would reduce social isolation, guarantee respect for human rights and non-discrimination, as well as strengthen psychological resistance of individuals, groups and communities.

During the abovementioned period the attention of Lithuanian society, decision-makers and media has been mobilised, and the Ministry of Health undertook the opportunity for Lithuania to potentially become the leading member state in putting the Mental Health Declaration and Action Plan for Europe in practice. Following the Helsinki Conference a working group was formed for development of the National Mental Health Action Plan. This Action Plan was developed as a strategic national health policy document and formally approved by Seimas on 3rd April 2007. It is foreseen to review the progress of the implementation of this strategic policy document in Lithuania at the time of the upcoming Conference. The progress of development of a modern mental health system in the general European context will also be discussed.

Objectives of the upcoming Conference - Lithuanian and international experts in the field will explore and discuss the main changes achieved whilst implementing the Lithuanian mental health policy over the past 10 years - since the Helsinki Conference, 2005. Special attention during the Conference will be paid to the following priorities in the comparative context of the situation in Lithuania and the rest of EU:

  • - Development of community services and deinstitutionalisation;
  • - Involvement of service users and the NGO sector in decision-making processes;
  • - Re-structure of the primary mental health care services sector;
  • - Suicide prevention;
  • - Strengthening of mental health for children.

Conference programme.

We invite you to watch live streaming online

 

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2014 06 26  

Position of the Coalition „Mental Health 2030“ on status change of the Vilnius Republican Psychiatric Hospital into Vilnius University Psychiatric Hospital


Public Organization Mental Health Perspectives approached Lithuanian Government by expressing concerns to the decision of the Lithuanian Ministry of Health to change status of the Vilnius Republican Psychiatric Hospital into Vilnius University Psychiatric Hospital.

On behalf of the Coalition „Mental Health 2030“ Mental Health Perspectives argue that this decision would negatively contribute to the mental health care reform, strengthen biomedical approach and hinder development of community based mental health care services in Lithuania.

Representatives of Mental Health Perspectives shared their concerns and expressed their arguments during the meeting at the Ministry of Health on 26th June 2014 with representatives of the Ministry, Vilnius University, Vilnius Republican Psychiatric Hospital, and other Republican and University clinics.

The final decision is not taken yet and Mental Health Perspectives invites Ministry of Health to analyze consequences of this decision in the light of main international documents (UN Convention on the Rights of Disabled Persons, WHO report 2001 Mental Health: New Understanding, New Hope, The Mental Health Declaration for Europe and the Mental Health Action Plan for Europe (2005) and many others, and offers its expertise at further steps of the mental health reform.

 

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2014 02 06

European experts see historic opportunity for people in institutions


Transition from institutional to community-based care European Expert Group (EEG) has issued a statement welcoming the recent agreements reached on the use of EU Structural Funds in 2014-2020.
Last December the European Council and the European Parliament approved the new EU cohesion policy investment regulations. For the first time they specifically indicate support for the transition from institutional to community-based care. EEG believes that this is a historic turning point, especially given the fact that the European Commission recently approved the Code of Conduct on the Partnership Principled for using European Union Structural and Investment Funds. This is a legally binding document which ensures that EU member states will plan and implement structural fund investments in close cooperation with civil society and other stakeholders.

In the statement EEG calls European Commission:

  • to provide recommendations for the EU member states, in order to give priority to the transition from institutional to community-based care;

  • to ensure that all EU member states are legally obliged to move from institutional to community-based care;

  • to ensure that implementation of these commitments are effectively monitored at national and European Commission levels.

NGO Mental Health Perspectives participates in EEG activities through membership in Mental Health Europe organization and supports the indictated statement. Full statement text available here.

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2014 01 21 

Experts oppose Mental Health Strategy and Suicide Prevention Action Plan

 

Public statement


Mental health and human rights experts who are included theW group formed by the Ministry of Health of the Republic of Lithuania are critical towards and oppose the prepared Mental Health Strategy and Suicide Prevention Action Plan.

Experts welcome Health Minister’s Mr. Vytenis Povilas Andriukaitis political will to solve mental health and suicide problems, but at the same time points out that those initiatives get stuck in the implementation phase.

At the Working group the experts were promoting implementation of contemporary mental health policy and suicide prevention principles, which are clearly stated in the World Health Organization and the European Union documents, as well as Lithuanian Mental Health Strategy approved by the Lithuanian Parliament in 2007.

Experts indicate that all measures, including public education on mental health, a wide range of preventive and clinical interventions, and comprehensive monitoring must comply with those principles. Unfortunately, the strategic plan prepared by the Ministry lacks consistency. It can be described as a list of poorly related measures the effectiveness of which is difficult to assess.

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2013 12 04

NGO Mental Health Perspectives raises wings of change


Aiming to contribute to the development of the civil society and to anchoring of the social justice in Lithuania through initiation of reforms in the fields of the mental health and child’s rights, NGO "Mental health perspective starts the project "Wings of Change". Project is funded by EEA Grants thought NVO Programme.

Project “Wings of Change” was initiated for several reasons. Foremost among these is the fact that Lithuanian mental health and social security policy is based on an outdated institutional models, and community-based services are not developed, as well as there is no effective human rights monitoring mechanism in place. In addition, the NGOs working in this field do not have sufficient advocacy resources and skills to be able to considerably influence political decisions, which up to date are mainly directed to the maintenance of the existing system.

The project will seek substantial systemic changes, as well it will aim to initiate public discourse and political decision-making process in representation of people with mental disorders and their family members. An important task - to strengthen the capacities of the newly created Mental Health and Human Rights Initiative Groups and other NGOs working in the field of mental health and human rights.

It is expected that Mental Health Strategy Action Plan prepared during the project implementation will be reflected in Lithuanian legislation; deinstitutionalisation process monitoring and submitted proposals will result in decisions which are transparent, open and compatible with the needs and the rights of the target groups; as well as persons with mental disabilities right to fair trial will be ensured at all levels.

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2013 09 04 

Expert search for the development of bilateral relations with Iceland’s mental health NGO’s and human rights activists

 

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The Director and Programmes Director of NGO ‘Global Initiative on Psychiatry’ Karilė Levickaitė and Virginia Klimukienė respectively visited Iceland on 25-28th August 2013. The aim of the visit was to build bilateral relations with Iceland’s NGO’s and human rights specialists working in the field of mental health. The visit was funded by the Bilateral Relations Fund of the NGO Programme in Lithuania as a core activity of the project "Expert search for the development of bilateral relations with Iceland’s mental health NGO’s and human rights activists".

During this inspiring visit meetings were held with the representatives of eight organisations as follows: Margret Maria Sigurthardottir of Children's Ombudsman's Office, Head of the Psychiatry Department of the National Hospital Pall Mattiasson, Icelandic Centre for Human Rights – an umbrella NGO that brings together 14 organizations, Margret Linda Asgrimsdottir and Bjarni Thor Petursson of Reykjavik’s Labor Exchange, Mental Health Alliance – an NGO operating since 1949, which is an umbrella association currently hosting about 500 members, the Role Center’s Director Eline Ebba Ásmundsdóttir, the Recovery Centre’s Director Auður Axelsdóttir and finally the Children's Counseling Centre.

As Head of the Psychiatry Department of the National Hospital Pall Mattiasson noted, Iceland has no separate mental health care policy, and in his opinion such a policy is not needed because mental health policy has to be integrated into an overall national health policy. Interestingly, Iceland has nratified the UN Convention on the Rights of Persons with Disabilities and the UN Human Rights Convention’s Optional Protocol (OPCAT), nevertheless, human rights monitoring activities are being actively implemented and shadow reports are being consistently developed.

UN Convention on the Rights of the Child is not only ratified, but also used as the backgound for the national law on Child Rights, which was adopted recently.

It should be noted that the physical restraint at the time of psychosis has long since ceased being applied in Iceland and the number of involuntary hospitalisation’s cases is decreasing every year (it currently stands at only 3.6 % of all hospitalisation cases). The last institution where people who lacked mental capacity lived was closed down in 2010: the law had been passed that people with disabilities have the right to live in the community and receive the support they need there, thus the whole system of care was re-shifted to more empowering and inclusive community-based services.

Our organisation benefited from the site visit for building capacities and gained knowledge and capaccities to advocate for human rights, child rights and rights of people with disabitilies. Also international relations were strenghened keeping new contacts for further advocacy activities in Lithuania.

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Full text in Lithuanian