Users and Community PARTICIPATION AND EMPOWERMENT

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Users and Community PARTICIPATION AND EMPOWERMENT

• plurality of the individuals (the emergence of
  the subjects)
• real interactions and alliances promoted by
  deinstitutionalization
• To optimize both exchanges and relationships,
  within the range of action of the services
• "potential mental health agents"
• the casting of active roles, the activation and
  the productivity of those values which are used
  in relationships
• participation as a contribution to further
  modifications of a mental health service

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WORKERS' EMPOWERMENT IN CMHS

• Developing a shared therapeutic culture.
• Not only a multi-disciplinary approach but
  optimization of human resources
• overcoming of the rigidities of professional
  roles
• different subjectivities
• different points of view
• power decisional spaces and initiatives

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• Should we use the person key to change the
  systems? How (power, rights, values)?
• (the risk of ideology)
• Should we use the systems change (more
  integrated) to reach the person and to empower
  him/her?
• (the risk of pragmatism)
• What about community building around mental
  health?
• De-institutionalisation distance, power,
  language, paradigm

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Deinstitutionalisation

• The gap between values (statements) and practice
• What is practically true (Sartre)? Visible?
• Whole systems approach is related to complexity
• De-institutionalise our practice is a key for
  change (power gradients and shifts, subjectivity)

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From hospitalisation to hospitality

• Institutional rules
• Institutionalised Time
• Institutionalised (ritualised) relations
• among workers / and with users
• Time of crisis disconnected from ordinary life
• Stay inside
• A stronger patients' role
• Minimum networks inputs

• Agreed / flexible rules
• Mediated time according to users needs
• Relations tend to break rituals
• Continuity of care before/during/after the crisis
• Inside only for shelter /respite
• Maximum co-presence of SN

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From hospitalisation to hospitality

• Difficult to avoid
• Locked doors
• Isolation rooms
• Restraint
• Violence
• Illness /symptoms /body-brain

• Open Door System
• Crisis / life events / experience / problems

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• The model comes out from deinstitutionalization
  of roles, of powers,
• Hence the development of a therapeutic culture in
  the service (community mental health)
• Relation with the person, not with the illness
  lifetime (continuity) / social reproduction
  processes of the individual (as a subject)
  between health and illness
• The user becomes a subject in front of the
  service, in relation with -
• No treatment and specialist techniques but
  uniqueness of the project therapeutic/of life
  (recovery).
• MEET the challenges!

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Toward a value-driven service

• A citizen with rights
• Helping a person and not treating a illness
• Understand events of life, overcome crisis
• Explain and discuss experience
• Not losing value as a person (invalidation,
  neglect, violence)
• Keep social roles and maintaining social networks
  / systems
• Develop growth potential (recovery)
• Have opportunities real empowerment
• Change (living conditions, style)
• Material resources (work, money, practical help)