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IMHCN Charter Articles
- Article 1: Promoting and advocating for human rights for people with mental health issues
- Article 2: Campaigning for social inclusion for service users and their families
- Article 3: Protecting and respecting culture and religion
- Article 4: Developing innovative community based services and supporting deinstitutionalisation
- Article 5: Advocating for new thinking in practice, treatments and care
- Article 6: Encouraging action research in new ways of working
- Article 7: Self determination, wellbeing and recovery for user
Article 1: Promoting and advocating for human rights for people with mental health issues
All over the world there is still widespread stigma about mental health and towards people with mental health problems
This can take various forms;
- complete isolation from the community
- laws that discriminate and exclude people
- suppression and denial by families
- institutional services and practices
- violation of basic human right
- physical and psychological abuse
This stigma and belief system has its origins in how society chose, 200 years ago, to deal with people that they thought were very different from the “rest’ of society. Consequently, this has dictated the nature of the legal response, service provision, clinical practice, this in turn has perpetuated stigma and the social exclusion of people with mental health problems.
Whilst there has been some worthy exceptions to this, they are few in number, compared to the general situation throughout the world.
The IMHCN is committed to work with others to continue to fight all forms stigma and to promote actions and solutions to overcome them.
Some of the actions that can be taken to reduce the misunderstanding and misconceptions of society are:
- No restrictions in life for people with mental health problems in society through laws that discriminate
- Developing educational programs in schools, colleges and universities and vocational learning
- Promoting positive messages and stories of good mental health and recovery to all forms of media (including journalists, TV and Radio producers, online platforms etc)
- Organising effective, consistent and regular anti discrimination and positive identity campaigns within local communities
- Developing publications and other media (e.g videos and audio) to educate the public empowering and enabling carers and users to share their own stories
- Advocating and campaigning for legislation to protect the rights of users.Educating professionals on how to interpret correctly the implementation of mental health laws to the maximum benefit of people with mental health problems.
- Mental health service providers also need to play their part in challenging practices and services that perpetuate stigma and discrimination.
Some essential targets for action include:
- Reducing and ending locked facilities in acute in-patient settings
- No physical or chemical restraint
- Reducing compulsory admissions and treatments
- Reducing the need and use of specialised forensic services
- Reducing the lengths of stay in acute in-patient and other settings
Article 2: Campaigning for social inclusion for service users and their families
We need to Develop the responsibility and commitment of the wider community for mental health through harnessing community resources and seeking the active support and partnerships of local and national community organisations and groups.
The key causal and aggravating factors to good mental health and the opportunities for recovery is improving social determinates in the community. These are factors such as poverty, unemployment, poor housing, lack of education, social isolation etc.
It is also important to move away from the ever increasing preoccupation and misunderstanding that society has about security and risks posed by people with mental health issues. This has led to unjustified anxieties and myths resulting in social exclusion and restricting the potential and real ability for people with mental health issues to play their full part in society.
ActionWe need common purpose and understanding for improving mental health and wellbeing of the population by harnessing community resilience. This will be achieved by the the development by communities of a Whole life Whole Systems Strategy for Mental Health.
The process of developing a strategy will be through engaging with forming partnerships with all relevant community stake holders that have real or potential capacity to improve opportunities and access in all life domains (housing, employment, volunteering, art and culture, sport and leisure and education).
Article 3: Protecting and Respecting Culture and religion
Good mental health is recognised as an integral part of a person’s wellbeing, embedded in all aspects of a whole life, their beliefs, faith, culture, environment, spirituality, work, housing, education, family and community respect.
There is much to be learnt in western countries from the holistic approach practiced in some developing countries.
When assisting developing countries and black and minority ethnic populations within western counties, care must be taken not to promote or impose western ideas and models, as these only perpetuate outdated ideas of a western medical model.
Further, it is important to apply culturally sensitive approaches and competencies in attitudes, understanding and practice towards people all over the world.
To achieve this, recognition and respect for peoples backgrounds, traditions, beliefs, customs and local and natural helping networks must be fully acknowledged.
Article 4: Developing innovative community based services and supporting deinstitutionalisation
The design and development of a community mental health service system should be based on the creation of community mental health services which are integrated, non-stigmatizing, transparent and coherent. The main focus is to enable the development of community strategies that address the wider mental health and well being of people in a given community.
To achieve the development of community health service the fundamental starting-point remains a deinstitutionalisation of all services, this aims to supersede the psychiatric hospitals, but also the danger of retaining an essentially reductionist medical model, which finds expression in current psychiatric practice of only “treating and curing illness”.
The fragmentation of separate responses for specific needs of individuals should be avoided. The primacy of bureaucratic categories and ideologies of exclusion only reproduce separation and depersonalization. Further, notions of ‘primary and secondary’, ‘enduring and common’, ‘serious and mild’ create barriers that prevent the adoption of citizenship and community models of care.
The following basic presuppositions are at the heart of the Network’s drive for modern practice intended to produce positive outcomes for communities and people with mental health problems:
- Breaking the domination of the medical paradigm, and reconstructing and endowing individual life-stories with value in a culturally and community appropriate way.
- We must acknowledge that illness or distress can be an expression of suffering within persons life domains. Therefore the adoption of a therapeutic approach should take the ‘whole life’ of the individual into full account and recognises his or her uniqueness as a citizen of a given community. People do not wish to be excluded because of a mental health problem as everyone has the potential to have a whole life with or without the presence of mental health symptoms or problems.
- We affirm the need to protect human rights as the fundamental element in the care of any individual by supporting a person to good health, whilst protecting and enhancing their status as a citizen.
- A community mental health and social care service system should be comprehensive and integrated with primary and secondary health services. It must be part of a Whole System of social/welfare services, education, housing and employment agencies, meaningful work opportunities, using community resources and operated as a whole community system.
- Wherever people are receiving services it is important to ensure trusting relationships, consistency of approach and continuity of care between services, therapies and treatment.
- All services should be planned and implemented based on IMHCN shared practice, values and principles.
- The lessons learnt from the ongoing deinstitionalisation programmes around the world for the last thirty years need to be captured for policy makers, service providers, campaigners and community leaders wishing to undertake the closure of psychiatric institutions and the development of community wide services.
Article 5: Acting on and developing new thinking in practice, treatments and care
There have been many advances in our understanding of how to promote mental health wellbeing,
resilience and recovery. The evidence for this comes from various sources and methodologies, including individuals, communities, health and social care services from many different cultures. These includes individual testimony of service users and families and research findings.
Research and best practice indicates that there are key innovations that we need to further develop and implement to provide effective support, care and treatment for people with mental health issues.
- New community mental health practice and systems should be based on these foundations:
- All practices should be provided in non-coercive ways and without the use of force or restraint
- Care, support and treatment should be provided to people in their own local communities,in their homes, wherever possible based on the choices made by the person
- Mental health services should be integrated into primary health care systems
- Services must be accessible and available when and where the person requires them, on a 24 hour / 7 day a week basis
- All people regardless of their status must have equal opportunity and culturally appropriate access and experience of relevant service provision
- Identifying mental health issues at an early stage and providing effective support should be provided as quickly as possible
- Care, support and treatment must be person centred and based on individual need and choice
- Practices should incorporate the means to evaluate service user experiences in their use of treatments and supports
- Improved access to effective modern methods including talking therapies
- Mental Health systems should adopt the latest service user led research evidence for delivering effective support and practice
- Mental Health systems should encourage and support the development of user run services as an essential learning in the development of all services
- Effective recovery care practice should be coordinated through Multi-disciplinary Team Work that promotes access to a range of effective services
- Greater promotion of self-management and peer support techniques and skills by service users and family members
- Increasing access to individual talking or psychological therapies
- Developing support to families
- Promoting in everyday practice, opportunities for employment through vocational training, social enterprises and engagement with local businesses
- Promoting the proper and effective use of medication
- It is essential to ensure service users have access to, and the necessary provision of physical health care
Article 6: Encouraging action research in new ways of working
It is necessary that innovative practices are further researched to demonstrate their effectiveness.
Further, qualitative and participatory research needs to be given equal status to quantitative methodologies. Importantly equal care needs to be taken in determining the validity and applicability of current “scientific methodologies”.
Research must be based on peoples experiences and narratives. It should be co-produced and encompass a diversity of view points and positions and relevant to the priorities identified by people, their lives and needs.
New research centres and networks need to be established and further developed, for example the IMHCN Research Network and the Hearing Voices
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Article 7: Person Centredness
People have a responsibility for determining for themselves the lives they lead and their own wellbeing. This is particularly relevant when they are concerns about the persons mental health and well being. The services should encourage and support the important principle of self determination by providing services and practices that support and underpin this.
1. Choice: Service users should be able to determine their own recovery plan in collaboration with their workers, families and significant others. Service providers should accept that recovery is a process requiring every service user to be regarded as a unique individual. Their wishes, needs and hopes should be at the centre of service provision.2. Relationships: The service user should be able to determine the person they want to work with based on the importance of a trusting relationship.
3. Ownership: Service providers should accept that the service users are experts in their own life experience and this should be the foundation of a therapeutic alliance with the expert by profession.
4. Opportunities. The service user should have available the same life opportunities as a person without a mental health problem.