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A call to action to the development community to improve inclusion of people with psychosocial disability

21-11-2014
This image shows the psychosocial youth programme in Sri Lanka meeting regularly.
© Kirimichchai
The psychosocial youth programme in Sri Lanka meets regularly.

Aleisha Carroll, CBM Australia discusses why it is important to include people with psychosocial disability in development.

©CBM
Aleisha Carroll
This month I was privileged to represent CBM at the 2nd Trans-Asia Transforming Communities for the Inclusion of People with Psychosocial Disability Conference convened in Bangkok by Bapu Trust Research Centre for Mind and Discourse and supported by the International Disability Alliance and Open Society. Since its first meeting in 2012, the representation from countries has grown from three countries to twelve and is reflective of the exciting growth in collective voice of people with psychosocial disability in the region. 

The last decade saw the leading body representing people with psychosocial disability actively participate in developing the first internationally binding framework for comprehensively addressing discrimination against people with disability -The Convention on the Rights of Persons with Disabilities (CRPD). The CRPD committee, in May 2013, recommended that international communities should "take measures to ensure that persons with disabilities enjoy their right to development on equal basis with others." This requires supporting people with disability, including people with psychosocial disability, as rights holders who are capable of making their own decisions and participating as active members of society rather than as ‘objects’ of charity and medical treatment (OHCHR, 2014).


Inclusion of people with psychosocial disability is a neglected area of development

CBM Australia provides technical advice and capacity building support to governments, international and national NGOs, and civil society organisations through its Disability Inclusive Development Partnership Program with the Nossal Institute. We have seen in the development sector, a growing recognition that people with psychosocial disabilities are marginalised in inclusive development efforts and, in some contexts, within the disability movement.

Evidence from both high and low income countries tells us that while the concept of psychosocial disability is evolving, what is common for people with psychosocial disabilities is the experience of discrimination and the pervasive exclusion from the social, economic, civil and political life of their communities, including what amounts to human rights abuses within the places that propose to provide 'care' such as institutions, prayer camps, and social care centres (WNUSP, 2008; Drew et al, 2011).

Opportunities for improving the inclusion of people with psychosocial disability in development programs

CBM-Nossal together with colleagues across the Indo-Pacific region and with financial support of the Australian Government Aid Program, recently undertook a synthesis of the available evidence to support development actors in identifying strategic opportunities to improve inclusion of people with psychosocial disability in development programs. Some of the key learning from this review are:

•    Fundamental to the CRPD is the role that people with psychosocial disability play in representing their own interests and priorities. Development agencies should accordingly develop and support partnerships with Disabled People’s Organisations in developing countries. Although people with psychosocial disability remain underrepresented in DPOs in many nations, there is opportunity to build on the growing collective through directly supporting self help groups, networks of people with psychosocial disability, and building the capacity of DPOs. In particular, supporting people with psychosocial disability to lead advocacy campaigns that promote their capabilities.

•    Agencies need to collaboratively examine the communities in which they are working, identifying the multiple ways in which inequality and discrimination is manifest for people with psychosocial disability in different contexts, and formulate approaches to address barriers which are based on a human rights framework. Representative groups ask for particular attention in addressing Article 12 (equal recognition before the law), Article 14 (liberty and security of the person); Article 19 (living independently and being included in the community); Article 15 (freedom from torture or cruel, inhuman or degrading treatment or punishment); and Article 25 (the right to health) (WNUSP, 2013).

•    Development agencies can play a key role in supporting States to target additional support and services to equalize access and opportunities for people with disability, including "providing an array of services, developed in consultation with user/survivor organisations, which may include peer support, crisis hostels and places of safe respite, and advocacy (WNUSP, 2008, p. 20). Although affordable, accessible, and quality medical services are important, comprehensive systems to challenge societal barriers and provide support to people in times of crisis or in daily life that are culturally appropriate and include the communities they serve in its formulation, should be developed.

•    Given the interrelationship of poverty and disability and that high rates of unemployment is particularly evident for people with psychosocial disability, their inclusion in income generation, skills development and economic empowerment programs such as financial services, employment and social protection is vital.


In addition to this review, CBM is supporting an analysis of the effectiveness of State reports on the CRPD to address the situation of people with psychosocial disability. The analysis will help to identify barriers that people with psychosocial disability may experience in participating in the CRPD’s reporting and associated advocacy processes. The outcomes of this work aims to further inform DPOs and INGOs so that they can effectively target awareness raising and advocacy efforts, holding States to account in local planning.

References
Burns, J. (2009) Mental health and inequity: a human rights approach to inequality, discrimination, and mental disability. Health and Human Rights, vol. 11(2), 19 – 31.
Drew, N; Funk, M, Tang, S, Lamichhane, J, Chavez, E, Katontoka, S, Pathare, S, Lewis, O, Gostin, L, Saraceno, B (2011) Human rights violations of people with mental and psychosocial disability: an unresolved global crisis. The Lancet, 378(5)
UNHR (2013) Statement of the Committee on the Rights of Persons with Disabilities
on including the rights of persons with disabilities in the post 2015 agenda on disability and development, May 2013, United Nations Human rights, Office of the High Commissioner, Geneva.
UNHR (2014) The Convention on the Rights of Persons with Disabilities: A training guide. No.19. United Nations Human Rights, Office of the High Commissioner, Geneva.
World Network of Users and Survivors of Psychiatry (2008) Implementation Manual on the Convention on the Rights of Persons with Disabilities. World Network of Users and Survivors of Psychiatry , retrieved November 3, 2014, http://www.wnusp.net/index.php/crpd.html, p. 9.
World Network of Users and Survivors of Psychiatry and Bapu Trust (2013) Human Rights of persons with psychosocial disabilities in the post 2015 Inclusive Development Agenda: Towards HLMDD, September


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