A rights-based critique of the Turkish mental healthcare reform: deinstitutionalisation without independent living?

Abstract

This article offers a critical examination of the 2006 Turkish mental healthcare reform aimed at deinstitutionalisation and introduction of a community-based approach. Combined with Turkey’s ratification of the Convention on the Rights of Persons with Disabilities, the rhetoric of the reform signified a step towards a rights-based approach. Despite some evidence of progress towards deinstitutionalisation, this article suggests that the reform has largely failed in its goal of implementing a rights-based approach, for three reasons: its inability to address unmet needs for mental healthcare, its failure to complement community-based mental healthcare provision with social policy programmes, and its deficiency in legislating civil rights protections. These failures have engendered an ineffective trend towards deinstitutionalisation rather than facilitating the transition to independent living. Finally, this article calls for a nuanced understanding of deinstitutionalisation, with consideration of the broader social policy and civil rights environment within which the mental healthcare system is embedded.

Points of interest

• While Turkey introduced a reform in mental health in 2006 and ratified the Convention on the Rights of Persons with Disabilities in 2009, the broader implications of these changes for people with mental health problems remain unknown.

• The 2006 reform facilitated independent living of people with mental health problems by launching community-based provision of mental health services.

• Despite this positive outcome, the reform has largely failed to promote independent living as mental health service provision is still limited; employment, housing, personal assistance and income support programmes are lacking; and the rights of people with mental health problems are not brought under legal protection.

• The article argues that to promote independent living, decreasing the capacity of institutional care is necessary but not sufficient. It must be complemented with social and economic support programmes and legal guarantees for the equal rights of people with mental health problems.

Keywords:

• Community-based mental healthcare
• deinstitutionalisation
• independent living
• mental healthcare reform
• social policy
• Turkey

Disclosure statement

No potential conflict of interest was reported by the author(s).