WHO assessment: European mental healthcare institutions below standard

WHO assessment: European mental healthcare institutions below standard

A new WHO/Europe report has raised concerns over the quality of European mental healthcare institutions, saying that it is well below standard.

The report, ‘Mental health, human rights and standards of care’, assesses the quality of European mental healthcare institutions care for adults with psychosocial and intellectual disabilities.

A total of 75 institutions across 24 countries and Kosovo (in accordance with United Nations Security Council resolution 1244 [1999]) were evaluated in collaboration with national authorities.

About the assessment

Out of over 2,000 ratings made by national assessment teams, only 25% fully complied with internationally agreed standards of care. This finding has indicated that improvements need to be made to reform every country’s system of institutional care.

The assessments looked at the goings on behind the scenes within long-term institutions through the lens of the United Nations Convention on the Rights of Persons with Disabilities, in terms of quality of care provided and the extent to which human rights are being protected.

Throughout the countries and facilities assessed, there was shown to be a general lack of awareness about mental health and human rights, even among the staff.

A substantial proportion of the institutions were found to be violating the rights of residents, including their:

  • Dignity;
  • Liberty;
  • Physical and mental integrity;
  • Legal capacity; and
  • Freedom from torture and ill treatment.

Change comes from the inside

Dr Daniel Chisholm, programme manager for mental health at WHO/Europe and project lead for the report, said: “If we want to improve institutional care, we can’t simply renovate or update buildings. The change has to come from inside. We need to build up awareness, skills and literacy around mental health and human rights.

“This needs to happen at all levels of society, from policymakers to the staff working in institutions. Armed with this knowledge, we can then start to implement more humane practices and give people more positive experiences within – or, far preferably, outside – institutions.”

From quality assessment to quality improvement

Chisholm added: “This assessment takes us to the next phase of work, where we move from quality assessment to actual quality improvement. For example, next month we are bringing together 15 country teams for advanced QualityRights training with a view to subsequently roll out better standards in selected institutions from each country.

“An independent monitoring mechanism is also an important part of raising standards in countries, and WHO recommends countries give full consideration to the creation of such a mechanism.”

The ultimate goal

He concluded: “The ultimate goal is to move away from institutionalisation and towards community-based care. But that process can be lengthy and requires transitional funding. This report focuses on what we can do right now to equip those already working in the system to change their mindset to see that the people living in institutional care have rights like any of us.

“Once you start doing this, you begin to understand that long-term institutions really aren’t the right places to care for these people.”

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