Harassment and discrimination faced by people with psycho-social disability in health services. A European survey

The action project "Harassment and discrimination faced by people with psycho-social disability in health services" is organised in the framework of the Community Action Programme to combat discrimination 2001-2006, and is funded by the European Commission (EC) – DG Employment and Social Affairs. The preparatory phase was concluded in March 2002. Between October 2002 and August 2003 the project was developed further on. In September 2003 the EC approved the results, and a third phase is funded in which the results will be disseminated. The German Organisation of (ex-) Users and Survivors of Psychiatry BPE replaced FNAP Psy, the the French network of users' associations.

GOALS

The project aims through a European partnership of European/national/regional organisations to collect information on discrimination against people with mental health problems in health services and/or with a psychiatric history (both general health care and mental health services) on strategies to tackle this discrimination. While everybody has the right to health care, discrimination towards people with mental illness and/or with a psychiatric history may take different forms, e.g., hostility, degrading jokes and remarks, disbelief, violence such as involuntary treatment, seclusion or even sexual assault, and it can take place at several levels: access to services (hospital, dentist care, rehabilitation centre, emergency service, etc), information, type of treatment, attitudes of staff, different level of funding between somatic and psychiatric health care services.

PARTNERSHIP

• Bundesverband Psychiatrie-Erfahrener e.V. (BPE) – German Organisation of (ex-) Users and Survivors of Psychiatry (2003 – 2004)
• European Network of (ex-) Users and Survivors of Psychiatry (ENUSP)
• Pro Mente Austria – represented by Pro Mente Salzburg
• Cliëntenbond (NL) – Dutch organisation of (ex-) users and survivors of psychiatry
• FEAFES (E) – Confederación Española de Agrupaciones de Familiares y Enfermos Mentales – Spanish Confederation of Family Grouping and Mentally IIl People
• Mind (UK) – British largest Mental Health Charity covering both England and Wales
• FNAP Psy (F) – Fédération Nationale des Associations de Patients et [ex] Patients "PSY"; French network of users' associations (2002 – 2003)
• LUCAS Institute (B) – a research and training institute
• Mental Health Europe (MHE)

Co-operation will be sought with organisations of health professionals at national/regional and European level (e.g., European Standing Committee of Nurses, European Standing Committee of Doctors, European Hospital Federation), and with national/regional authorities.

EXPECTED RESULTS

There are 3 objectives to be reached:

1. To collect information and hard facts on discrimination based on different types of indicators of stigma and discrimination (service related indicators, self rating of (ex-) users and survivors of psychiatry and relatives, legal provisions, establishment of interested groups).
2. To identify strategies to combat discrimination against people with mental health problems and/or with a psychiatric history within general health care and mental health services.
3. To disseminate and raise awareness about strategies to overcome discrimination against people with mental health problems and/or with a psychiatric history within general health care services.

METHODS

Step 1 – to collect information on discrimination facts (September 2002 – January 2002) To increase the knowledge on discrimination, several indicators of stigma and discrimination will be envisaged:

• self rating of (ex-)users and survivors of psychiatry and relatives regarding experienced and perceived discrimination
• legal non discrimination provision concerning people with mental health problems and/or with a psychiatric history
• the resources available for mental health care
• the way the movement of (ex-) users and survivors is organised in each country involved in the action project (e.g., self-help groups, advocacy groups).

Step 2 – to identify strategies to combat discrimination against people with mental health problems and/or with a psychiatric history (February 2003 – May 2003). We expect that this step will highlight the most relevant strategies to combat discrimination against people with mental health problems and/or with a psychiatric history in health care. MHE believes that (mental) health organisations and (ex-)users/relatives organisations should work in collaboration with health professionals in this phase of the action project. It is necessary to establish a dialogue between these groups in order to find projects that implement strategies to combat the discrimination. ENUSP believes that organisations and rights of (ex-)users and survivors should be strenghtened.

The National Partners will identify projects and strategies and will organise Focus Groups with health professionals and (ex-) users and survivors of psychiatry.

Step 3 – to raise awareness about discrimination faced by people with mental health problems and/or with a psychiatric history in health care services and ways to overcome it (from June 2003) Different target groups should be reached at national and European level:

• disability organisations
• organisations of (ex-) users and survivors of psychiatry and of relatives
• health professionals
• politicians and decision makers

To do this, specific activities and materials will be produced, e.g., brochures, seminars, etc.

EVALUATION

Evaluation will be carried out at two levels:

• at the level of the co-operation between the partners of the project and
• at the level of the strategies to combat discrimination.