THURSDAY  17 ^th JUNE
 DIGNITY  and  DAILY LIFE

  INTRODUCTION
  WELCOME by Neil Davies - SAD (CZ)
  PRESENTATION of SMES-EUROPA by Luigi Leonori  President of SMES-EUROPA        

  SHARING OF TESTIMONIES
  Testimony from daily life of any current and former users of services

Presented by Pavel Penkava:

Ostrov nad Ohří State Penitentiary, 13th June 2004

Dear Sir or Madam

My name is Václav.

I am currently serving a stint in jail.

I am an homeless invalid with rich criminal record.  Sounds silly, doesn´t it ?

I am not wholly aware of the issues to be discussed at your conference, but I plead that you have it on your mind that we are, too, and perhaps just due to it, mere humans.

I beg you to stay always on the side of those who need help of any form.

Regards,

Václav, a convict.

At name of all participants, Luigi Leonori asked to Pavel Penkava presenting to Václav many thanks for participation in the conference and insurance that SMES will implementing and improuving the promotion of  "human dignity and right's respect" with especially attention in prisons too.

   *  ...
   *  ...
   *  ...
 discussing with Lucie Ripova, Pavel  Penkava and Neil Davies.

 FRIDAY  18 ^th JUNE
 DIGNITY  and  RIGHTS

 OPENING
     Mr Neil Davies  - Representing of SAD 
     Ms. Hana Halová - Counsilor on Health and Social Affairs of Prague Municipality
     Mr. Luigi Leonori  - Presentation of  "D&H-5Project" and the 8° European Conference.         

THEME:  Human dignity and the right to health care

Chapter I of the Charter of fundamental rights of the European Union is entitled « Dignity » and Article 1 borrows from the German Grundgesetz the principle of inviolability of human dignity.

The following introductory remarks will be divided into two parts : first a short evocation of the philosophical sources of the concept of human dignity and second, a review of the modalities of access to the effective enjoyment of such right, namely in the field of health care.

I.  Philosophical Sources of Human Dignity

The very concept of human dignity goes back to the earliest Antiquity, Christian and pagan.  The human being is invested in the Creation and above all other living beings with a dignity which makes him according to a Cartesian expression “master and possessor of Nature”.  One is nowadays conscious to what excesses has been brought the exploitation of natural resources. Such criticism which is akin to ecological preoccupation is stressing the aristocratic ideal which seems inherent to human dignity.

The exploitation of nature and its consequence, the destruction of the environment is a violence made to nature — in Latin and in latin languages the word is feminine and it suggests that, as women have been and still are, nature is the victim of the violence and the greed of men. The word “rape” is perfectly fit to describe the exploitation of nature, which was assumed by rich peoples for the benefit of the rich at the expense of the poor, Indian communities, slaves, workpeople devoid of any right. It would be too simple to oppose North to South.  All inhabitants of the Northern countries do not share in the exploitation of natural resources and there exists in the South social strata which are helping in the looting.

The most actual philosophical expression of human dignity has been framed in the last years of the eighteenth century by a German thinker, Kant.  Human beings may not be treated as an object or a means, but as an end.  The Kantian golden rule is : “behave against the other as you wish to be treated yourself”.  Kant adds : “humanity is itself a dignity”.  The notion of humanity is universal : dignity belongs to every human being, whatever his or her race, religion, nationality.  The international provisions which forbid discriminations are only referring to such criteria.  Poverty, destitution, ignorance are no sources of discrimination because one does not want to be conscious that such discriminations are engendered by the social fabric.

The aristocratic origin of the concept of dignity is corroborated by a semantic usage which is more alive than the egalitarian approach.  The word points to a function or an attribute which distinguishes and separates their holder from all other human beings : such as the royal dignity, the episcopal dignity, etc.  In the dictionaries of theology, either of protestant denominations or of the Catholic church, the word “Dignities” makes no reference to the dignity of all men and women, but to the attributes invested on dignified persons.  According to Cicero, “dignitas” is a virtue of the male, corresponding to “venustas” (Venus) in the fair sex. 

II.  Juridical consequences of the concept of human dignity and their application to the field of health care

Some international instruments — but not the European Charter — set health among the fundamental human rights.

Art. 25,1 of the Universal Declaration of Human Rights (1948) :
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services …

Art. 12,1 of he International Covenant on economic, social and cultural rights (1966) :
The State Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. 

See also Article 11 of the European Social Charter (1961).
In the European Charter, the enjoyment of health is dealt with in two articles.

Article 3, Right to the integrity of the person

Everyone has the right to respect for his or her physical and mental integrity.
In the fields of medicine and biology, the following must be respected in particular :
-          the free and informed consent of the person concerned, according to the procedures laid
        down by law,
-          the prohibition of eugenic practices, in particular those aiming at the selection of persons,
-          the prohibition of making the human body and its parts as such a source of financial gain,
-          the prohibition of the reproductive cloning of human beings.

Those provisions protect everyone against state’s immixtion within the bodily integrity.  It does not guarantee any effective access to health care, which is contemplated by another Article.

Article 35  Health care

Everyone has the right of access to preventive health care and the right to benefit from medical treatments under the conditions established by national laws and practices. A high level of human heath protection shall be ensured in the definition and implementation of all Union policies and activities.

The first sentence contains a notable restriction : ”under the conditions established by national laws and practices”.  The Charter hand over the protection of health to the legal order of each state.  No trace whatever of a fundamental right enjoying a higher level of protection. The second sentence is a pious vow.

As other economic, social and cultural rights the right to health care is handicapped by the necessity of requiring positive prestations of the collectivity. Traditional human rights, those which are fairly well guaranteed by the European Convention protect the subject against States’ aggression or immixtion.  Such is also the nature of Article 3 of the European Charter.  It is much more difficult to realize rights implying a positive performance of the collectivity.

No progress can be contemplated but for a strong action of the organs of the civil society.  Public authorities have to be required to implement a health policy favourable to the needs of the most destitute.  Health care expenses have become a burden of the collectivity.

The actual choices remain elitist : sophisticated medicine instead of a preventive one, favour to health care of already privileged people.  In democratic states, each citizen is, through the electoral process, able to influence the state : the access to health care for the most destitute should be an objective of political parties and NGOs should act in that direction.

I shall terminate by the quotation of a German poet : Friedrich Schiller, who had retained Kant’s doctrine, embodying it in a manner adapted to the subject-matter of this conference :  

Würde des Menschen
Nicht mehr davon, ich bitte euch.  Zu essen gebt ihm, zu wohnen,
Habt ihr die Blösse bedeckt, gibt sich die Würde von selbst.
(Schiller, Epigramme)

Human dignity
      Don’talk any more, please.  Give him food, lodging,
      Cover their nudity, dignity will follow by itself.
      (Schiller, Epigrams)

François Rigaux
Prof emeritus of the
Université catholique de Louvain

 1. HEALTH    :       Access on Heath /Mentale Health,             ? 1st seminar in  Prague, 
     Neil Davies,  S.A.D.  (CZ)                                                                                                       

 2. RESOURCES:   Decent life ressources                                 ? 2nd  seminar in Bucarest          
                                       Marieta Radu, Casa Ioana (RO)

 3. HOUSING:          Housing - identity - privacy                            ? 3rd seminar in Sofia            
                                       by Douhomir Minev, EAPN,  (BG) 

 4. JOB :                 Marginalisation & work                              ? 4th seminar in Warszawa         
                                      by Andrzej Czarnocki, Caritas, (PL)

 
1.   POLISH CONTEXT  :  SOMETHING TO BE RECKONED WITH IN A UNITING EUROPE

• 38 million inhabitants

• 30% of people in direct risk of poverty

• 30-80 thousand homeless people

• 7-10 million people directly and indirectly affected by alcohol abuse;

• 3% with serious psychic problems – another 17% diagnosable with psychic problems

• 20% unemployment rate reaching is some areas 40% and more - 40% unemployment rate among young people - 14% employment rate among the disabled

 5. EDUCATION :     Appropriate & universal education               ? 5th seminar in Riga                     
                                         Rita Erle,  Street Children Project  (LV)

  
No dignity without exercising the citizen’s rights !

 Each workshop should be able to articulate, as regards reflection as well as exchanging experiences, the social field to the health fields in order to avoid – in as much as possible – a mere juxtaposition, where there is no relation. We would like to avoid the workshops to just focusing on poverty or on mental health of the tramps or homeless people. We would like them rather to explore the complex relationships that exist among all these social and health elements.

  DIGNITE ET CITOYENNETE, FACE A LA NON DEMANDE D’AIDE :QUELQUES QUESTIONS.

Une catégorie de personnes peut ne plus vouloir rien demander : ceux qui vivent à la rue de manière chronique, sans avenir autre que cette quotidienneté répétitive émaillée d’offres d’assistances qui s’inscrivent rarement dans un projet de vie à long terme. Au bout d’un temps souvent long, très long, le désenchantement et les illusions de l’alcool finissent par avoir raison de toute demande d’aide. Derrière cet abandon majeur d’une quelconque accroche de lien social, c’est l’identité elle-même qui finit par être anéantie. Si, comme nous le pensons, en suivant Hannah Arendt, il n’est possible de parler de dignité qu’à partir du moment où elle s’attache à considérer l’homme dans son engagement de parole au sein de la cité, si donc la dignité sous-tend l’accession et la non remise en question pour l’homme de sa citoyenneté, alors, dans ces cas d’exclusion majeure et chronique, le refus d’assistanat pourrait être entendu de deux manières :
*  Dans les plus graves cas, ce refus témoigne de la perte de toute pulsion de vie autre que celle apportée par la satisfaction immédiate des pulsions primaires : manger, boire, dormir, boire de l’alcool, - parler de dignité est alors difficile, voire dangereux, car la pensée, le souvenir, le projet singulier est alors aboli.
*  Dans d’autres cas, heureusement plus fréquents, le refus peut au contraire s’entendre comme un ultime sursaut de dignité : au-delà de la honte, en deçà de l’accès à la citoyenneté active. La personne exclue, par son refus de l’assistanat, peut en effet être entendue comme celle qui attendrait d’être reconnue dans sa dignité : par un projet de vie qui la remettrait dans une position de sujet social.
Ces constats nous amènent à l’interrogation suivante : et si c’était notre propre dignité, à nous, soignants, intervenants sociaux et bénévoles, citoyens témoins de cet abandon majeur de toute une population, qui nous mettaient dans l’obligation de prendre la parole au nom de ces hommes, femmes et enfants devenus invisibles parce que silencieux ?
La dignité devient alors un concept important, qui permet d’interroger nos propres positions au-delà du seul aspect compassionnel ou humanitaire souvent mis en avant.

Sylvie Quesemand Zucca,
psychiatre psychanalyste,
Réseau Souffrance Précarité

 Samusocial de Roumanie: un dispositif d’intervention en urgence pour les personnes en crise socio-médicale

Quand on parle des ressources, on se réfère implicitement aux besoins. Pour ceux qui travaillent avec les personnes en crise psycho-socio-médicale la première démarche est de se focaliser sur l’identification des besoins des bénéficiaires. Une autre démarche, aussi importante, est d’évaluer et de connaître les services sociaux qui existent dans la communauté et auxquels on peut faire appel. A l’heure actuelle il existe à Bucarest une discordance entre les besoins de la population dans la rue et les services offerts, dans le sens que les nécessités vitales des personnes socialement exclues ne sont pas couvertes. Dans ces conditions, les travailleurs sociaux (assistants sociaux, médecins, psychologues) sont soumis à une suprasollicitation et souvent le phénomène"burn out" surgit. Le Samusocial de Roumanie offre un complexe de services socio-médicaux d’urgence pour assurer la survie, au moins décente, des personnes socialement exclues. On essaie en même temps d’établir des liaisons avec d’autres organisations et institutions en vue de créer un réseau de services qui se soutiennent reciproquement.

Victor Badea
Samu social din Romania
Fax: 0040212527623    
samusocial_admin@pcnet.ro

Health and Homelessness : The role of FEANTSA

Housing and Homelessness

• Housing is an important element in tackling homelessness, but the housing dimension of homelessness varies from country to country:  
  -   Belgium:  housing is a priority in homeless policy
  -   Ireland  :  focus on other forms of support

• Homelessness is not only a housing issue – education, independent living, employment, and health

• Link between health and housing: Bad temporary shelter conditions/housing conditions are associated with a number of health problems – both physical and mental – e.g. little privacy or security, sharing facilities such as kitchens and bathrooms, typical problems of poor quality housing such as overcrowding, dampness, cold

Mental health and homelessness

• Homelessness is really the end of an exclusion process – so homeless people tend to be excluded from all services, including health services

• The health problems of the homeless: depression, anxiety, borderlines personalities, stress, lack of confidence (often due to childhood traumas)

• Children of homeless families are prone to behavioural disturbances, poor sleep, etc

• So from FEANTSA’s point of view, health is important in relation to homelessness:
  1.   It may be a factor which triggers homelessness
  2. Health treatment is a crucial step for reintegration – unmet health needs may contribute to trapping people in homelessness

Role of FEANTSA – link between homeless issues and EU policy

• While the European Observatory on Homelessness carries out research on the causes of homelessness and the profile of the homeless, FEANTSA focuses on creating links between homeless issues and EU policy-making

• Our members work with governments and ministries at national level - FEANTSA works with EU policy-makers to improve knowledge of homelessness and to improve policies addressing homelessness

• Working groups – statistics, employment, housing/right to housing, health

Feed the results into the EU policy framework

• EU policy framework: We monitor closely the EU Social Inclusion Strategy, European Employment Strategy, Services of General Interest, etc.

Open method of coordination - much potential/much scope for learning

• Our aim is to continue strengthening the fight against homelessness – the best way is to establish an integrated strategy (within the framework of the EU Strategy). A strategy combining all relevant actors in the fields of health, housing, employment, social support, rehabilitation, etc, which works on two fronts: prevention and reintegration

Results of FEANTSA strategy

• Homelessness is a complex and wide-ranging issue: unlike a targeted rough sleeping strategy which has a very clear target of getting people off the streets, FEANTSA tackles different types of homelessness : rough sleeping, sleeping in temporary shelters; sleeping in inadequate housing, sleeping in insecure housing

• Nevertheless, the results are visible

• Homeless statistics – FEANTSA is a member of the homeless taskforce coordinated by Eurostat. We offer our expertise to develop indicators for the EU Social Inclusion Strategy and EU Housing Ministers to develop homeless statistics/indicators

• Publications of the European Observatory on Homelessness

• Active Participation of FEANTSA in the EU Peer Review Programme on the England Rough Sleepers Strategy (FEANTSA carried out a “shadow” peer review amongst its members throughout the enlarged Europe)

Enlargement of the EU/Enlargement of FEANTSA

• FEANTSA has now enlarged to encompass member organisations from all EU25 except for Cyprus.

• Evaluation - We are currently therefore evaluating the impact of Enlargement on the objectives of FEANTSA by revising our strategies and our instruments taking into account the new challenges in the New Member States

• The increasing differences in EU25 countries are perceived as a resource for improving policies and exchange

• We encourage our members to work together  - transnational CATCH project, NAPs Awareness, etc, etc

• But no sector can achieve its aims without partnership with other sectors – and FEANTSA is open to projects with organisations working on health issues or with mental health patients.
   

Social Co-operation in Italy:                                                                                         
The Contribution to Working Insertion and Job Policies
Gianfranco Marocchi  -  Idee in Rete - Consorzio Nazionale

While in the eighties the third sector stimulated public welfare state and anticipated innovative services that would be later assumed from the public sector, in the nineties it developed a prominent role in direct production of social welfare services.

There are about 6,500 social co-operatives in Italy, with 200,000 estimated total workers. Their sphere of action consists of managing social welfare services (e.g.: elderly people house assistance; household communities and day services for disabled and children; drug addicts treatment) and of inserting disadvantaged people (disabled, prisoners, drug addicts, mental patients, diseased minors) in self supporting market productive activities.

The role gained in services production and the reinforcement of economic solidity (about 6.5 billion Euros of aggregated income) determined the entrepreneurial evolution of these organisations.

The two main social co-operatives spheres of action that are a) the supply of welfare services and b) the insertion of disadvantaged people in self supporting productive activities. The second of these fields is described in this abstract.

Working insertion social co-operatives provide job occasions and professional and personal growth chances to disadvantaged people; therefore these co-operatives can perform any enterprise activity – agricultural, industrial, commercial, tertiary activity – but they have to reserve to disadvantaged people almost 30% of job positions; social co-operatives predispose individual inserting projects that are often compiled in collaboration to social services. According to law 381/91, disabled, drug addicts, mental patient, prisoners, diseased minors are disadvantaged categories.

Insertion results can be, in case of success, both job finding in profit enterprise and permanent integration in the same social co-operative.

Many research state that working insertion project, frequently take to stable jobs; these research also state that anyway insertion projects bring to a personal and professional growth and also that economic advantages (lower assistance expenses, tax yield from disadvantaged people employed thanks to social co-operatives), are higher than costs (state coverage, possible local support measures).

Local administrators have appreciated this activity and they have reserved, according to law 381/91, job orders to social co-operatives to promote working insertion. In this way local administrators perform a social intervention through ordinary expenses like green areas maintenance or public buildings cleaning.

1. What Social Co-operatives are
1.1. Introduction
1.2. Birth, Development, and Juridical Acknowledgement of Social Co-operatives
1.3. Social Co-operation today in Italy
1.4. Social Co-operation Peculiarity

2. Social Co-operative Activities
2.1. Social Services Co-operatives in Welfare Renovation
2.2. Working Insertion and Job Policies
2.3. Developing Sectors: not Welfare Personal Services and Services to Local Community

3. Social Co-operatives Integration and Relationship with other Third Sector Organisations
3.1. Integration among Social Co-operatives
3.2. Integration among Social Co-operatives and other Organisations

4. Social Co-operation and Social Enterprise in Europe

President: Gianfranco Marocchi
Place: Piazza Vittorio Emanuele II°, 31 00185 Roma
Tel.: 06-490821    Fax: 06-491623   e-mail: ideeinrete@libero.it

SMES
Networks

 Paris and SMES Network                                                                   

 SMES Network   E
 SMES Network   B 

SATURDAY 19th JUNE
FIGHTING AGAINST POVERTY and
EXCLUSION for DIGNITY and HEALTH

   THEME:  Using NAPincl as an instrument for inclusion process                                      
   "ERADICATE  poverty - exclusion - homelessness ...:  between utopia and challenge"              
     by Mr. Huges Feltesse, repr. Of Unit E2 Politics and programmes for inclusion of the European Commission

The EU's Social Inclusion Process

The Open Method of Coordination Aim: "to make a decisive impact on the eradication of poverty and social
                                                                         exclusion by 2010"

Lower life expectancy than EU15 (men -5 % women -3 years)
Poor basic services
Big regional and rural/urban differences
High risk Groups:
-   Roma
-   homeless
-   people with physical/ intellectual disabilities
-   ex-prisoners
-   people with poor heath
-   people in or leaving institutions
-   the mentally ill
-   alcohol and drug abusers

Further Information
DG Employment and Social Affairs web site on social inclusion:
http://esnet.cec/comm/employment_social/soc-prot/soc-incl/index_en.htm
 

1.  Presentation of CZ Joint Inclusion Memorandum JIM,                                             
       by Ilja Hradecky,  Naděje Director

A Brief History

2.    Presentation of "Piano Regolatore Sociale"
       Franco Alvaro,   Director Dip. V of  Municipalité de Rome.

SYNTHETIC FRAMEWORK OF THE  SOCIAL
REGULATORY PLAN  OF THE CITY OF ROME

The law no 328/2000, indicate the basic goals for a social service integrated system, the services have new tasks and resources, and represents a highly integrated public-private initiative.

In the Plan there are six areas of action each with it’s own objectives and measures:
   1.      welfare actions
   2.      system actions
   3.      integration actions
   4.      joined planning between Urbanistic Regulatory Plan and Social Regulatory Plan
   5.      objective projects (plans  for target group: child, older, immigrants..)
   6.      structure of the stretch budget

 In the welfare actions we have six actions:
   ·        access to services
   ·        civic responsibility
   ·        responsible system of welfare
   ·        social inclusion and autonomy
   ·        welfare residential (type: elders, minors, homeless…)
   ·        intervention of social emergency

 This structure assures both the unity of service for the overall dimension of the citizens of Rome  for all its citizens and for specific local needs (welfare for individual district).

 Our objective is to assure all social services at essential levels to all.

 Dignity and Health-Rights and Access, What does the Municipality of Rome do?

 MEASURES-SUPPORT FOR THE HOMELESS

 We can estimate that around 2.000 people live on the streets and around 6.000 live in temporary accommodation and emergency shelters. 1/3 have psychiatric disturbances, 1/3 have alcoholism problems, and a 1/3 is made up of drug addicts.

Extension of rights

Residency represents a right/duty of each citizen, in spite of his or her living conditions. Residency allows one to be a citizen (renew documents, get the pension, exercise the right to vote).

Since 2002 the homeless people can obtain Official Domicile at theirs District Via Modesta Valenti, an official domicile for the homeless  instituted in memory of an elderly woman who died in privation at the Termini Station after an ambulance didn’t care for her because she was dirty.

In Rome there are 19 official domiciles Modesta Valenti, one for each District.

Dignity to have first aid

In February 2002  the Social Operation Room was launched with a view to guaranteeing rapid reaction in social emergencies: it is free of charge and active 24 hours a day, 7 days a week, holidays included.

All citizens of the municipality of Rome can access the service by applying directly or after being brought to the attention of the relevant authorities. No formal requirements have to be met to use it. Applications are to be filed by telephone, calling a toll-free number. Emergency actions target all socially disadvantaged people.

1.        Operation room it is located in the premises of the municipality of rome’s 5^th Department. Experts are always ready to take calls, analyse and interpret them, assess any request, define and activate actions accordingly.

2.        Mobile Units   9mobile units are always operational in the field, and are permanently connected to the operation room through a satellite system. The personnel of each mobile units consist of two vocational trainers and a home carer with a total of 36 staff working in shifts. Those units react rapidly to any request by carrying out the required actions on the spot, meanwhile activating the relevant institutional actors in order to identify the resources available. Thanks to their constant presence in the field, mobile units can identify situations of marginalization that would otherwise be undetectable; they contact invisible users, who would otherwise only become visible when the situation is unmanageable, thus playing an extremely significant preventive role.

3.       Office experts these social workers or psychologists act constantly as links with local social and health services.

Structuring/Organization
Those without a fixed abode are mainly an itinerant population. This shows the importance for a flexible articulation of the specific services geared towards them, therefore there is a need to provide the services for these people in two areas: citizen and municipal.

• Social emergency

• Primary and secondary shelters, the people who use these centres, night and day, are those which do not have significant connections with the area or they do have connections in the area which do not coincide with those at the shelter structures. These in fact, in relation to the type of population which they turn to, have relationships with more than one town hall.

• Possible economical hotel structures.

• Family house: the area importance has shown the necessity, within a social reintegration programme, that this type of structure interweaves connections with the neighbourhood to allow a connection between the area and the people received.

• Specific shelter for the resident family nucleus.

Economic hardship - right to housing
One of the most significant prevention areas regards the housing policy. Resolution number 163/98 which offers economic support, rent, has an important prevention function, necessary to avoid the entry into the circuit for people with no fixed abode to those who have just lost a home and the consequent chronic process of social exclusion.

1. Set up a permanent work table dedicated to people with no fixed abode open to the workers in the sector. The table will also be open to people who live with hardship.

2. Carry on to increase the overall places in the first shelter (or called basic level) at a citizen level.

3. Continue with the policy of small sized shelter structures spread throughout the area.

4. To expect a system which allows the permanent stay of guests in the secondary shelter centres not any more on the basis of a prefixed time in a contract, but rather on the basis of intervention projects carried out periodically to check the situation, with also the participation of all the interested area services.

5. Work for the projects. The micro project, as a starting point for the taking on the person with no fixed abode, which allows, a constant verification of the team’s work and the programme of the person taken on.

6. Training of the social workers who work in the extreme poverty sector.

Dignity to have medical treatment: in Rome there is a list of doctors on health insurance panel available to work with homeless

MEASURES-SUPPORT FOR PEOPLE  WITH MENTAL HEALTH PROBLEMS

Rome is a capital city without a mental hospital. In recent years much has been done in the mental health field, thanks to the joint cooperation between the City Council and the five Mental Health Departments of the Local Health Units. The collaboration with the departments has allowed, among other things, the setting up and running of 24 day centres, 16 social assistance residences and 19 personalised apartments. Certainly, regarding the needs and the new urgencies, the work to be done is still notable, which needs greater coordination of the forces in the field, so that all can use the services, the treatment, the resources. The collaboration and support initiatives between the council authority and the Local Health Units have identified different sectors:

There are 24 so called intermediate structures, located in a capillary way within the whole citizen area, they mainly receive serious psychotic patient, in the 20 to 45 age group. Each centre is open for eight hours daily, from Monday to Friday, with the presence of a multi skilled team from the Local Health Unit responsible for the therapeutic rehabilitation project and the health related activities, both for the workers within the social cooperatives, chosen by the Local Health Units, which manage the recreation and expression activities as well as the professional training. Within each centre it is foreseen, meetings between the workers and the patients and specific meetings with the families and the users to verify the work carried out and to build a rapport of collaboration, important for the development of the patient’s therapeutic project.

The residences are low assistance level structures, directed towards patients who have reached a sufficient level of autonomy and who have a discrete possibility to experiment with normal living conditions. The residences are categorised into two types:

1.   16 social assistance residences (low assistance level structures and/or self managed). They are structures which can receive up to a maximum of six patients. They represent a housing solution outside the protected psychiatric circuit and which foresee, organised assistance in daily living through the presence of trained personnel and/or volunteers for the support activities in daily life.

2.    19 personalised apartments. They represent housing solutions for users with a sufficient level of autonomy. The project is carried out in owned apartments rented to the same. The increase in personalised housing is foreseen (from one to four people), that is the housing which allows to progressively leave the psychiatric structures for a definitive social integration.

These are projects which aid the work integration of citizens with mental problems both, both through the setting up of new productive activities managed by the social cooperatives, and the setting up of schemes to recover and re qualify degraded green areas.
articulated in the by now long term different experimented forms (short breaks, trips, week end) constitutes a fundamental opportunity to verify the rehabilitation and therapeutic interventions undertaken by the services during the year.

Training, awareness and prevention
these are initiatives geared towards the associations and family members, social health workers, social cooperatives, and even all citizens to encourage a cultural change and the change of attitudes regarding mental illness to increase the experience of social and employment reintegration of citizens with mental health problems.      

Transfer of economic cheques
the economic contributions for the realisation of personal projects (work placement, economic support, residency…) are paid annually to the psychiatric patients.
 

3.  The National Action Plan (NAP) for inclusion Danish Ministry of Social Affairs
      Peter Juul,

Realism and criticisme of NAPincl and JIM

1.   A juridical vision: the right & access in reality,   Ieva Leimane-Veldmeijere,
       LV Centre for Human Rights.Open discussion of participants for recommandations

2.   Social worker vision of the reality Pedro Meca

3.   Illigal immigrants : job & health MSF I  - B                                                                                                   

          SMES Statements of 8th SMES Seminar in Prague                

    As a conclusion:
                               The decent society is one in which
                                the institutions and the people do not humiliate
                                the person benefiting from their services... !  

Pietà Rondanini, (unfinished) 1552-64
             Marble, height: 195 cm Castello Sforzesco, Milan.
             This version, still unfinished at the artist's death.
              Was probably begun not much later then 1555.

SMES-EUROPA SECRETARY
Place Albert Leemans 3   1050 Brussels  -  Belgium
Tel/Fax: +32 2 538 58 87 - smeseu@smes-europa.org