Glossary

1. Glossary • Support • Care • Disability • Mental Disability • Psychic Disability • Mental illness • Life project • Users • Therapeutic foster families • Social foster family • Evaluation • Temporary care • Respite/relief care • Compensating the handicap • Dependency • Autonomy • Stabilised • Acute episode • Ageing • discrimination

2. SUPPORT A Holistic approach of individuals, including all the dimensions of their situation (housing, family, work, leisure, culture, daily activities…). Taking these needs into account is a process that can be defined. For people with a disability, this is a response to their right to: • Freely choose their life project • Effectively take part to the community’s life • Be the central point of any measure concerning them

3. Care Care might be understood as the means to « carry » the persons possibly depriving them from the status of “subjects”.

4. DISABILITY • The February 11 2005-102 Disability Act for Equal Rights, Opportunities, Participation and Citizenship of people with a disability, introduced within the Social Action & Families Code (CASF) a definition of handicap : « A disability, defined by the present Act, is any limitation of an activity, or restriction in the participation to community life, suffered in their environment by people because of a substantial, lasting or non-reversible alteration of one or several physical, sensorial, mental, cognitive or psychic functions, (a multi-handicap or an impairing health disorder) ».  For the first time a definition of handicap is inserted in the CASF Code, thus officially acknowledging «altered psychic functions» and « multi-handicap ». This definition takes into account the environment surrounding people’s life. This definition is derived from the International Classification of Functioning, Disability and Health aiming at identifying the individual and environmental causes restricting participation, in a perspective of equal opportunities for people with disabilities.

5. MENTAL DISABILITY Mental disability is an expression from the Seventies. Its original meaning essentially covered all intellectual deficiencies Existing theories acknowledge different aetiologies. Mental deficiencies are ranked according to stages. Deficiencies are divided into three sub-groups (advanced, moderate, mild).

6. PSYCHIC DISABILITY • Mental illnesses, like other diseases, can be impairing. • The notion of « disability caused by mental illness » is a statement made in compliance with the International Classification, of the personal and social impacts of psychic disorders on the capacity for autonomy and adaptation of a certain number of affected persons. • The term « disability caused by mental illness » has the advantage of overriding the traditional and questionable opposition between handicap, as a « fixed » condition, and disease, as condition that can be progressive or steady. • In this perspective we will choose the term « psychicdisability ».

7. MENTAL ILLNESS The following is about mental illness and mental disability Traditionally, the core needs of people with a mental disability are considered to be educational aids. The condition of the mentally ill requires therapy and care aiming at a possible cure of the disorders. This distinction made between the deficit of the rational thought (mental disability) and the loss of rationality (mental disease, mind disorders) is often excessive and must be handled with caution: * the disease can stabilise or cause an occasional regression, hence we talk of a disability caused by mental illness. * A person with an early age mental disability can show real capacities to change and progress, and just like anybody, can have real existential problems..

8. LIFE PROJECT With a holistic approach of individuals, including all the dimensions of their situation (housing, family, work, leisure, cultures, daily activities…), one can take their needs into account in a process that can be defined as: Concerned individual OWNING THEIR PROJECT. The array of measures must be made to suit the individual, and not the other way round. The individual is a subject, not an object.

9. THE USER This is the lawful, legal title defining individuals in the framework of medical and social areas.

10. THERAPEUTIC FOSTER CARE IN A FAMILY • The beneficiaries are people suffering from mental disorders, for whom care in a stable replacement environment will be beneficial. • The hospital employs foster families. Official texts: Act n°89-475 from July 10th 1989 Order from October 1st, 1990

11. SOCIAL FOSTER CARE IN A FAMILY • People either unable or unwilling to stay in their home because of the loss of their autonomy or because or their disability. • Remunerated foster care by private persons, in their home, of elderly people or adults with a disability, accredited by the General Council (local authorities). • Source: DGAS (General Direction of Social Affairs) informative briefing of June the 15th 2005, containing all the reference legal texts.

12. EVALUATION • One major challenge to support people with a psychic disability. • Greatly diverging evaluations between psychiatric services and other professionals (social, medico-social, private practitioners) Examples : stabilised condition, acute episodes…

13. TEMPORARY CARE • One possible response to develop and diversify care facilities • Accommodation , day-care facilities. • Beneficial space/time bringing an experience of concrete, real-lifesituations… • The best way to determine a compensation scheme.

14. RESPITE, RELIEF or RELAY CARE • It’s a possible temporary care. • Gives a break to families and carers: it’s a time of respite. • Allows people with a disability to have a different life and/or to envisage a life project….

15. DISABILITY COMPENSATION • It is a right translated into a service offer= the PCH or Disability Compensation Service • PCH is the central financial mechanism within the Act of February11-2005: compensation of the over-cost generated by a disability. • Needs/expectations/ life project/ personalised compensation scheme/multidisciplinary team from MDPH (One-desk Services for People with a Disability)/ CDAPH (Commission for the Rights & Autonomy of People with a Disability). • PCH is about human and technical support; accommodation of housing, vehicle; transports; disability aid-dogs..

16. DEPENDENCY It is a condition in which the person needs partial or complete support in order to perform a basic current life action.

17. AUTONOMY « It’s the capacity to govern oneself, to make choices in one’s life». ‘Petit Robert’ dictionary Consequences : * People with a physical disability have autonomy but are dependent. *Psychic handicap/autonomy = to master know-how, practices, social skills, social/relationships integration in one’s environment.

18. STABILISED • Medical/psychiatric term relating to a patient whose symptoms are relatively controlled by therapy, with regards to his/her disease. • Socially speaking, it means people capable of living according to the rules of the community or work environment …

19. ACUTE EPISODE • Acute syptom of a pathology, existing or latent. possibly life-threatening (epilepsy fit, panic attack, appendicitis, delirium..). • It requires urgent medical and/or surgical response. • From a social point of view, it may be to bring specific and fast support to people, (not necessarily a medical treatment), because of a behaviour, inadequate to community life.. It’s an emergency.

20. AGEING • A moment in life, difficult to define, in which different factors are changing people’s perspective on themselves, other persons, social situations and health status. • Whether people with a disability have a specific way of ageing, is impossible to demonstrate. • To take into account the process of ageing itself, as well as people’s wish to have either collective or individual housing, we need flexibility in the care modalities.

21. DISCRIMINATION • Direct discrimination: when an individual is not treated as favourably as another is/was or would be in a similar context, (according to a list of protected conditions and status listed under the Law.) • Indirect discrimination: when a practice or a norm, seemingly neutral, is likely to cause specific prejudice to individuals, whose condition and status is listed under the Law, and protected.