The terminology “psychosocial disability” was introduced by the World Network of Users and Survivors of Psychiatry” to eradicate the “mental illness” stigma. Persons with psychosocial disability are people whose mental health condition interacts with a social environment that presents barriers to their equality with others. This concept emerged along with the strengthening of recognition of Human Rights. Unlike the “mental illness” label which is believed to be insanity, psychosocial disability is a concept of human diversity. The psychosocial disability concept also altered the treatment for them from “institutional treatment in mental hospital/asylum” to “provision of community-based psychosocial support services”.
In accordance with Sustainable Development Goals (SGDs)
2030 persons with disabilities, including persons with psychosocial
disability should be one of the subjects targeted by the development works.
Thus, persons with psychosocial disability should be treated as a part of the
nation’s future, not reduced to a group of people who will only receive medical
treatment constantly. As a subject of development, they should be able to
meaningfully participate in the development itself, or even lead the
development agendas. Only by including persons with disability, inclusive
development can be reached where everyone can live and enjoy the future
together.
In 2022 WHO launched deinstitutionalization
guidelines that offer community-based psychosocial support services as a new
solution to replace mental health hospital inpatient “treatment”.
Community-based psychosocial support services offer a comprehensively new
approach where the community holds an extensive role in the provision of
psychosocial support services. Instead of giving them “treatment” in a
closed-setting institution like a mental health hospital or similar facilities,
persons with psychosocial disability could live a better life as a part of the
community, where their surroundings are able to provide psychosocial support.
This is due to the historical context that mental health hospitals formerly
known as asylums were infamous for their roles of alienating those known as
“mentally ill people” since the 8th
century, which later added “medical treatment” starting from the 16th
century. Since the beginning, such institutions have been infamous for
their inhumane treatment where they imprison, confine, and even inhumanly experiment
on them on the pretext that they are “irrational”, “uncontrollable”, and
“committing violence without a cause”. Ironically, they received despicable and
severely inhuman treatment from the self-proclaimed rational people. Thus, the
emergence of human rights discourse makes mental health hospitals and similar
closed-setting institutions became less relevant these days. In recent days,
inpatient treatment inside any closed-setting institutions that makes the
residents vulnerable to violence and inhuman treatment are gradually left
behind and replaced by community-based services.
Inclusive development contains multi-disciplinary
factors such as economic, social, health, education, individual well-being,
etc. As a multi-disciplinary concept, the focus of this concept should not stop
at only one discipline such as public health which is only a health-related
matter. Talking about disability issues as only a part of public health
discourse will never be enough. Shifting from public health into inclusive
development in the disability conception means that we need to view disability
issues as complex multi-disciplinary problems. Thus, disability issues should
be a part of each disciplinary discourse in addressing our future development
goals.
In Human Rights standard persons with psychosocial disability have the rights to be included and fully participate in the community. Such standards are stated in CRPD Article number 19 and 29 respectively. The main idea of inclusion within the community is to ensure persons with psychosocial disability can live amongst others as well as participate effectively in the activities held by community members. This idea opposes institutionalization which alienates persons with psychosocial disability inside the secluded mental health treatment facilities. Since centuries ago, institutionalization always excludes them from the community and is infamous for the inhumane treatment(s) of its residents. Thus, such an approach should be left behind due to its susceptibility to human rights violations.
Support System is a concept that promotes equality as well as strives for each member of society to live independently. Thus, each individual does not have to be alienated in mental health treatment center or similar institution. In this concept the role of the Individual as a subject is essential, thus shifting the role of mental health institutions that usually carry out ‘treatment’ to a role that helps the community to provide psychosocial support to one another. This idea is based on the scientific findings that one’s surroundings have much more impact on their mental health condition compared to the mental health institutions.
The social model and Human Rights Model are paradigms that place persons with disabilities (including persons with psychosocial disabilities) as a part of human diversity that is inseparable from society which has equal rights with others. This definition is a means to replace the medical model paradigm which presumes disability as an individual tragedy that needs to be ‘treated or cured’. As a result, it creates normal-abnormal as well as abled-disabled segregations which exclude persons with disabilities from society due to direct and indirect discrimination in various forms such as cultural, structural, and attitudinal. Thus, the Social and Human Rights Model which carries the inclusivity spirit tries to alter the paradigm, so that no one is left behind and each and every person could have and able to exercise their rights on an equal basis with others.
Is an organization of Persons with Psychosocial Disabilities focusing on the monitoring and implementing the rights of Persons with Psychosocial Disabilities in Indonesia. REMISI believes, in order to build an inclusive community, we have to change the paradigm of medical model of disability to social and human rights model of disability.
We aspire the inclusion of Persons with Psychosocial Disabilities involves a paradigm shift and reassembling of medical model policy to social model; mental illness to psychosocial disability, groups of patient to persons with psychosocial disabilities as a subject of development, mental hospital to community-based psychosocial services, public health to inclusive development; institutionalization to inclusion within the community, and treatment to support systems.
To fight the stigma, discrimination, and human rights violation, REMISI advocates the rights of Persons with Psychosocial Disabilities to achieve equal rights in every aspect of life with dignity and fundamental freedoms to live independently, meaningful participation and contribution, and being included within the communities.
REMISI was founded by Persons with Psychosocial Disabilities who are experts from various cross-issues such as disability, gender, sexual minorities, and also involves professions from various areas of expertise.
Society that fully includes persons with psychosocial disabilities
Revolusi Dan Edukasi Masyarakat Untuk Inklusi Sosial Indonesia
Jl. Kramat VI No. 18, Senen, Jakarta Pusat, Indonesia – 10450
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