9th  SEMINAR  SMES-EUROPA: Berlin 6-8 October 2005

 

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Summary

SESSION  A

HUMANISM & MENTAL HEALTH  as the focus of all the seminar.

par le Prof. Michel Joubert sociologue

A.1      

Epowerment : regain of dignity – right – place in society

A1.1

Empowerment : regain of dignity – right – place in society.    
Mariela Todorova,

A1.2

The impact of urban environment on health
Mariantonietta Fresu
Coauthor: Haroon Saad

A1.3

From Empowerment to Social Inclusion.        
Anse Leroy, Planner

A1.4

The Fountain House – Experiences from a user-perspective.
Barbara Kierccz, Danuta Mlynarczyk (PL)

A2.     

Deinstitutionalisation : alternatives to total institutions at social & health level

A2.1

Psycho-rehabilitation and the therapeutic centres (chantiers).   
Alain Mercuel

A2.2

Psychiatric care in Italy, 27 years after the closure of psychiatric hospitals.
Vito D'Ansa

A2.3

ASTIR: a network of people working in psychiatric services. Directions in work placement and projects set up in prisons.  
Loretta Giuntoli e Simone Gelsumini e Daniele Cipriani.

A3.   

Participation, evaluation, control: involvement of users & family associations

A3.1

SPEAK OUT : what's the use for homeless' speech?   
David Giannoni

A3.2

Participation: Making the voices of all citizens heard.  
Dearbhal Murphy

A3.3

Changing views: users involvement in psycho-social services
Annette K. Lorenz.

A4. 

Chronicity and outreach : at the street, in the institutions, at home

A4.1

Outreach for returning life to people living in hard condition of exclusion..  
Isabelle Duportal

A4.2

Madrid samur social service: perspective of street teams. 
Cánovas Andreo, Rubén; Hernández Mondragón, José Antonio

POSTER THEME : …PROYECT PRISEMI, FROM STREET TO HOME

A4.3

PsyCoT - Co-ordination of care in the home for chronic psychotic patients..
 Patrick Janssens

A4.4

Boule-de-neige: HIV and hepatitis - prevention work by peers among drug users.
Hariga F.; Donner I., Saliez V.

A5.     

The position and rights of immigrants as individuals, active citizens and agents for change.

A5.1

Roms in Europe.   
Jean Marc Turine

A5.2

Mental health care for those with precarious housing situations: the experience of the Ulysse association in Brussels.    Pascale De Ridder and  Alain Vanoetereny

 

SESSION  B

Europa muss den Herausforderungen menschlicher Gesundheit entsprechen  statt den Herausforderungen der Globalisierung.   Gaby Zimmer MP of European Parliament

H
EALTH & SOCIAL CARE IN COMMUNITY :
Access for all to rights & services
.
Nat MJ Wright ; Charlotte NE Tompkins

B1.     

Empowerment

B1.1

What seems impossible is not necessarily impossible in reality
Preben
Brandt

B1.2

Mental Health and Human Rights: From Recovery to Dignity.    
Nora Jacobson

B1.3

Santé et inclusion sociale : réintroduire la complexité dans l'approche des usages de drogues. 
Henri Patrick Ceusters ;  Coauthor:Christelle Versluys

B2. 

De-institutionalisation

B2.1

‘L'Hôpital Social Actif ', or how to exclude the most excluded.
Serge Zombek

B2.2

Beyond the asylum for the alienated and the alienators.
Luigi Attenasio

B2.3

The working model of Caritas Institution in Kielce,  for people soffering of psychical disturbs.... 
Stanislaw Slowik

B3.     

Participation & Evaluation

B3.1

Evaluation of psychosocial programs to homeless people in Madrid (Spain).
Manuel Muñoz;  Sonia Panadero

B3.2

Low threshold centre for the homeless as a door for community mental health resources

David Blanco Rosado;  José Antonio Hernández Mondragón

B3.3

Taking a Stand. Psychiatry and Homelessness from Users’ Perspectives.
Jasna Russo , Thomas Fink

B4.  

Outreach & chronicity

B4.1

Outreach and rehabilitation: Madrid Homeless mentally ill program.
María Isabel Vázquez Souza, Francisco Recalde

B4.2

The growing changes in the Romanian society
Catalina Hetel

B4.3

How can we take health onto the street? Project : Waiting for better days.
Rina
 Horowitz

B5.  

health of immigrants  in a global perspective : physical, psychical, social.

B5.1

Guaranteeing access to care in a desadvantaged context  (maltraitant). 
Chantal Van Oudenhove;  Pierre Ryckmans

B5.2

The presentation is shown Bulgarian experience in the contemporary society.
Terzieva  Ekaterina 

B5.3

Invited Schouber-Ocak…

 

SESSION  C

a)  Users & Survivors of psychiatry express themselves: reflections from
      an antipsychiatric perspectiveby Iris Hölling,

b)  Users and Survivors of the street, express themselves: down & up

C.1

Empowerment

C1.1

The German Federal Association of users and survivors of psychiatry; 
J
urand Daszkowski, and Hannelore Klafki

C1.2 

Introduction of the ideas of user-control and self-help
Thomas Schlingmann, Petra Hartmann, Martina Hävernick.

C1.3

Title (?) ARIPI  Monika Simionescu

C.2

De-institutionalisation

C2.1

How patients change when their care changes.   par Paolo D'Angeli

C2.2

It’s Possible to prevent social exclusion among mentally ill?   
Bravo Ortiz Maria Fe;  Santos Olmo Ana Belen

C2.3

Alternatives to Institutional Care – Community based services in Bulgaria;
George Bogdanov

C.3

The users - non users   and   survivers - not survivers..

C3.1

Participation, power, conflict & change: dynamics of service user participation in UK social care.  Sarah Carr

C3.2

Invited German Association

C3.3

Invited CZ Association

C.4

Outreach and Chronicity

C4.1

Support and intervention cellule at the crossroad between mental health and social exclusion.
Jenny Krabbe

C4.2

To be present, before all...
Patrick Rouyer  -  invited  Diogène
and  The presentie

C4.3

Outreach to do what? 
Bontemps Planeix , Nadine,
St Anne CHS

 

ROUND
TABLE  
A


Impact of NAP/ Inclusion:
from Lisbon 2000 : "...eradicating poverty & exclusion to 2005 wirth 68 million of European citizens poor or at risk of exclusion.

What about housing, health, education, job, fundamental  human right in building Europa of citizens ?


Arrigo Zanella,
                 animateur de la T.R. -  Sécrétaire générale de "RETIS"

Invited:               

(B)   Annette Perdaens       Observatoire de la Pauvreté
(D)  
Helga Burkert             Senatsverwaltung Berlin - Coordinator of NAP Inclusion
                                             
  City.: Berlin   -   Helga.Burkert@SenGSV.verwalt-berlin.de

(DK)Worning Anne            Danish Centre for Research on Social Vulnerability)
(CZ) 
Hana Janečková         A Czech National Action Plan for Social Inclusion
                                                from the NGO´s point of view

(F)    Mylène Stambouli      les modalités d'accès aux soins et au logement
                                                des immigrés en situation régulière et irrégulière en France

and other political, administrator and NGO's responsible involved in NAP elaboration and application.

 

 

ROUND
TABLE  
B


NEW CHALLENGE FOR EUROPEAN UNION : from 2005 to 2010:

"
Competitivité de l’économie et dignité des personnes :
(traide-off) enjeux alternatifs ou complémentaires" ? 
by
Jerôme VIGNON - European Commission

 

Report & evaluation of "Dignity and Health: exchanging project " by  
Luigi Leonori 
Eu
ropean Coordinator of the D&H/II-5Projects with :
- > Mariela Todorova  (BG)

- > Ilja Radesky  (CZ)

- > Rita Erele  (LV) : 

- > Andrejn Czarnocki  (PL)

- > Marieta Radu  (RO)

Synthesis - Statments - Proposals : Results after the D&H/II-5Projects : we observed;  we exchanged; we evaluated, in order to propose and recommande.

PLENARY  SESSION  A :  Thursday 6 October     from  14:00 to 16:00 

Humanism and mental health as the focus of all the seminar.  Criteria for individual and social existence: Having a place, possibility to make one’s voice heard, to be heard and be recognised. What means today to have a place in the society? How can this be substituted by silence and violence?


HUMANISME et SANTE MENTALE  par le Prof. Michel Joubert sociologue,
                                                                            
Université Paris 8, Membre du CESAMES  (CNRS-INSERM)

 

Confrontés aux multiples difficultés, contraintes et épreuves, imposées par le monde moderne, avec souvent le sentiment de ne pas être reconnus comme êtres dignes d’estime, pouvant aspirer à prendre place au sein de l’espace commun, des femmes et des hommes de plus en plus nombreux font l’expérience de la souffrance sociale.

Cherchant à « faire quelque chose de ce que l’on a fait d’eux » (Sartre à propos de Genêt), beaucoup d’entre eux sont conduits à engager – dans un contexte où les solidarités collectives sont toujours plus fragiles et dispersées – des luttes de reconnaissance contre la tendance au délaissement.

Actes et paroles sont souvent mêlés dans ce mouvement pour retrouver place.

La subjectivation (le fait de faire connaître ce que l’on ressent, de le parler ou de l’agir) est l’un des processus essentiels à ce travail (De Certeau). Toutes les institutions, tous les professionnels, tous les acteurs associatifs, revendicatifs et politiques y sont confrontés.

Derrière le vocable de santé mentale (espace de travail de la subjectivation et des inter-subjectivités), c’est en grande partie ce type de tensions (entre le dire et le faire) qui se trouve mis en jeu.

Beaucoup de conduites dites « à risques » (violences, addictions, tentatives de suicide) s’inscrivent dans cet entre-deux où le silence, la souffrance sociale, la plainte et le sentiment d’injustice tendent à prendre le dessus.

Quelques enseignements de recherche en sciences sociales seront convoqués pour rendre compte de la conjoncture qui se trouve ainsi exacerbée pour l’action publique et les aspirations à plus de justice.
 

ballred.gif (924 octets) Workshop  Session  A:   Thursday 6    from  16:30   to 18:30
    
A.1  Empowerment :
 regain of dignity – right – place in society

 

A1.1   The theme “Empowerment : regain of dignity – right – place in society” is an actual and serious problem for all, who work in the field of mental health and reintegration in the society.

The practice shows that the decision of this problems depends of several important factors:

  • Institutional system of health care for the people with mental problems;

  • The attitude of the family to its member which have mental problem;

  • Development of the democratic system and the place which it gives to the civil society sector or the possibilities of work for NGOs.

In the presentation will be made analysis of the state in the Bulgarian conditions today.

With the concrete examples will be illustrate the picture of the real problems and possibilities to work to regain of dignity, rights and place in the society.

In conclusion will be made reflection for the perspectives and interactions among the three key factors mentioned above.

 

AUTHOR(s) : …Dr. Mariela Todorova, experts from NM “WMAV”;

KEYWORDS : …dignity,rights, evaluation, institutions, users, NGOs, perspectives.

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A1.2    The impact of urban environment on health


Despite the strong correlation between urban environment, social exclusion and health, and despite the increasing importance of this topic at European level, there is a limited awareness of the contributions that a “healthy” urban policy can make to tackle health inequalities and related social exclusion. This topic requires an analysis and capitalisation of existing practice in several interconnected areas, according to a holistic approach to urban environment.

To promote exchange of good practices, Quartiers en Crise (www.qec-eran.org)is setting up a European working group which will focus on a number of interrelated sub-themes on the basis of target-specific intersectoral areas:

  1. Housing: "Healthy housing" is a comprehensive concept concerning a range of factors contributing to the quality of housing and housing environments. Healthy housing covers the provision of functional and adequate physical, social and mental conditions for health, safety, hygiene, comfort and privacy. Still, a healthy home is also represented by a residential setting that is capable to fulfil the expectations of the residents in respect of safety, comfort and hygiene

  2. Poverty: Processes of social exclusion and the extent of relative deprivation in a society have a major impact on health and premature death. The harm to health comes from material deprivation, poor housing and nutrition, as well as from the social and psychological problems of living in poverty. People who have lived most of their lives in poverty suffer particularly bad health.

  3. Diversity and Vulnerable Groups: migrants from other countries, ethnic minority, guest workers and refugees are particularly vulnerable to social exclusion, and their children are likely to be at special risk. They are sometimes excluded from citizenship and often from opportunities for work and education. The racism, discrimination and hostility that they often face may harm their health. In addition, communities are likely to marginalize and reject people who are ill, disabled or emotionally vulnerable, such as former residents of children’s homes, prisons and psychiatric hospitals. Women, children and elderly people are particularly at risk from social, psychological, biological and environmental factors. Stigmatizing conditions such as mental illness, physical disability or diseases such as AIDS makes matters worse.

 

> Author:  Mariantonietta Fresu

> Coauthor: Haroon Saad

> Instit: Quartiers en Crise - European Regeneration Areas Network

> email: merifresu@hotmail.com; hsaad@qec.skynet.be

 

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A1.3  From Empowerment to Social Inclusion

 
The Danish Association of excluded people with brain damage has started an inclusion project together
 with partners in Poland (Dom pod fontana, Warsaw)and Italy (ITACA, Milano).

 People with brain damage caused by accidents are severely excluded, frequently without proper care and
 traing and left without hope and support.

The association - in charge of the project and the activites - is formed by patients with brain damage and family members. The progam is thus user adapted, multiple and holistic. The participation in the association empowers the members and the members support each others. The program provides a pathway for integration in the society and development instead of exclusion and further detoriation.

The project is run by the NGO and accepted by the European Commission / Employment and Social Affairs / EQUAL.


Author:   Anse Leroy, Planner

Coauthor:  Nils Anton Svensson, Trainer, Special education

Instit: Association of excluded people with brain damage

email: anse@leroy.dk

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A1.4 The Fountain House – Experiences from a user-perspective.


Being a user of a Fountain House I would like to speak not only for myself but also on behalf of other users. We all have a history of mental problems behind us, we all have felt badly isolated from the mainstream of life, we all still encounter ignorance and prejudice in our social environment. And we all have not given up yet on our lives, on other people, on hoping to achieve something worthwhile.

 

After over 10 years of bringing up children and keeping the household I felt I needed contact with other people, preferably with similar experience of mental (and ongoing) problems. The Fountain House that is at the moment being created in Kielce seems really to be an opportunity for that. I appreciate the sense of autonomy and of community that it can give. The possibility of Transitional Employment offered to the users, the possibility to oppose as a group the practical and legal discrimination against mentally ill make us feel better about ourselves and gradually recover our human dignity.

 

Author : Barbara Kierccz, Danuta Mlynarczyk (PL)

 

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A.2.  Deinstitutionalisation  : alternatives to ”total” institutions at social and health level


A2.1  Psycho-réhabilitation et chantiers thérapeutiques


A partir d'une unité de soins proposant des activité de restauration, réhabilitation de logements de malades par des malades, une expérience de psychoréhabilitation  peut être menée. Un gradient d'activité s'étalant du soin au social prouve qu'un engagement est possible tantdu côté des soignants, du côté des paients que du côté des actuers du champ social.

Le chantier thérapeutique ne réprésentant en fin de compte qu'un médiateur entre soin et social, au même titre que la prise en compte du corps ou de l'habitat.

 

Dr Alain Mercuel

CHS St Anne – SMES Paris

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A2.2   L’assistenza psichiatrica italiana dopo 27 anni dalla chiusura dei manicomi.

                                  

A far-sweeping change has been produced in our country over the past 27 years of implementation of a psychiatric reform which led to the closing down of public mental hospitals and restored the right to citizenship to people with mental disorders. However, this change raises with increasing force and urgency the question of the quality of these Services, which appear to be too often marked by an embarrassing disconnection between theoretical enunciations and actual practices, between principles and organizational models, between the resources available in the field and the needs for support of the people for whom the Services have been established in the first place. The increase in the number of exemplary positive experiences throughout the country makes such disconnection all the more contradictory, so that the need to identify the reasons for this gap emerges with stark clarity.

In addition, both the Departments for Mental Health, and technical, political, and legislative bodies show a behaviour marred by uncertainty, inaction, delays, as well as a  passive and ambiguous attitude, which stop them from clearly and precisely planning out guidelines to develop and change Mental Health policies and strategies alike.

The continued existence of  University courses removed from the actual reality of the Services, as well as from the indications provided in national and regional laws, and culturally separate from the concrete existence and practical lives of the people makes the situation above even worse. As a consequence, quite often the needs of the people requiring assistance from the services, as well as of their family members, are simply not met, or only find inadequate responses. This has led to the emergence of a new institutionalization process, with social and iatrogenic problems becoming chronic (cultural attitudes, contexts, organizations).

 

Keyword:  neo-istituzionalizzazione


AUTORE(i) : VITO D’ANZA

Istituzione:   ASL 3 di PISTOIA
Email v.danza@mail.vdn.usl3.toscana.it - vito.danza@tin.it

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A2.3     ASTIR: una rete di soggetti che si occupano di servizi psichiatrici


              ASTIR, consorzio di Cooperative sociali di tipo A (gestione di servizi alla persona) e di tipo B (inserimento lavorativo di soggetti svantaggiati), si caratterizza come una “rete” di soggetti che si occupano di servizi psichiatrici.

I valori: la centralità della persona come individuo, come lavoratore, come utente;  la democrazia: come partecipazione alle scelte basata sul consenso, sulla trasparenza e circolarità delle informazioni;

la sussidiarietà: intesa come partecipazione attiva alle politiche, alla progettazione in una logica di bottom up.

L'operato di Astir è caratterizzato da: Territorialità; Intersettorialità;  Sperimentazione; Residenzialità – Gestione comunitaria; Attività ricreative - Trattamenti riabilitativi; Inserimento lavorativo

 

Percorsi di inserimento lavorativo e progetti attivati in ambito carcerario

 

                     Il Consorzio Astir , consorzio di cooperative sociali , ha al suo interno 10 cooperative di tipo B impegnate nell’inserimento lavorativo di soggetti svantaggiati in svariati ambiti di attività; I settori di intervento sono essere raggruppati in macroaree e più precisamente in : Area Ambiente ;  Pulizie ; Turismo Sociale Agircolo Forestale;  Tessile e Manufatturiera

Le cooperative socie del consorzio astir impegnate in percorsi individualizzati in ambito Giustizia sono 5: Cooperativa L’Anfora , Cooperativa La Traccia , Cooperativa Esperienze , Cooperativa Verdemela. Il Consorzio Astir dall’anno 2002 ha iniziato una serie di collaborazioni che hanno portato alla strutturazione di una rete di particolare efficienza sia con le cooperative, sia con enti del territorio Pratese,tale da attivare una serie di progetti con finalità lavorative particolarmente efficiente.

 I progetti attivi attualmente con la Casa Circondariale di Prato sono i seguenti: Area Ambiente: Differenziare per Recuperare ; Manutenzione degli spazi verdi; Area Turismo sociale Realizzazione di manufatti in legno ; Area Agricolo Forestale Gestione ;  Area Tessile e Manufatturiera Realizzazione di un laboratorio tessile e di cucito in gestione alla cooperativa L’Anfora, per la realizzazione di camici e lenzuola monouso.

Author: Loretta Giuntoli

Coauthor: Simone gelsumini e Daniele Cipriani

Institution: Consorzio ASTIR

email: segreteria@astir.it

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A. 3.  Participation, evaluation, control: involvement of users & family associations

 

A3.1      SPEAK OUT : what's the use for homeless' speech?

 

                    "What's the use for speaking?" How many times we hear these words in our everyday life? And in our work with homeless people it's frequent to hear them. This often mean: What can we change? We have no power! We have no place! We would like to participate but workers and institutions treat us like passive persons...

In Brussels, since 2003, we try to enforce the right and ability to speak for homeless people: with meetings; trying to spread this kind of representation (users deserve space and time to express themselves) all over the social network; etc. Then we try to create bridges within users and workers, users and institutions (social and political).

A 3 sided project: meetings to speak; a website (www.webzinemaker.com/espacesdeparole) and the project of a Paper tribune...

 

Keywords: Homeless, Users, Speach, Participation

Auteur: David Giannoni :
Institution : Espaces de Parole – Bruxelles

email : espacesdeparole@hotmail.com 

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A3.2   Title: Participation: Making the voices of all citizens heard

 

Key Words: empowerment, ownership, dignity, democracy, citizenship, inclusion

Summary: This workshop could explore the principle of participation and what it aims to promote.

FEANTSA can offer the perspective of participation by homeless people within the structures of homeless services and in policy-making beyond those structures.

 

What is participation?

The term “participation”, in the sense we have come to use it in FEANTSA, is intended to denote full inclusion in decision-making processes. It is a term often used in discussions of citizenship, as participating in the democratic process at national level is a part of fully exercising ones rights as a citizen. The importance of ensuring the inclusion of all who are affected by decision-making in the democratic process has been raised in various sectors and contexts: whether social initiatives and action on poverty; access to culture; education policy or human rights. The principle of implicating all affected persons and interest groups in decision-making procedures is often applied in consultation processes on national policy for example, or at local level in relation to city or municipal decision-making. However, this same principle is increasingly finding its place within the decision-making practices of non-political bodies seeking to operate in an inclusive and democrat!  ic way. Thus one increasingly finds examples of schools consulting their pupils, hospitals consulting their patients and homeless services consulting the homeless people that use them etc. The idea is not only to give meaning to the structure and its functions by creating a sense of ownership around the decision-making process, but also to improve the quality of the work undertaken or the plan or policy produced by increasing its applicability and relevance and taking account of a greater diversity of views.

 

Why participation?

Aside from the benefits of participation mentioned above, participation can be particularly empowering for groups whose opinions may all too often be sidelined, such as homeless people, or other excluded groups. Participation in decision-making processes affecting the services that they use can be a vector of empowerment by providing groups whose views may often be disregarded or marginalised with a voice. To be given this chance may lead these marginalised groups into forums and actions that they might not otherwise ever have thought about being a part of. It can lead to a new understanding of their own capacities. Thus we can conclude, in the words of one of the terms of reference of the European meeting of people experiencing poverty and social exclusion, that: “Participation is a valuable addition to the other forms of democratic process which is apt to enhance both social policy-making and the empowerment of disadvantaged groups.”

 

FEANTSA presentation : Participation of Homeless People

 

FEANTSA will present the audit it undertook this year to explore participation practices among its members. This explored:

-              why members have undertaken to promote participation

-              what the main benefits are

-              what the main pitfalls are

-              Conclusions: the value of participation for homeless people.

 

Author:  Dearbhal MURPHY

Instit:      FEANTSA

email:     dearbhal.murphy@feantsa.org

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A3.3      Changing views: users involvement in psycho-social services. Annette K. Lorenz

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A. 4.  Chronicity and outreach : at the street, in the institutions, at home

 

A4.1     Aller à la rencontre pour rendre une existence aux grands exclus

                         

                    Le Samusocial va au devant des personnes les plus exclues de Bucarest. Nous allions au plus profond de notre action ces paramètres : humanité et santé. Par la santé, nous voulons rendre aux bénéficiaires une existence. Ces personnes s’appellent les « SDF », mais ils pourraient aussi s’appeler les « invisibles ». Ils sont sales, ils sentent mauvais, ils sont parfois mêmes agressifs au moindre contact, nous faisons donc un détour pour ne pas les voir. Les équipes mobiles du samusocial veulent sortir ses grands exclus de l’ombre, les rendre visibles, à leurs yeux, aux yeux des autorités, et de la population civile.

 

Aux yeux de la société civile :

Un SDF gît parterre, ivre, face contre terre. Tous font un détour : il nous renvoie une image trop négative de notre société et de l’Homme. Le médecin d’une équipe mobile du Samu s’approche. Par ce  geste samaritain de santé, le SDF existe de nouveau aux yeux des passants qui se préoccupent alors de lui. Si le SDF réagit de manière agressive, (ce qui se passe fréquemment) les passants fuiront, en pensant qu’il est vraiment irrécupérable. Le SDF s’enferre dans son identité d’invisible et il faudra beaucoup de patience aux équipes du Samu avant de rendre une identité d’homme aux grands exclus.

 

A leurs yeux.

Cette invisibilité aux yeux de tous est aussi un moyen des exclus pour se protéger eux-mêmes de leur image. Aller à leur rencontre et les soigner c’est aussi leur faire prendre conscience de leur isolement psychique et de leur état de santé souvent dramatique. Leur rendre une existence d’hommes demande un accompagnement psychologique professionnel.

 

Aux yeux des institutions et des autorités.

Les équipes du samusocial sont la première porte ouverte vers les autres dispositifs. Elles doivent tout mettre en œuvre pour que les bénéficiaires soient pris en charge par les hôpitaux, les hébergements d’urgence… et lutter contre les refus et le mépris des institutions.

Enfin, il s’agit de demander pour ceux qui ne demandent plus rien, et de faire porter leur voix auprès des autorités pour développer des structures adaptées aux grands exclus.

 

Author:   Isabelle DUPORTAL

Institution:   Samusocial din Romänia

email:   samusocial@pcnet.ro

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A4.2       MADRID SAMUR SOCIAL SERVICE: PERSPECTIVE OF STREET TEAMS

 

                     Samur Social Street Teams are a specific social service within a Municipal project that Madrid City council offers and whose primary goal is to guarantee social attention for all those citizens who use to live in the street. The 8 Street Teams that composes this resource detects new cases, looks for them, and ensures the follow up tasks for all the homless people who locate themselves in the streets of the 21 districts that compose the Municipality of Madrid.

 

The intervention methodology begins with an approach, through one first interview to continue with an assessment and elaboration of a diagnosis-prognosis in which goals  of a plan of individualized for rehabilitation are established.  In later follow up contacts, these objetctives are developed, making the social support, follow up, derivation and later evaluation that the case requires. 

 

Within the context in which it is developed the work of Street Team is necessary to underline the difficulties with are cvery often found by the technicals:  In the health aspects (mental Disease, substance abuse, alcoholism, hygiene and precarious feeding...) and social (rejection to resources and aid, language, isolation, conduct of citizens...).

 

The municipality of Madrid counts at the moment on a network of general and specific resources for the attention of the necessities of the group of homeless people

 

Author:               Cánovas Andreo, Rubén

Coauthor:           Hernández Mondragón, José Antonio

Instit:                    Grupo 5/Ayuntamiento de Madrid

email:                   hmondragon@grupo5.net; rubenandreo@grupo5.net

 

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POSTER TITLE or THEME : …PROYECT PRISEMI, FROM STREET TO HOME


In this poster we picture
the Proyect PRISEMI ( project of rehabilitation and social insertion of Homeless people  with serious and chronic mental disorders.), this proyect began in 1989 and it is of public funding (Regional Goverment and Town hall of Madrid) and private management (Group EXTER), we have

Three areas of  intervención with three especialized teams;  initially we made  outreach work ,  then we have a Program of rehabilitation inside the Homeless Center of San Isidro in Madrid  and we have  6 normalized flats .

 

KEYWORDS : …Mentally ill, Homeless, Rehabilitatión, normalized flats
AUTHOR : …Paloma Martinez Heras, Fran Recalde Iglesias, Noemi Moreno Hoya

INST.  : Prisemi  
email :  prisemi@grupoexter.com
 

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A4.3     PsyCoT - Coordination des soins à domicile pour le patient psychotique chronique


                    Dans le but de continuer à situer socialement les soins prodigués aux personnes souffrant de problèmes psychiatriques, ce projet tient compte de la réalité qui montre que de nombreux patients souffrant de problèmes psychiatriques graves et chroniques ne sont pas pris en charge dans des établissements psychiatriques spécifiques. Le plus souvent, ce sont les médecins de famille et les autres thérapeutes de première ou deuxième ligne qui assurent les soins.  Malgré la qualité des soins administrés, ces patients posent souvent problème pour les soins à domicile réguliers en raison de leurs problèmes comportementaux et émotionnels

 

Le concept : Créer et soutenir un réseau de thérapeutes autour d’un patient.  Ce réseau est spécifique à chaque client et est organisé avec les thérapeutes qui ne font pas partie de l’entourage du patient.  De cette manière, le patient fait l’objet d’une intervention cohérente et peu radicale bien que très efficace. L’aide existante a tout d’abord été mieux mise à profit.

 

L’objectif : Offrir une cohérence de contenu à l’aide dispensée et coordonner ces soins complexes et de longue durée.  Cet objectif augmente la qualité tant pour le client que pour le thérapeute. La connaissance partagée, la possibilité d’échanger ses points de vue ainsi que ses attentes augmentent la force de travail des thérapeutes.

 

Author:  Patrick Janssens

Institution:  Centre de Santé Mentale Antonin Artaud - Dienst eestelijke Gezondheidszorg

email:  patrickjanssens@advalvas.be

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A4.4     Boule-de-neige: prévention par les paires du VIH et hépatites auprès des usagers de drogues

               
              Le projet Boule de Neige consiste à mener des actions de prévention par les pairs du sida et autres risques analogues auprès des usagers de drogues.  Il s'agit d'opérations de proximité, visant un public d'usagers de drogues marginalisés et peu touchés par les campagnes de prévention destinées au grand public.  La méthodologie employée lors des opérations se veut participative : concrètement, cela signifie que des (ex) -usagers de drogues, les “ jobistes ”, sont recrutés, formés, et envoyés " sur le terrain " à la rencontre de leurs pairs, sur les lieux de vie même de ceux-ci, pour répercuter des messages de réduction des risques.  Ils diffusent également les informations sur les dispositifs locaux d’accès aux moyens de prévention (comptoirs d'échange de seringues, centres de dépistage, associations relais, etc.).  Cette phase de terrain s'accompagne d'une récolte de données permettant d'apprécier l'évolution des opinions, comportements et modes de consommation des usagers. !  Grâce au développement de partenariats locaux différents, le projet vise également la sensibilisation des intervenants des secteurs toxicomanie et connexes à l’intégration de messages de réduction des risques dans le cadre particulier de leurs pratiques.  Ces opérations permettent d’entrer en contact avec environ 1000 usagers de drogues chaque année. 

Ce projet a connu un prolongement européen en Espagne, Portugal, Italie, Grèce, Finlande et Slovénie.

 

Author:       Hariga F.

Coauthor:   Donner I., Saliez V.

Institution: Modus Vivendi ASBL

email:           modus.vivendi@skynet.be

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A. 5.  Denied identity – illegal migrants : dignity and health without boarders

 

A5.   Les Roms en Europe

 

                    La situation des Roms en Europe et la discrimination qui les frappe dans l'accès aux soins de santé. D'une façon générale, les Rroms sont en mauvaise santé et la précarité dans laquelle ils sont contraints de vivre n'améliore pas leur situation.

 

Auteur : Jean Marc Turine   (auteur du livre  : Le crime d'être Roms, éditions Golias, mars 2005)

Instit:    Assosciation Romani Phuu

email:   jmturine@pi.be

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A5.2     L'aide en santé mentale pour les personnes en précarité de séjour: l'expérience de
                   l'association Ulysse à Bruxelles
.


                   L'association Ulysse a ouvert il y a près de trois ans un service qui s'est spécialisé dans l'accompagnement psychosocial et psychothérapeutique de personnes exilées. Pour ce faire, son équipe a mis en place une série d'aménagements destinés à répondre aux spécificités de ce public pour lui faciliter l'accès et lui rendre possible le cadre de l'aide en santé mentale. Entre autres, une attention particulière doit être accordée à la précarité du statut et des conditions d'existence de nos bénéficiaires, ainsi que des obstacles divers -dont souvent l'attitude peu bienveillante des autorités à leur égard- à leur accès aux droits sociaux les plus élémentaires. A l'occasion de ce séminaire, nous nous proposons de faire le point sur notre pratique et de vous faire part des questionnements qu'elle engendre.


Author: Pascale De Ridder

Coauthor: Alain Vanoeteren

Institution: Ulysse

email: ulysse.asbl@skynet.be

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PLENARY  SESSION  B        Friday 7        from  09:00     to 10:45  
Health & Social care in community :  Access for all to rights & services
How can the health system be efficient and take care of the major mental and wider health problems
of those who
‘survive’ in permanent precarious conditions, whilst acknowledging their social condition?


TITLE:  How can health care systems effectively deal with the major health care needs of homeless people?

The issue
Homeless people have poorer physical and mental health than the general population, and often have problems obtaining suitable health care. This synthesis has critically reviewed the international literature pertaining to the health care needs of homeless people in countries with relatively welldeveloped health care systems. It does not deal with the causes and prevention of homelessness, but focuses on the evidence of effective treatment for the types of ill-health from which homeless people often suffer.

Findings
Homeless people constitute a heterogeneous population characterized by multiple morbidity (primarily alcohol and drug dependence, and mental disorders) and premature mortality. The problems need to be addressed by many measures, requiring a focused primary health care system and multi-agency cooperation. There is evidence that behavioural interventions for mental health problems, drug and alcohol dependence, and sexual risk behaviour can empower homeless people, and lead to lasting health gain, as well as helping in treatment retention. Effective interventions for drug dependence include pharmaceutical treatment, hepatitis B vaccination, advice about safe injection and access to needle exchange programmes. There is an emerging evidence base for the effectiveness of supervised injecting rooms for homeless intravenous drug users and for the peer distribution of naloxone in reducing drug-related deaths. Early evaluation of medically supervised injecting centres (MSICs) would suggest they have the capacity to reduce the incidence of drug-related deaths, stop the increase in reported hepatitis B and C infections, reduce the risks involved in injecting, increase the likelihood of starting treatment for drug dependence, reduce public sitings of discarded syringes, and do not increase theft and robbery.

Policy considerations Access to primary health care is a pre-requisite for effective treatment of health problems among homeless people.
This will require addressing barriers to provision such as lack of health insurance. Cultural barriers due to stigma or lack of knowledge among health service staff can be addressed by relevant training activity. Barriers to effective multi-agency cooperation need to be addressed in order for homeless people get access to medical and behavioural interventions, re-housing and financial support.

Keywords   HOMELESS PERSONS   -   DELIVERY OF HEALTH CARE – organization and administration
HEALTH SERVICES NEEDS AND DEMAND   -   META-ANALYSIS   -   EUROPE

The authorsNat MJ Wright Clinical Director Leeds Community Drug Treatment Services,
Inst.:                 North East LeedsPrimary Care Trust Centre for Research in Primary Care
Email:              n.wright@leeds.ac.uk

                           Charlotte NE Tompkins Research Assistant,
                           North East Leeds Primary Care Trust Centre for Research in Primary Care
Email:               c.tompkins@leeds.ac.uk

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ballred.gif (924 octets) Workshop  Session  B:   FRIDAY 7    from  11:15   to 13:00
    
B.1  Empowerment :
 

 

B1.1    What seems impossible is not necessarily impossible in reality - changes can be initiated!

 

                  What a few years ago seemed hopeless and a challenge impossible to overcome to modern social and psychiatric work: the care and treatment of homeless mentally ill has during the last years been in a growing political and professional focus and is now an area for a lot of activities.

There are around better and better strategies for integration programs forcluded people with mental health problems.

There have in many places been established local municipality-based outgoing social and health street-work with the aim to establish contact to the most vulnerable street-dwellers.

Some places there have been established special permanent housing facilities to excluded people, especially mentally ill with severe addiction to alcohol or illegal drugs. The right to this kind of housing is not connected to acceptance to treatment or stop of use of drugs/alcohol, but strongly connected to right to support and care.

And not least user-involvement and user-organisation has been a more and more common part of the way professionals and users cowork. But there are still some fields with unchanged problems. I should mention the inpatient treatment of mentally ill addicts and the co-work between different systems, as for instance the psychiatric and the social system.is mostly about seeing the excluded (here mentally il homeless people) not only as individuals which we have to change but as member of a community and changes must as well be in the communty as in the indivudual.

 

Preben Brandt
UDENFOR Projekt

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B1.2    Mental Health and Human Rights: From Recovery to Dignity

 

                 Since the mid-1990s, service users, advocates, providers, policymakers, and families in a number of countries have made the design and implementation of “recovery-oriented” mental health systems and services a priority.  In the mental health arena, recovery is a word that often signifies something other than its dictionary definitions of symptom abatement or return to a pre-morbid state.  For some service users and advocates, recovery refers to a phenomenology of learning to live with, then beyond, the symptoms of mental illness.  For others, it is explicitly political, an attempt to wrest authority away from the state and psychiatrists and place it in the hands of users who have been “empowered” to reject the labels of psychiatric diagnoses.  For many mental health professionals and families, recovery represents a rationalized approach to service provision, one that synthesizes the best of extant service models. Others look upon it as a pernicious promise of!

  “false hope.”  For policymakers who are also the funders of care, recovery has fiscal implications: it may either increase costs—by expanding the definition of “medical necessity”—or control costs by justifying the termination of services once individuals have achieved certain functional goals. Thus, depending on how it is defined, recovery may have many different implications for mental health policy and practice. 

 

In this presentation I will use a health and human rights perspective to explore how recovery-oriented system reform may either promote or threaten the achievement of human rights goals.  I will draw on my previous work to examine several definitions and models of recovery and to assess their potential successes and failures from a human rights perspective.   Turning to new work, I then will describe an emerging model of dignity and consider whether dignity might be a more fruitful concept for promoting a human rights agenda in mental health policy and practice.

 

Key words: health and human rights; mental health; recovery; dignity

 

Author:                     Nora Jacobson

Instit:                         Centre for Addiction and Mental Health

email:                         nora_jacobson@camh.net

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B1.3   Santé et inclusion sociale : réintroduire la complexité dans l'approche des
               usages de drogues

     

                    La question de l'usage de drogues est d'abord pour nous une question anthropologique et socio-culturelle bien avant de constituer une problématique prioritairement clinique. Pour nous, cette démarche anthropologique se réclame d'une conception humaniste tolérante qui vise le respect des consommateurs de drogues considérés comme des individus citoyens librement consentants. Ainsi, notre souci est de montrer que les usages occasionnel, habituel ou problématique des drogues adressent des questions à la société dans ses fondements éthiques, ses modes de fonctionnement et plus encore, des interrogations sur les types de liens que les individus qui la composent entretiennent avec les drogues.

C'est pourquoi nos stratégies de travail, en terme de prévention des méfaits liées aux usages de drogues, ne visent pas une population spécifique mais tout public intéressé et sensible aux questions autour des assuétudes. Nos missions d'accompagnement de projet, de formation et de communication offrent des outils aux adultes relais (ayant en charge l'éducation, l'enseignement ou l'aide aux personnes) qui souhaitent s'informer, se former et mettre en place des démarches de prévention des méfaits et/ou de gestion des usages en collaboration avec les usagers eux-mêmes. A partir de "la promotion de la santé", nous valorisons l'émergence des responsabilités, des compétences et des ressources de chacun.

Nous avons développé une approche cognitive qui propose de dépasser le jugement moral et idéologique porté sur la consommation en tant que telle, la toxicomanie ne représentant qu'une facette très restreinte de la consommation. Ainsi, la suspension du jugement de valeur moralisant, soutenue par l'acquisition de connaissances variées et approfondies enrichies par une dynamique réflexive centrée sur les facteurs individuels et contextuels de consommation, autorise la consolidation du sens critique et de la responsabilité ainsi qu'une relative autonomie des personnes. Ces dernières, qu'elles soient simples consommateurs occasionnels, toxicomanes ou encore abstinents sont toujours considérées comme des sujets de droits et leur choix, quel qu'il soit, doit être respecté.

Le choix de consommer une drogue, quelle qu'elle soit, relève toujours de facteurs individuels (conscients et inconscients) et environnementaux inscrits dans une culture et à un moment donnés. C'est donc le sens et la signification de la consommation, ou de l'abstinence, qui sont privilégiés.

Il est donc nécessaire de disposer de suffisamment d'informations avant de conclure à un usage abusif de psychotropes. Il est souhaitable que tous les acteurs concernés puissent agir à leur niveau si l'on vise une prévention globale et cohérente. En ce qui nous concerne, nous travaillons sur certains facteurs : les représentations sociales, les adultes relais, les contextes professionnels, la transmission des connaissances, les démarches communautaires et la construction politique, le tout dans une logique de réflexion et d'action concrète mettant clairement produit, personne et contexte en interaction. C'est ainsi que nous pensons pouvoir prévenir des risques de stigmatisation et de désinsertion sociale.


> Author: Henri Patrick Ceusters ;  Coauthor:Christelle Versluys

> Institution: Prospective jeunesse asbl ; 27 rue Mercelis - 1050 Bruxelles

> e-mail:  christelle.versluys@prospective-jeunesse.be

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ballred.gif (924 octets) B.2:   Desinstitutionalisation


B2
.1   L'Hôpital Social Actif ou comment exclure les plus exclus

 

                   Le secteur de la Santé en Belgique vit comme partout ailleurs en Europe une crise sans précédant. L'hôpital public n'échappe pas à la règle et est contraint de sélectionner parmi les "malades" qui s'adressent à lui ceux qui vont pouvoir entrer dans des modules de soins rapides et performants. Les plus démunis, ceux qui vivent dans la grande précarité, risquent bien de ne plus être inclus dans ce système de médecine aigüe. Alors que la vocation première de l'hôpital était de fournir des soins aux pauvres, ces derniers se voient de plus en plus exclus des lieux mêmes qui leur était historiquement destinés. 

 

Author:                      Dr Serge ZOMBEK

Institution:               CHU Saint-Pierre, Service Médico-Psychologique, Bruxelles

email:                         serge.zombek@skynet.be

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B2.2   Au delà de l'asile pour aliénés et aliénant   

                   Comme on sait dejà, l’Italie est la seule nation et Rome la seule capitale au monde sans asile d’aliénés.

 

Le modèle de prise en charge de ceux qui souffrent psychiquement, né de la réforme mise à exécution par Franco Basaglia qui a conduit à la loi 180, peut et doit être connus à l’ètranger. Là, malheureusement, existent ancore trop de situations dans lequelles la reponse à la maladie mentale comporte négation de droits et privation de liberté.

Sur iniziative de l’Association Psichiatria Democratica – Section Latium – soutenue avec enthousiasme par les europarlementaires messieurs Giovanni Berlinguer et Roberto Musacchio, à la date du 11 et 12 mai 2005 44 personnes (la pluspart des quelles abonnés de la ASL C de Rome et leurs menbres de famille) ont allés à Strasbourg invités par le parlement européen. La délégation a participé à beaucoup d’initiatives parmis lesquelles une conférence de presse, une visite au Parlement même et une rencontre avec des Parlementaires et des journalistes auxquels ils ont présenté un document de sensibilisation au sujet “pour une Europe sans asiles d’aliénés”.

Même en cette circonstance, on a confirmé la caracteristique fondamentale de l’expérience italienne de la dernière décennie c’est-à-dire la position centrale des abonnés à garantie d’un coté de la validità de la loi 180 et de la fermeture consécutive des asiles d’aliénés et de l’autre côté de la construction et du develop des différents services territorials, pour une culture de la santé mentale de communauté.

 

> Author: Luigi Attenasio
> Instit: Associazione Psichiatria Democratica
> email: attenasio.luigi@aslrmc.it

 VIDEO:   Yes

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B2.3        Le model du travail de l’institution Caritas a Kielce pour les personnes qui s’ouffrent
                      aux maladies psychique


                      Un de principaux problèmes des soins médicaux et socials en Pologne est la distribution du ressort de ces secteurs et la vivante lacune continuelle comment reste entre le service médical et l'aide sociale. Depuis 8 ans, l’institution Caritas a Kielce réalise le programme holistic des soins pour les seniors et les personnes de malade psychique. Le principe du programme est l’union dans le cadre d'une institution des services des infirmieres médicalaux qui travaillent pour les familles dans l’institution Caritas, des aliénistes et les infirmières psychiatriques de l ‘institution qui realisel’aide pour les familles et la facile accessibilité de repas chauds offerts par la Cantine Caritas, qui se trouve dans le meme lieu.

La part de personnes vient dans l’institution Caritas pour les courts du jours ou pour les démarches ou pour déjeuner. Une autre part de personnes arrive des villages aux autres le personnel arrive à la maison et realise la-bas les soins indispensables et permet à ces personnes subsister dans leurs maisons aussi longtemps comment il est possible d’enteretenir leurs autonomie.

De ces actions sont enrichies du travail des rehabilites qui s'affairent pour entretenir la propre forme physique et les dispositions du libre-service.

A present il y a 5 institutions, qui travaillent pour le milieu du village. Cette aide holistigue realisee pour le malade dans village est la nouvelle solution en Pologne et retrouve un grand réspect.


Author: Rev. Stanislaw Slowik
Instit: Caritas Kielce
email: kielce@caritas.pl

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ballred.gif (924 octets) B.3:   Participation & Evaluation


B3.1  
   Evaluation of psychosocial programs to homeless people in Madrid (Spain).

 

                    The aim of this research was to assess the effectiveness of a net of programs for homeless people in Madrid (Spain), based on a previous European study: To Live in Health and Dignity, project set out by SMES – SME to identify good practice in the delivery of health and social care to some of the most vulnerable and deprived populations in Europe.

 

Three studies were carried out:

The first one, was a study to develop an instrument to describe programs to social inclusion, a structured interview, Módulos de Inclusión Social. The functioning of these scale was prove in a small study with 12 programs to social inclusion. The results show that the interview is a very brief and easy to apply instrument.

The second study described 11 programs (best practices) to homeless people in Madrid. Results show some problems in these programs but some positive aspects too: active involvement of users in the programs, individual intervention and multidisciplinary teams.

The third study assessed the situation of 130 users of those (11) programs for homeless people in different variables: quality of live, health, self-esteem, satisfaction with programs, consume of drugs and alcohol, in three different moments (wave one, wave two 6 months later (55 persons) and wave three, 12 months later first wave one (55 persons). Results show improvement in different variables: accommodation, health, economic situation, and satisfaction with life and with family relationships.

 

Author:                     Manuel Muñoz

Coauthor:                 Sonia Panadero

Instit:                         Universidad Complutense de Madrid

email:                         mmunoz@psi.ucm.es

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B3.2     Low demand center for homeless as a door for community mental health resources


                   Low demand “Puerta Abierta” Center was created in 2001 trying to give an answer for a group of people that used to have no access to lodging services in the accomodation net for homeless people, or when they could access there was no continuity. The variables managing in those cases were often complicated, and there was a tendency to attribute the low success rates to the strictness of the existing services or to the lack of adaptation of professional strategies. From its creation, in "Puerta Abierta" center it was detected a very high prevalence of chronic mental disorders between the users.

Most of them were derivated from street teams of SAMUR SOCIAL service and had no previous diagnosis. A few, although had a diagnosis for their mental disorders, had had no success in following treatment along the time. Many of them presented dual pathology, within mental health diseases and substance abuse.

From January 2005, at Puerta Abierta, 93 persons of a total of 76 vacancies offered were attended; between them, we could find a 76,34 % of alcohol abuse problems and a 33,33% of users with mental disorder diagnosis. The philosophy of low demand centers for homeless and its characteristic of being an opened and flexible centre without conditioning about maintenance the vacancy, has provided a new instrument for engagement with users and it has let them an access to the community mental services and to a continuous follow up.


Author: David Blanco Rosado Coauthor: José Antonio Hernández Mondragón
Instit: Grupo 5/ Ayuntemiento de Madrid
email: davidblanco@grupo5.net; hmondragon@grupo5.netn

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B3.3   Taking a Stand. Psychiatry and Homelessness from Users’ Perspectives


                 Despite a range of mental health services and services for the homeless in Berlin, there are still people living on the streets and ending up in psychiatric hospitals now and again. We wanted to explore this situation from the point of view of those who are not reached or do not feel supported by services.

"Taking a Stand" is the report of the first user controlled research project launched in Germany. The presentation will explain the background and some of the principles of this kind of social research. We will also report on findings of our work with people who experienced both psychiatry and homelessness and explore the ways how their expert knowledge could influence policy and service provision.


Key words: Research, User involvement, Psychiatry, Homelessness

Author: Jasna Russo

Institution: Service User Research Enterprise (SURE), Health Services Research Department, Institute of Psychiatry

email: Jasna.Russo@iop.kcl.ac.uk

 

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ballred.gif (924 octets) B.4:   Outreach & chronicité


B4.1       Outreach and rehabilitation: Madrid Homeless mentally ill programme

·     

                       In 2003 was created in  Madrid a programme to attend those homeless suffering severe mental illness who reach not or cannot reach mainstream mental health services. Initially, it consists of a team doing outreach work with objective of provide diagnosis, treatment, follow-up and to facilitate integration in mainstream mental health services,and to facilitate self autonomy and social integration to this population and improving coordination. This team were two nurses (SERMAS), an social and juvenile worker (Provided by PRISEMI) and a psychiatrist (SERMAS).

Soon we find that all these objectives related with social integration and autonomy required of begginig with rehabilitation strategies since we meet the person in the street but also that required a structured long term individualized rehabilitation plan after their get a place to live in and before their integration in more normalized services, and even if they don´t reach them.

In this year 2005, the increased of our team with three more social and juvenile worker, a social worker and a psychologist (Provided by PRISEMI) This allowed us to divide in two teams working together; one, involved in outreach, street working, care… and the other, involved more specifically  in rehabilitation and integration

We discuss in this workshop this short- term experience…

AUTHOR(s) : María Isabel Vázquez Souza, Francisco Recalde, Equipo de atención psiquiátrica a enfermos mentales sin hogar
KEYWORDS : Outreach, rehabilitation, mentally ill, homeless

Institution : PRISEMI*.  MHSE GROUP MADRID


 

POSTER  : WE NEED MORE COORDINATION!

                       There is no doubt that coordination is one of the key points in working with severe mentally ill persons. This became more important when we talk about homeless suffering enduring and severe mental illness. In these population, need are not only social or medical but both and get  increased with the handicaps related with mental disorders and social stigma and social- mental services need to work coordinated. This usually make us complaint: we need more coordination!

In this poster we picture the coordination pannel and the different coordination strategies in our complex network working with homeless people and discuss about coordination.


AUTHOR :
…Francisco Recalde, María Isabel Vázquez.
KEYWORDS : Coordination, mentally ill, homeless

INSTITUTION : PRISEMI* -  MHSE  Group Madrid
Equipo de atención psiquiátrica a enfermos mentales sin hogar

mvazquez.scsm@salud.madrid.org

 

B4.2      In Romanian society

                    The growing changes in the romanian post revolutionary society, affected the entire social structure, mainly vulnerable categories such as pensionars, persons with disabilities or poor families.

The low level of income, the huge costs of bills, prices of food, cloth ant other  daily shopping, the crisis of the sanitary system, pushed the vulnerable social categories into a real social problem. Homeless people represents only the final stage of the social exclusion. In order to avoid the increasingly risk of this kind of social problems some prevention measures are being required. The mainly objective of Romanian social policy, in order to abide by the european regulations are to promote the dignity, the respect, ant the self esteem, no metter what the socio – economical status of that person is. Concerning romanian realities, based on the social experience acumulated in the Sector 2, in 2003 appeard a new service called The Social Ambulance. This social service is composed by several specialists, such as doctors, nurses, social workers and psicologistrs. The purpose is social evaluation, medical diagnosis and primary medical care care and establishing of the best emergency solution for each case. Social Ambulance intervines in the folowing situations:

-              homeless people;

-              elder people;

-              home violence victims;

-              neglected children;

-              people with disabilities.

The activities of Social Ambulance are;

-              social evaluation;

-              advices concerning the social rights;

-              primary medical treatment;

-              simple ambulatory treatments;

-              hospital transporting;

 

Author:                     Catalina Hetel

Instit:                         Social Protection Departement of Sector 2, Bucharest

address:                    Olari 11-13

email:                         catalinahetel@yahoo.com

 

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B4.3       Comment aborder la santé dans la rue ? Projet : En attendant des Jours Meilleurs
 

                     Dune asbl, service actif en matière de toxicomanie, accomplit un socio-sanitaire dans la rue. Jusqu’à présent, il visait essentiellement la réduction des risques liés à l’injection de drogues.

Cependant, les besoins et les risques de santé dans la rue sont divers. Dès lors nous envisageons d’étendre la démarche à tous les problèmes de santé liés à la vie dans la rue. Pour cela, un carnet « trucs-santé », destinés aux sans-abri a été conçu.

En 9 cartes postales, il propose des gestes de prévention et des renseignements utiles sur les problèmes d’hygiène et de santé rencontrés par les habitants de la rue. Les thèmes ont été sélectionnés après enquête auprès d’habitants de la rue. Une fois élaboré, des usagers ont été consultés (avec convention et rétribution) sur la pertinence de cet outil, sur les possibilités de parler de sa santé quand on est habitant de la rue et sur l’accès aux soins. Les carnets (outils de dialogue) sont destinés à être diffusés par des travailleurs sociaux ayant des contacts fréquents avec le public-cible. Ceux-ci se sentent quelquefois peu à l’aise pour aborder ces questions touchant l’intimité des personnes, ou ressenties comme non-prioritaires. C’est pourquoi, des réunions sont prévues pour trouver ensemble différentes façons de diffuser des informations en santé parmi les sans-abri.


Author: Horowitz Rina
Institution: Dune asbl

email: rhotowitz@dune-asbl.be

 

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B.5:   The HEALTH of immigrants in a global perspective : physical, psychical, social


B5.1.   Garantir l'accès aux soins dans un contexte maltraitant.

 

                Force est de constater que malgré un système de sécurité sociale élaboré et des dispositions légales visant à garantir un accès aux soins psycho-médico-sociaux, la société belge génère de l'exclusion en matière de soins de santé.


Sur base des principes de l'accès réel pour tous aux consultations en médecine générale avec une attention spécifique à la santé mentale, MSF a développé des consultations psycho-médico-sociales qui prend en compte la santé globale du patient.
 

Notre objectif est de réinsérer chacun dans les structures existantes mais aussi de sensibiliser les acteurs publics aux améliorations à apporter au système.


Le travail avec les migrants en séjour illégal met en exergue la difficulté de gérer émotionnellement des situations de vie tragique dans un contexte maltraitant; une société qui non seulement ne reconnaît pas leur existence et leur souffrance mais qui plus encore les rejette activement (politique d'expulsion, messages dissuasifs, discours insidieux, manque de volonté politique, mentalités peu ouvertes à la différence,…).

 

Author: Chantal Van Oudenhove

Coauthor: Pierre Ryckmans

Instit:  MSF

email: msfb-projets-belges@msf.be   

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B5.2       
The Bulgarian experience in the contemporary society.
                 
                 
In the presentation is shown Bulgarian experience in the contemporary society. Will be given concrete examples of work of the Red Cross with illegal migrants /youth people/ on the street and the refugees in Bulgaria. It’s will be analysed concrete activities which show planned work on this problem. Personal examples of good work of volunteers from the Red Cross about this problem will show the real results in the topic “dignity and health without borders”

 

POSTER: …Visual examples of the work of the Red Cross- Youth section on the theme: ”Denied identity – illigal migrants : dignity and health without borders”..

 

Author :Terzieva  Ekaterina

National Coordinator,Volunteer, Student 
Organisation: Red Cross- Youth Section

E-Mail:  Ekaterina_Ter@Abv.Bg

 

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PLENARY SESSION C           Friday      7        from  14:00     to 16:00  

a)   Reflections from an antipsychiatric perspective:
 Users and Survivors of psychiatry express themselves, exchange views & compare: their place and their active involvement in society, the participation in programming & evaluating the services involvement & active participation of users and survivors   of  psychiatry in the process of integration of excluded people.


Human rights are a key issue for users and survivors of psychiatry as well as any other excluded or disadvantaged groups. Full participation in society requires respect of human rights without any exception.

The World Network of Users and Survivors of Psychiatry (WNUSP) promotes human rights, self determination, equality and empowerment of users and survivors of psychiatry. The work WNUSP does for the Comprehensive and Integral International Convention on the Protection and Promotion of the Rights and Dignity of Persons with Disabilities at the United Nations will be presented as an example for the importance of full human rights. The importance and value of user and survivor of psychiatry controlled services will also be illustrated by examples as the Berlin Runaway-house. Nothing about us without us is a central message WNUSP promotes. This implies users and survivors of psychiatry defining their own needs, developing their own support structures and having the right to choose on a fully informed basis. Valuing the knowledge and experience of users and survivors of psychiatry also means considering them as experts to consult with on everything that concerns them. Meaningful participation, empowering services, access to resources, the power to define issues and perspectives, influence or control to make change will be presented as elements of an attitude that puts users and survivors of psychiatry in the centre instead of keeping them in a marginalized position.

 

Author:           Iris Hölling

Institution:     WNUSP

email:               ihoelling@web.de

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b)   Users and Survivors of the street, express themselves..

- > The process of the descent to the hell and social context
- > The divers points of view and "feeling" of  of who is "in" and who is "out"
- > The basic needs; the received help ...
- > The recirpocal looking and judgement 
: excluded people < -- >the "social workers... in this time
- > The "factors - reasons - facilitators for beginning the contrary process
- > Today : vision of life -  job - recommendations

 
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ballred.gif (924 octets) Workshop  Session  C:   FRIDAY 7    from  16:15   to 17:45
    
C.1  Empowerment :
 


C1.1
  Title :The German Federal Association of users and survivors of psychiatry

 

The German Federal Association of [ex-] users and survivors of psychiatry  is called Bundesverband Psychiatrie-Erfahrener. "We want a different psychiatry" is said in a flyer of our Organization, "we demand the development of efficient alternatives to the mentality in nursing and supervising of the conventional medical psychiatry". For most of us there is generally an attitude of central importance that can be described best as 'empowerment'. That means "self-authorisation". Users and survivors of psychiatry should have or regain the authority over their own life, get access to information and money and speak with their own voice. Empowerment is the basis of prevention of mental disorders and promotion of mental health.


Author:                     Jurand Daszkowski, Hamburg

Coauthor:                 Hannelore Klafki, Berlin

Instit:                         Bundesverband Psychiatrie-Erfahrener e.V.

email:                         vorstand@bpe-online.de

 

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C1.2:      :   Introduction of the ideas of user-control and self-help


Tauwetter e.V. drop-in center for men who have been sexually abused during childhood;

Weglaufhaus „Villa Stöckle“ association for protection from psychiatric violence e.V.;

Wildwasser women self-help center and advice for women who went through sexual voilence as girls.

 

During the workshop we`d like to introduce and discuss the idea of user-control and ist specific implementations into our daily work within all the three of the above mentioned projects (up to 20 years of experience with the self-help and user-control approach).

Thereby we hope to elaborate our ideas becoming them transparent and want them to become fruitful and transferabel to other projects and working contexts.

Fundamental for the work in our projects is that users come to us totally spontaneous, just following their own free will. There must be no refferals or admittances of any institution.

Within the scope of our work we very consciously refrain from any form of diagnosis or categorization as far as possibel.

The users decide self-determined, what and how much they want to disclose about themselves. Likewise all of the aid will be worked out and arranged together with the users.

By that way we reach out for people who would never make use of differently structured support offers because they`ve made negative experiences in the past.

 

All three projects are originated from initiatives of people who were themselves affected by the experiences of violence in its specific forms as mentioned above.

The projects fixed it in their concepts that ex-users and survivors should be employed (that is 100 % at Tauwetter and at Wildwasser - women`s self-help, 50 % at Weglaufhaus).

The own experience is explicitly acknowledged as a separate qualification and is given priority towards other formal qualifications. Fundamentally the opportunity is given that users can become employees.

 

Target groups of the projects:

Tauwetter e.V.: Offers aid and assistance for men who have experienced sexual violence as boys and for supporting persons

Weglaufhaus Villa Stöckle: Homeless people or people threatened by homelessness who are affected by psychiatry

Wildwasser women`s self-help and counselling e.V.: Offers aid and assistance for women who experienced sexual violence as girls and female supporters

 

We´d like to carry out a workshop (90 min.) with introductory lectures as an impulse for the following discussions.

Responsible people to address to:

Thomas Schlingmann, Tauwetter e.V. 030/ 693 80 07  mail@tauwetter.de

Petra Hartmann, Weglaufhaus Villa Stöckle, 030/ 406 321 46  weglaufhaus@web.de

Martina Hävernick, Wildwasser Frauenselbsthilfe, 030/ 6939192  selbsthilfe@wildwasser-berlin.de

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                               +++++++++++++++++++++++++++++++++++++++++++

Vorstellung des Betroffenenkontrollierten und Selbsthilfeansatzes


Tauwetter e.V. Anlaufstelle für Männer, die als Jungen sexuell missbraucht wurden; Weglaufhaus Villa Stöckle Verein zum Schutz vor psychiatrischer Gewalt e.V.; Wildwasser Frauenselbsthilfe und Beratung für Frauen, die als Mädchen sexuelle Gewalt erlebt haben. 


Im Rahmen des Workshops möchten wir den Ansatz und die konkrete Umsetzung in der täglichen Arbeit ( z.T. 20 jährige Erfahrung mit dem Ansatz) bei Tauwetter, im Weglaufhaus und in der Wildwasser- Frauenselbsthilfe vorstellen und diskutieren.

Wir hoffen unsere Ansätze transparent zu machen und sie so für andere Projekte und Arbeitszusammenhänge übertragbar und nutzbar werden zu lassen.


Grundlegend für die Arbeit unserer Projekte ist, dass die NutzerInnen freiwillig zu uns kommen, eine Überweisung/ Einweisung gibt es nicht. Im Rahmen unserer Arbeit wird bewusst möglichst auf jede Form von Diagnostik oder Kategorisierung verzichtet. Die NutzerInnen entscheiden selbstbestimmt, was und wie viel sie von sich offen legen wollen. Genauso werden alle Hilfsmaßnahmen mit den NutzerInnen gemeinsam erarbeitet und abgestimmt.

Wir erreichen mit unserem Angebot auch Menschen, die aufgrund negativer Erfahrungen anders strukturierte Hilfsangebote nicht in Anspruch nehmen.


Alle drei Projekte sind aus den Initiativen Selbstbetroffener der jeweiligen Themen entstanden. In den Projekten ist konzeptionell verankert, dass  Betroffene eingestellt werden (50% beim Weglaufhaus, 100 % bei Tauwetter und in der  Wildwasser- Frauenselbsthilfe). Die eigene Erfahrung wird als eigenständige Qualifikation explizit anerkannt und hat Priorität gegenüber anderen formalen Qualifikationen.  Es gibt die grundsätzliche Möglichkeit, dass NutzerInnen zu MitarbeiterInnen werden können.


Die Zielgruppen der Projekte sind:

Tauwetter e.V.: Angebote für Männer, die als Jungen sexuelle Gewalt erlebt haben und Unterstützende Personen

Weglaufhaus Villa Stöckle: Wohnungslose oder von Wohnungslosigkeit bedrohte psychiatriebetroffe Menschen

Wildwasser Frauenselbsthilfe und Beratung e.V.: Angebote für Frauen, die als Mädchen sexuelle Gewalt erfahren haben und Unterstützerinnen

Wir würden gerne einen 90 min Workshop durchführen mit einleitenden Impulsreferaten und anschließender Diskussion.


Ansprechpersonen und durchführende sind:
Thomas Schlingmann, Tauwetter e.V.  030/ 693 80 07 mail@tauwetter.de

Petra Hartmann, Weglaufhaus Villa Stöckle, 030/ 406 321 46 weglaufhaus@web.de
Martina Hävernick, Wildwasser Frauenselbsthilfe, 030/ 6939192 selbsthilfe@wildwasser-berlin.de

 

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C1.3      Title (?) ARIPI Monika Simionescu

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C.2  Deinstitutionalisation  


C2.1     Comment changent le patiens quand change le système de soins


                   C'est de l'organisation des soins psychiatriques en Italie et de ses conséquences cliniques que traite le texte. Depuis la loi 180 ayant fermé les hôpitaux psychiatriques, l'unité de base de la psychiatrie, l'unité territoriale, doit faire face à tout patient qui se présente à elle et à tous le besoins de ce patient :soigner ses symptômes, le soutenir, l'aider à devenir citoyen, etc. L'objectif actuel des cliniciens italiens est de se dégager de cette situation d'emprise réciproque, de renoncer peu à peu à cet activisme clinique et social, d'accepter que leur pratique ait des limites - ce qui est un moyen de restituer sa vie au patient.

Author: Paolo D'Angeli

Institution: AUSL ROMA "E" - DSM XX° MUNICIPIO

email: ax.se@tiscali.it

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C2.2   It’s Possible to prevent social exclusion among mentally ill?    IPSE Project,  " Clinical Case
                 Management " in Schizophrenic Patients two catchment areas  in Madrid (Spain)

 

                 The present study is about the clinical and social outcomes of schizophrenic patients included in three " Clinical Case Management (CCM)” programs in two catchment areas of Madrid (Spain)

 

It’s part of an effectiveness study of this case management programs (Project IPSE) in schizophrenic patients that have been attended in three CMHC in two catchment areas in Madrid (Spain). In this areas there exists a Psychiatric Case Register (PCR) since 1985 that includes information about admissions, emergencies and outpatient care. There has been carried out a differential analysis of the clinical and social characteristics of the patients that there are included in the programs by respect those that have not been included.

 

There have been studied 744 patients diagnosed of schizophrenia according to criteria CIE-10 and that have been attended from January, 2002 to October, 2003 in three CMHC (corresponding to a population of 552.000 inhabitants). Of them 267 were included in programs of CCM with different components (professional caseload, keyworker assignment, written individualized plan, team work,  domiciliary visits and control of drop out).

 

The assessment instruments that have been used are: Positive and Negative Syndrome Scale (PANSS) (Kay SR, Opler LA, Lindenmayer JP., 1989); World Health Organization Disability Assessment Schedule (WHO DAS); Global Assessment of Functioning Scale (DSM-IV);  adherence to treatment, and data of admissions, emergencies and outpatient care in PCR.

 

This research has being supported by the Departament of Health

 

Author:                     BRAVO ORTIZ MARIA FE

Coauthor:                 SANTOS OLMO ANA BELEN

Instit:                         HOSPITAL UNIVERSITARIO LA PAZ

email:                         marife.bravo@uam.es

 

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C2.3   Alternatives to Institutional Care – Community based services in Bulgaria


In the abstract will share experince of delivering social servises for children and families based in Sumen munisipality. Also we will share our opinion on delivering social services in Bulgarian context.

 

Community based services for children and families in Bulgaria are offered based on the personal initiative of the individual initiators of the services – most often NGOs, financed by external donors. Community services for street children and children dropping out from the school system, field work in the Roma neighborhoods, etc. are not mentioned in the regulatory framework, which excludes the opportunity for financing them with funds from the state budget. 

 

In short, the management of community social services needs to take into account the continuing demand for social care. The lack of well-working decentralized institutions deforms the emerging initiatives for offering services, shifting them in the direction of offering traditional forms of care. The municipalities should have an integrated approach to the needs of the target groups. The role inherent to them in this regard is to be commissioners and not providers of services.  Studying the local needs they should be: a) commissioners of decentralized services in the specialized institutions for children, and b) commissioners of community social services, delegated to social service providers (NGOs, private companies, etc.).

 

AUTHOR : George Bogdanov

Institution:  Social activities and Practises Institute (SAPI)                             

Email : sapi@abv.bg

 

C.3  Self help : users participation  

 

C3.1     Participation, power, conflict and change: dynamics of service user participation in UK social
              care


              Drawing on the findings of a major UK review on service user participation in social care service development, this paper explores some of the challenging dynamics that are emerging as service users begin to take up strategic power in social care services and institutions. Many of the findings from the review seem straightforward, such as ‘organisations may not be responding’, but the question is why are they not responding? User participation has great potential for good service development and this should be a shared goal for everyone. Current proposals for social care reform in England centre on achieving far greater levels of service user control and involvement. This policy strategy will mean an almost unprecedented shift in power from worker to service user and a major culture change as a result.


But analysis of the current situation suggests that service user participation is challenging the very fabric of the institutions in which it is taking place. It is exposing not only issues about service development and delivery, but problems with the political, economic, strategic and structural elements of established organisations. On many levels traditional power relations are being unsettled. Many organisations seem to be ignoring these wider outcomes and their implications. Many have chosen to be non-responsive to user generated service development ideas because these are intrinsically linked to wider issues, which cannot be addressed easily and quickly in order to satisfy targeted outcomes.


Non-user controlled service providers are beginning to feel the larger effects of power devolution and are showing signs of resistance. What has been understood by policy makers and service providers as consumerism has developed into a demand on the part of service users for active citizenship. The conceptual clash between citizenship and consumerism is being exposed as participation becomes more widespread and sites of resistance are revealed. ‘The liberational model of empowerment, focused upon people’s lives and roles within society, is likely to be more relevant to people than consumerist definitions narrowly focused on having a voice within services’. There is ‘conflict between staff and managers’ desire to implement a rather limited consumerist agenda and the hunger of many users to reclaim their spoiled identity and reassert themselves as citizens’. Therefore the issues to be discussed in the paper are: power relations, conflict and democracy and organisational develo! pment.


Author: Sarah Carr

Institution: Social Care Institute for Excellence

email: sarah.carr@scie.org.uk

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C3.2 Invited German Association

 

 

C3.3 Invited CZ Association

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C.4  Outreach and Presence   

 

C4.1      Support and intervention cellule at the crossroad between mental health and social
                    exclusion.

 

                    This intiative offers support for social workers within services for excluded persons, in their workplace, taking into account the resources and constraints affecting the team in question. Secondly, it offers support and therapy for underprivileged persons, with the possibility of meeting them on their own ground in order to facilitate access to care adapted to their needs, either physical, mental or social. Mobility, flexibility and networking are some of the key terms that apply to this initiative.

Author : Jenny Krabbe

Institution SMES-B: Cellule d'appui

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C4.2  To be present, before all...  

 


 

C4.3      Aller à la rencontre pour "faire" quoi?

                                              

               Il faudra les situer où mieux convient et les prévenir  

 

Author : Bontemps Planeix , Nadine

CHS: St Anne

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1st ROUND TABLE    Saturday    from  09:00   to 11:00  
a)  5 Years after : what about NAP after Lisbon 2000  : Impact of NAP (National Action Plan for Inclusion)
      >   Lisbon 2000 : "...eradicating poverty & exclusion by 2010 "  
      >   What place is there for those not considered competitive, productive, consumers?
      >   In 2005 : 68 million European citizens are poor or at risk of poverty…  
      >   Today’s watchwords : competitiveness – productivity – consumption…. *   -   And for tomorrow?

b)  Citizen's fundamental rights : what about housing, health, education, job, immigration?
      Participants in R.T. are from B-DK-D-E-FR-I and BG-CZ-LV-PL-RO  political or administrator or NGO
     
responsible
.

 
CZ -  
"A Czech National Action Plan for Social Inclusion from the NGO´s point of view “

 AUTHOR(s) : PhDr. Hana Janečková, PhD.

·KEYWORDS :  National Action Plan (NAP) , social exclusion, vulnerable groups,  health risks,
                                Non Governmental Organizations (NGOs), public administration, legislation, financing.

·        

The new social phenomenon which occured together with liberalization of the society after 1989 like homelessness, legal and illegal migration, drug abuse, unemployement, criminality and instability of families and traditional communities has not belonged to the priorities of the social policy of the CR. There was no governmental  commission for the deep analysis and continual empirical study of these phenomenon. The weak social groups are not only endangered by the social exclusion and by the higher morbidity and mortality but also the surrounding society is at risk of some infectious diceases, like hepatitis, sexually transmited diseases, HIV-AIDS, TBC. Until our access to the EU the homelessness in CR was neither recognized nor solved as a social phenomenon. Only in 2004 the Czech government was made by the press from EU to create the NAP for social inclusion. The role of the state has been overtaken by the NGOs, which provided services, educated professionals, provided material background for homeless people,  prostitutes,  Roma population and  other marginal social groups. Figures from the Censuses in 1991 and 2001 show that the number of peple living in some emergency shelters increased nearly eight times and the only counting of homeless people in the CR was done in Prague in 2004 by NGOs and showed  number higher than 3000. The experience of NGOs has been showing, that there is lack of the access to the health care and the tendency of the health facilities to send the patients back to the NGOs, which are neither personallly nor economically equipped for the provision of the wide range or the qualified care. These organization suffer from the high ammount of existentional uncertainty due to their dependency on the governmental (regional) subsidies which are shortened and delyed. NGOs are not the equivivalent partners of the state due to the lack of legislation in the area of social services, community planning, quality of care, continuity of health and scial care and social living. So the NGOs, which are for years not respected enough by the state, often solve the failure of the public administration and overtake  the heavy burden which the state bodies should be responsible for.

AUTHOR(s) : PhDr. Hana Janečková, PhD

Institution:  Institute of Postgraduate Medical Education

Email: janeckova@ipvz.cz.

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 F -     Les modalités d'accès aux soins et au logement des immigrés en situation régulière et irrégulière en France et sur les dispositifs de la collectivités parisienne pour faciliter l'accès au droit des étrangers.

AUTHOR(s) : Mylène Stambouli,  adjointe au Maire de Paris  chargée de la lutte contre l'exclusion 

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2nd ROUND TABLE    Saturday    from  11:30   to 13:00  
       SYNTHESIS and PROPOSALS Presented by all D&H/II-5P partners.
       Discussion with the Representative of Commission
       Public Debate

 

 


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ABOUT  WORKSHOPS
 

SPEAKERS All abstract authors will have opportunity to participate in the relevant workshop.
However,  only three abstracts  for each of 5 workshops will be selected by the organisers for official presentation in the specific workshop.

The workshops are the core of the Seminar . This is where reflection on an exchange of ideas should be translated into proposals of integrated and innovational practices, planned synergetic strategies and create a really lobbying in proposals and advocacy in denouncing inadequateless between analysis - programs - resources for efficiently answers to the 'global needs' in exclusion chronically situation.

After each of 3 plenary session: A -B -C,  five parallel workshop will be held on the following topics:
      1. 
Empowerment : regain of dignity – right – place in society
      2.  Deinstitutionalisation  : alternatives to ”total” institutions at social and health
level
      3.
 Participation, evaluation, control: involvement of users & family associations

      4.  Chronicity and outreach : at the street, in the institutions, at home
      5.  Denied identity – illegal migrants : dignity and health without boarders

  • Empowerment as prevention of exclusion: getting hold of one’s dignity, one’s right through
    recovering the access to quality services, at the social as well as health level.

    - A person exists when they have a place and their voice is heard.

    - The place, their place, which place within which society ?
    - Place sometimes occupied by silence and violence.
    - Which vision, which definition of person, in relation with the humanistic approach is the basis in the process of deinstitutionalisation, in working in institutions and services and in activities for empowerment and outreach, with chronically ill people and with migrants.
    - How are empowerment strategies utilised in institutions and services?
    - The professional and empowerment

    - Network, job and home

     

  • Deinstitutionalisation : alternatives to comprehensive Institutionalisation, at the social as well as
    psychiatric level.

    - Acceptance of de-institutionalized people in the community (NIMBY)

    - Community treatment in praxis

    - The risk of homelessness in the process of deisntitutionalisation.

    - Live in community with a mental helath problems.

    - Established good co-work between NGO's, public social services and the health care system

    - Others ways to treat mental health problems

    - Drug-addicts and alchoholics in the community: the needs of harm-reduction programs

  • Outreach as philosphy & aptitude in approch of excluded people who is abandoned and never is 'demanding' of service

    - Outreach & Chronicity at the street, in the institutions (shelters, prisons...), at home, everywhere where chronicity of poverty as well as the sickness discourages from any request, exactly when the need is the most complex and urgent.

    - Mobiles units : divers daily - streets practices

    - Samu social : a practice for co-working or for protagonism ?

  • Participation  by the users through direct involvement in the decisions about the programmes,
    and in the evaluation of the quality and efficiency of  the services, either directly by the ex/users and
    their families, or indirectly through  their associations.

    - Users organization. Presentation of exemplas.

    - Support to users and there organisations. Practical and economical

    - User rigths – what is in the law

    - The word & the silence - the writing & the image : discover the word's power  

    - User and user organizations involving in the NAP's

    - Dialogue between users and professionals
     

  • Undocumented migrant : Migrants, as a consequence of their migration process, are often physically, mentally, emotionally and psychologically strained. The separation from their family members, negative experiences in their country or region of origin as well as the traumas of wandering and of active rejection ..., affecting their physical and mental well-being. Full access to adequate health care is critically important for migrants, denieded of  identity and of respect for personal dignity.
    In this 3 workshops N°5 we would deepest exchange about 1) the place - 2) the health - 3) the participation
    Any suggestions :

MIGRANTS between welcome and rejection : denied identity - dignity - health, the first step is welcome , only after comes  integration: situation, initiatives and proposals

- ANTINOMIES between :  law - ethics – humanism

- WORKERS & USERS :  Dignity and health for users and for workers in "reclusion & parking" camps

- RIGHT & ACCESS to rights : to health & social services;  protection in jobs for immigrants : situation,  initiatives  and proposals

- TRAUMATIC STRESS  for  loss  -  mourning : so many factors that link them to the people who are “the deprived ones….”.

- They have left everything in order to find nothing

- A crossing  to hope that ends up in wrecking in despair !

  Other subjects for exchange and discussion, but concerning the same theme of this workshop's  session are very welcome

SMES-EUROPA
Pl. Albert Leemans, 3 - B-1050 Bruxelles
Tel./fax : (+) 32.2.5385887
Mail :
smeseu@smes-europa.org
PARITÄTISCHE 
R. Kollwitzstr. 94/96 D-10435 BERLIN 
Tel :  (+) 49.30.315919-26 /  fax :...-29

Mail : ditolla@paritaet-berlin.de
web : http://www.paritaet.org/berlin