REFOCUS: TRANSFORMATION OF SERVICES IN A NEW ERA

1. REFOCUS: TRANSFORMATION OF SERVICES IN A NEW ERA Jean Pierre Wilken President CARe Europe Professor of Participation, Care and Support HU Utrecht University for Applied Sciences, Netherlands Tallinn, 8 May 2013

2. Welcome Participants from 15 countries Armenia, Belgium, Bulgaria, Croatia, Estonia, Georgia, Hungary, Kazakhstan, Kyrgyzstan, Netherlands, Slovenia, Romania, Spain, Turkey, United Kingdom.

3. Welcome Thanks to: Estonian Psychosocial Rehabilitation Association Tallinn Mental Health Centre Tallinn University Fund Storm Rehabilitation Mental Health Initiative Soros Foundation

4. Established in 2011 with the support of Fund Storm Rehabilitation. Serves professionals, service users and organizations to promote and realise the transition from institutional to community-based and recovery-based care.

5. We are active in the field of mental health care, social care and welfare services for (and with) persons with psychiatric, learning and physical disabilities. We connect practice, research, educationand policy. We connect Eastern and Western Europe (and central Asia).

6. Activities: 1. Disseminating information and knowledge 2. Providing opportunities for meeting, learning and exchange 3. Supporting the development of new initiatives by providing advice and training 4. Encouraging research and development 5. Encouraging partnerships between organisations in different countries

7. In collaboration with Global Initiative on Psychiatry Mental Health Initiative European Social Services Network

8. Our challenge REFOCUS; TRANSFORMATION OF SERVICES IN A NEW ERA How do we create / transform services towards a focus on recovery, personal development and social inclusion?

9. Inclusion is impeded by: * individual factors (e.g. self-stigma, lack of skills, lack of information, lack of self-confidence, poverty)* physical inaccessibility (e.g. buildings) * social inaccessibility (e.g. by stigma; individualised / network society)* inaccessibility legal rights (finances; discrimination)* separation between health sector and social (welfare) sector* one-sided focus of services on institutional life, professional knowledge & disability Facts

10. Field of Mental Health Care Professional -Institutional- Knowledge Experiential knowledge Professional knowledge psychiatrist, therapist, case manager Knowledge based on personal experiences ? RECOVERY= Getting rid of symptoms RECOVERY= Learning to live with and beyond symptoms ? Connecting to meaning, & strengths Peer Support Diagnosis ? Medication, Treatment plans etc. Personal medicine, learning, increasing self-confidence, role models etc. WRAP

11. We know how to support recovery, but are we doing it?

12. Professional -Institutional- Knowledge Experiential knowledge Field of Disability Care Professional knowledge residential workers, therapists Knowledge based on personal experiences CUSTODY= Taking care of persons. Shelter and protection PERSONAL DEVELOPMENT developing skills; fulfilling valued social roles Connecting to meaning, & strengths Social networks Assess-ment of disabilities Care plans etc. learning, increasing self-confidence, role models etc. Personal Future Planning

13. Refocus Shifting towards a new vision: • From focus on the disorder/disability to focus on the person • Experiential knowledge: the value of personal experience, focus on learning/development, peer support • From illness/disability based to strengths-based • From professional-directed to user-directed • From individual to community

14. New standards: Contemporary models of care for people with high and complex needs should be evaluated in terms of the degree to which services support people’s: • presence in the community; • active participation in every day life; • opportunities to develop, exercise and demonstrate to others their competence; • exercise of individual choice; and • dignity and rights (both legal and human) (cfO’Brien, 1992; Wilken, 2007)

15. So please: re-focus!