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Professional Conference

Deinstitutionalization* in Serbia

Belgrade, January 28-29, 2014

Recommendations to the Serbian government and relevant ministries for efficient deinstitutionalization process >>>


On January 28-29, 2014, at the close of two compatible projects – “Strengthening NPM and Advocacy for the Rights of Institutionalized Persons” and “Prison Reform Monitoring” – realized with the assistance of Civil Rights Defenders and the Royal Netherlands Embassy respectively – the Helsinki Committee convened yet another two-day professional conference under the title “Cooperation between the Civil Society and the Government in the Process of Deinstitutionalization.”

The purpose of the conference was to initiate the dialogue between governmental officials, independent regulatory bodies, managements of psychiatric and social care institutions catering for beneficiaries, NGO activists and formerly institutionalized beneficiaries on the challenges facing Serbia in the process of deinstitutionalization of psychiatric patients and persons with mental/developmental disabilities.

The conference assembled representatives of ministries of healthcare, education, labor and social policy, the Republican Bureau for Social Protection, Citizens’ Ombudsman and Provincial Ombudsperson, and, above all, professionals from specialized hospitals and social care homes from Vršac, Kovin, Novi Kneževac, Novi Bečej, Padinska Skela, Kragujevac, Tutin and Sremčica. Associations of former psychiatric patients, physicians, psychologists and other independent experts, and civil society organizations concerned with this complex problematic were also represented in the conferences. All of them actively participated in the proceedings, contributed to deeper insights into the problem of deinstitutionalized and helped organizers to formulate guidelines for future activities.

Welcoming the participants, Chairwoman of the Helsinki Committee Sonja Biserko underlined that the ongoing practice of institutionalization and treatment of persons with mental and developmental disorders seriously breached their fundamental human rights, and reminded of Serbia’s commitment to deinstitutionalization. Such a commitment is the more so important since the Chapter 23 of the accession negotiations with EU examines the level of protection of fundamental human rights of candidate states, she said. To meet the conditions laid down in the Chapter Serbia must undertake reformist moves that would positively affect citizens’ everyday lives, especially those coming from vulnerable groups of population, added Biserko.

According to Deputy Ombudsman Miloš Janković the Ministry of Healthcare and the Ministry of Labor and Social Policy, as crucial factors in the process of deinstitutionalization, were not cooperating at all. The state of Serbia must clearly define its concept of deinstitutionalization, adopt relevant laws and bylaws, develop an action plan and designate implementers so as not to allow poorly capacitated local self-government to independently cope with this delicate problem, he explained.

Dr. Vladimir Jović - psychiatrist, psychoanalyst, NPM expert and co-founder of the International Aid Network – said that medical officers were the biggest stumbling bloc in the way of deinstitutionalization. The so-called political will is not only weak but practically non-existent: as it seems, the relevant authorities are interested in maintaining the existing system of institutionalization of psychiatric patients, which contradicts contemporary methods of psychiatric treatment. Some progress has been made within the social care system but that is insufficient considering the strong resistance to deinstitutionalization of its counterpart – the healthcare system. This resistance is probably best illustrated by the recently adopted Rules for the Use of Physical Restraint and Isolation of Psychiatric Patients, he said.

Participants in the conference discussed the situation of institutions catering for persons with mental disorders and the problems inherent to relevant ministries, but also tackled many challenges to deinstitutionalization (current procedures for depriving persons of earning ability, education and employment, community-based medical care and other services to support persons with mental disorders, etc.), inadequate professional capacity of institutional personnel, the existing strategy, the newly established centers for mental health, the activities to promote community-based care and overcome resistance to it, etc. Focusing on the models of good practice such as special psychiatric institutions in Kneževac and Vršac, as well as the Kragujevac-based Medical Center and the Mental Health Counseling Service, the participants concluded these were nevertheless isolated cases relying on individual enthusiasms rather than on a systemic process.

The conference was the follow-up to the Committee’s years-long advocacy for the promotion and protection of human rights of all citizens of Serbia, especially those coming from marginalized and vulnerable groups. On the basis of its experience in on-site scrutiny of social care institutions catering for beneficiaries and psychiatric patients, the conference proceedings, as well as the exchanges with independent regulatory bodies, concerned NGOs and associations of former beneficiaries, the Committee has developed recommendations to the Serbian government and ministries aimed at speeding up the process of deinstitutionalization.


* Deinstitutionalization is the process of replacing long-stay psychiatric hospitals and social care institutions with less isolated community mental/social care services for those diagnosed with mental disorders or developmental disabilities.













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