Mental disability: rights, education, employment

Two debates on the problems of people with mental
disorders have taken place simultaneously in Moscow.  Participants in the session of the Federation
Council’s Disability Council discussed questions of legal regulation and
practical activity in the area of social protection of sufferers of mental
illness in Russia.  Problems of
stigmatisation of such patients, and psychiatry as a discipline, were reviewed
by experts and journalists as part of the round table meeting, “Psychiatry.
Society. The media”, at RIA Novosti.


According to statistics, More than 4 milion Russians
have been diagnosed with mental disorders, a third of whom are under the age of
20. In the last 20 years, the number of sufferers in Russia has increased by
17%.  Depression has hit 80% of people at
least once.  This is the world’s second
most prevalent mental disorder, leading to disability.


Experts at the Russian charitable foundation
“Quality of Life” ascertain that, today, people with mental disorders and
peculiarities of mental development are the most stigmatised (subject to
prejudice) in society.  Many are
therefore afraid to seek psychiatric help, so as not to receive the “stamp”
which could lose them their jobs and places in education.  This is partly exacerbated by inaccurate
accounts of psychiatric problems in the media.


Which measures must be undertaken to change the
situation was discussed in the Federation Council by senators, deputies,
representatives of federal and regional government, scientific and public
organisations, leading medical experts, and chief specialists in psychiatry
from the regions (in all, more the 100 people). 
Valentina Matviyenko, Chair of the Federation Council, emphasised that
“Sufferers should not have to adapt to their environment; a comfortable
environment should be provided for them to live in society”.


The most acute problem was deemed to be the
infringement of citizens’ rights by courts ruling that they are
incapacitated.  Today, 95% of people
suffering from mental illness have been declared incapacitated without the
right to have this verdict reconsidered, which automatically crosses them out
from public life and deprives them of the right to independence.  From a medical and social point of view, half
of these patients could adapt.  Valery
Seleznev, chair of the Duma committee on property and member of the Disability
Council, says that people should have the right to appeal a verdict of
incapacity every two to three years. 
Participants in the Council session proposed the introduction of a
concept of “limited capacity”.  In
contrast to incapacity, such people can independently accomplish small everyday
transactions.  Limited capacity would not
be an obstacle to marriage or opportunities of work.  This is particularly important since 70% of
people considered disabled by mental disorders are of working age.


The question of inclusive education is considered no
less important.  More than 122,000
children with mental disorders require special teaching to assist their further
public and professional integration. 
Anatoly Bogdanov, deputy chief doctor at the clinical psychiatric
hospital in Arkhangelsk, spoke about the programme for organising sheltered
housing for children leaving the boarding school for those with serious mental
disorders.  The essence of the
experimental programme is that former boarding school pupils are given housing
for three to five years, during which they undergo professional training and
find employment.  In the period from 1999
to 2012, 16 adolescents have participated in the programme, 13 of whom could
fully adapt to life in society: they are employed, have started families, and
are raising children.


Arkady Shmilovich, deputy chief doctor of the N.A.
Alekseyev Clinical Psychiatric Hospital No. 1, said that “Any rehabilitation of
the mentally ill has no meaning if the patient does not see the prospect of
employment”.  According to Shmilovich,
stages are the most important aspect of the process of work
rehabilitation.  First the patient must
adapt to production, to repetitive work processes, then transfer to a regime of
greater activity, and at the final stage, establish a regime of independent
work in individually tailored conditions. 
The professionals concerned with this should be medics. In the conditions
of a modern economy, however, the final link in the chain should be the
employer, but the problem of integration of the disabled in business remains


Maria Kulik, president of the “Quality of Life”
foundation, considers that the essence of the problem lies in the appraisal of
the employment of disabled people from the point of view of social support,
without taking into account the interests of business.  The provision of work conditions for the
disabled, in her opinion, leads to an increase in expenses, a rise in the cost
of products, and a decrease in competitiveness. With regard to this, government
support is necessary for employers who are prepared to take on disabled workers
in their enterprises.  The round table
discussion at the new agency also talked about the necessity of support for
people with mental disorders.  Experts in
the field of psychiatry explained to media representatives how their attitude
is important to the formation of public opinion in relation to the disabled.


Vasilyi Yastrebov, director of the Mental Health
Research Centre of the Russian Academy of Medical Sciences and chair of the Health
Ministry’s Public Council for Mental Health, considers that the most important
task of the media is to shed light on the problem of mental health and urgent
issues of psychiatry in a balanced way, which is possible only on the basis of
close collaboration between media representatives and psychiatrists.  Irina Kravchenko, press secretary of the
journal “Our psychology”, said that to achieve such cooperation is fully
practicable.  She proposed educating
journalists so that, while “sticking to the format demanded by the media
market, they respect the principle ‘do no harm’”.  As for the practical implementation of such
training, it could take the form of recommendations on how to cover particular
cases, and on the advantage of social advertising of psychological
rehabilitation centres and hotlines.  In
Kravchenko’s opinion, the platforms on which detailed recommendations could be
made are the professional associations of psychiatrists, journalists’
organisations, and the Public Chamber.


Contact: Russian charitable foundation “Quality of
Life”, tel. +7 905 587 44 64

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