deinstit-psy and community cure & care

Psychiatric  deinstitutionalisation  and
 Community  based  services  for  cure & care

 promote equality access to health & mental health services in community :

hospital   –   residential unit   –   protect housing   –   shelters...


Each person exists when

his silence is heard and his word is understood

WHO would hear the body's silence and the cry ?

Questions  & Debate


  The link between mental health/well-being and poverty has never been properly addressed in EU anti-poverty policies, and this issue becomes more important/urgent with the increasing numbers of homeless people with serious mental health problems living on the street without any appropriate support available to them.

  Because of the close interaction between  health & mental health problems   and   poverty & extreme poverty,  it is absolutely necessary -  first of all -  underline causes and factors involved in deterioration of this chronic situation and - secondly -  to define  coherent strategies, promote  adequate projects and programme  sustainable plans that are complementary to the social  and  health perspectives

1.      Deinstitutionalisation

Background : Today more and  more, European Institutions,  Organisation working for respect of  dignity & human right, Health / Mental Health Organisations,  have in agenda  - as priority  - the deinstitutionalisation, psychiatric deinstitutionalisation & community based cure & care  services.

Deinstitutionalisation  sure is not question of simple building renovation and not more structure modernisation, but of alternative vision of life and of respect of dignity , diversity, identity and fundamental rights of each people.

For this  deinstitutionalisations - first of all  - must  be an humanistic permanent process that involve all civic society:  patients and families, professional people and volunteers;  policy makers and administrators, civil associations and university, trade market and media, in order to insure that  each citizen is involved in this renovation of community life, in respect and  facilitation - for each people – the equality access to Rights and Well-being.

Permanently exist the risk – if deinstitutionalisation is mainly to restructure, to rationalize the cost  and similar practical exercise  -  of  a new institutionalisations, this means the tendency to uniform, to conform the differences of persons and of Organisations and Institutions  for better applications of models unique.


2.      Psychiatric deinstitutionalisation

Some key-words and topics  for  deepest innovative ideas , exchanges about alternatives practices,  propose absolutes priorities  :  

  The ‘Institution’  :  in general way each individual, needs of institution, but only as long as the institution does not become suffocating the dignity, identity and well-being of the individual person. (Ex. family institution, school institution, etc.)

  Decent Institution  is  each kind of  Institution  that  not humiliate , but take care and promotes the development, autonomy, growth up and empowerment of each person to whom makes the service  The benchmarks of each correct deinstitutionalization is the enhancement of the person and the promotion of human dignity and identity  

  The first deinstitutionalisation is in mentality: it’s a process that transforms the aptitudes & relationship not only between “users – professionals - families”,  but involving in this process of rebuilding all concerned people, from policy makers & administrators  to workers in social and health field, in order to invest together in community for health/mental health  services,  really efficient and of equality access for all.

  To invest in sustainability, in quality,  in proximity, in flexibility; co-working  for create bridge between inside institution and outside in community,  broking  close mentalities and barriers .

3.     Community based cure and care:   some  questions   

  1. what really we means  - today - with   : “Community” ?… and  ‘Social care’ ?   

  2. what kind of relation we realise between :  inside (health, mental health institution and outside (in community: health & mental health services, housing first? shelters?)

  3. what we means for sustainable  cure  (treatment) and care (take in charge) in community?

  4. About  ‘independent life’ :  evidently this concept is in opposition with depended institutionalised life’. But  exists  real   risk   slipping from independence to loneliness .
    “Nobody is a island”, but “inter–dependent” especially when people are working for inclusive participation and responsibility of each people in citizen life.

Which are the programs, projects and practical initiatives that aim to eliminate or at least to reduce the gap between the rights granted in international declarations (health – housing – labour) and the barriers preventing people in situation of great precariousness accessing these rights in practice.

 How to improve equal and  for all access to basic services especially in times of austerity and cuts ?  

 How promote and facilitate access of homeless to health/mental health services and of social & health service providers to homeless people when they are living on the streets ?

 How to ensure the fundamental rights of undocumented migrants: how their specific vulnerabilities & marginalisation impact on their mental health situation and their access to services ?


Deinstitutionalisation bibliography : please point us  documents, articles, studies, presentations of experiences that specifically address this issue; your comments and proposals concerning  this field are welcome  !  Thank

  Learning From History: Deinstitutionalization of People with Mental Illness As Precursor to Long- Term Care Reform 

  Deinstitutionalization and reinstitutionalization: major changes in the provision of mental healthcare Walid Fakhoury Stefan Priebe

  Some Perspectives on Deinstitutionalization H. Richard Lamb, M.D. Leona L. Bachrach, Ph.D.

 “Violent deinstitutionalization and economic crisis in Greece” Theodoros Megaloeconomou, CHMC, Athens, Greece


 Inside an abandoned psychiatric hospital: Building 25 at Creedmoor Psychiatric Center in Queens, New York

  L’approccio psico-sociale e comunitario al mondo della graveemarginazione Europea 2014-20

  Deinstitutionalisation and Community Living: Outcomes and costs - a report of a European Study.

 Homelessness and Mental Illness: A Story of Failure Robert E. Drake

 Out of the wards and onto the streets? Deinstitutionalization and homelessness in Britain : Ph Timms - Th Craig

  Homelessness and Mental Health, FEANTSA



  Social Europe - Aiming for inclusive growth:  Annual report of the Social Protection Committee on the social situation in the EU (2014)

SMES-Europa :  contact  Luigi Leonori    -   Tel. / fax: +32.2.5385887   -   tel. mob.  +32.475634710