http://orcid.org/0000-0003-1147-2970
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ABSTRACT
This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the Netherlands) confirms the findings of other studies that – regardless of geographical location – people with a psychiatric disability have difficulty fulfilling social roles in the community. They are often faced with fewer opportunities than other citizens, due to their health problems, stigma, discrimination and poverty [World Health Organisation. (2011). World report on disability. Geneva: WHO]. An important objective of social work is to help people find their way in society. Surprisingly enough, in all three countries, most social workers are mainly focused on solving individual problems, and not on community participation. Shifting the focus starts by having a clear awareness of the notion of community participation. Social workers have to work both on supporting individuals to find their way in the community (individual support), and on supporting social networks in the community to accommodate persons with a disability on the basis of equal and valued citizenship (community support).
ABSTRAKT
Artikkel uurib, mil viisil vaimse tervise ja sotsiaalteenused võimaldavad psüühikahäirega inimestel erinevates eluvaldkondades osaleda. Ulatusliku projekti käigus, mis keskendus kogukonnas osalemise uurimisele Eestis, Ungaris ja Hollandis, selgus, et sõnadel ‘kogukond’ ja ‘osalemine’ on erinevad tähendused. Uurimus kinnitab varasemaid tulemusi, et olenemata geograafilisest asukohast on psüühikahäirega inimestel raskusi oma sotsiaalsete rollide täitmisega kogukonnas. Võrreldes teiste kodanikega seisavad nad sageli silmitsi piiratumate võimalustega tulenevalt oma terviseprobleemidest, stigmast, diskrimineerimisest ja vaesusest (World Health Organisation. (2011). World report on disability. Geneva: WHO.). Sotsiaaltöö oluliseks eesmärgiks on aidata inimestel leida oma koht ühiskonnas. Mõnevõrra üllatuslikult on enamik sotsiaaltöötajaid kõigis kolmes riigis keskendunud peamiselt individuaalsete probleemide lahendamisele ja mitte niivõrd kogukonnas osalemise toetamisele. Fookuse muutumine algab teadlikkusest, mida kogukonnas osalemine tähendab. Selgub, et kõigis kolmes riigis omab kogukonnas osalemine erinevaid ja tihti ebamääraseid tähendusi. Me näeme kogukonda mitmekihilise mõistena, seega mitte ainult geograafilise asukohana vaid rohkem või vähem organiseeritud sotsiaalse kapitali vormina. See sotsiaalne kapital seondub sotsiaalsete võrgustikega, mis on seotud perekonna, töö, hariduse, religiooni ja huvitegevusega. Sotsiaaltöötajatel on oluline roll töötamaks mõlemas suunas: toetada indiviide ühiskonnas oma koha leidmisel (individuaalne toetus) ja toetada sotsiaalsete võrgustike (taas)loomist, kus inimesed üksteist, s.h. puuetega inimesi, vastastikku toetavad (kogukonna toetus).
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes on contributors
Jean Pierre Wilken is a professor of social innovation at Utrecht University of Applied Sciences in the Netherlands. His main fields concern the support of persons in vulnerable positions with regard to self-reliance and community participation. He is also a visiting professor at the School of Governance, Law and Society at Tallinn University and president of the CARe Europe network.
Zsolt Bugarszki is a social worker, expert of social policy, lecturer at the School of Governance, Law and Society at Tallinn University. His main field is mental health and disability care dealing with promoting community bases alternatives to large institutions in different Eastern European and Post-Soviet countries.
Karin Hanga is Executive of a Rehabilitation Competence Centre in Estonia and a Ph.D. student at Tallinn University, School of Governance, Law and Society. Her research activities relate to the development of assessment and intervention methods in the field of disability, social and vocational rehabilitation, and community participation.
Dagmar Narusson (MSW) is a Program Director of the Bachelor studies and Lecturer of Social Work in the Chair of Social Work at the University of Tartu, Estonia. Her research and teaching interests are related to community work and social inclusion of people with disabilities, support work qualities in mental health client work, social counselling, group work, health care social work and social rehabilitation process.
Koidu Saia is a Research coordinator and a Ph.D. student at Tallinn University, School of Governance, Law and Society. Her research and development activities have been related with the fields of mental health, coping of elderly and community support in social work. Her Ph.D. thesis is focused on interprofessional assessment and intervention in juvenile offenderś rehabilitation teams.
Marju Medar is an Associate professor at the School of Governance, Law and Society, University of Tallinn. She undertakes research in the field of social work and rehabilitation and actively contributes to the development of social and mental health services in Estonia. She has published various articles on social services, rehabilitation and care management. Alongside academic work she actively contributes to continues learning and development programs and projects related to case work methodology and rehabilitation directed to improve local communities in Estonia.
ORCID
Jean Pierre Wilken http://orcid.org/0000-0003-1147-2970
Notes
1 In his book ‘Kozossegek valsaga es hianya’ (The crisis and lack of communities) Hungarian sociologist Elemer Hankiss pointed out that communist ideologies had very bad impact on local communities. Continuous ideological trainings, forced campaigns and demonstrations created a false sense of community. In fact people preferred to withdraw into their private sphere. Researches, conducted in the early 80’s showed that the Hungarian society became extremely individualist without any natural defence mechanism of local communities.
2 Deinstitutionalization brought debates on the meaning of community and community based care in Hungary. Institutions and mental hospital often argue that their long-term care home is community based as they are located in the territory of towns or villages. On the other hand reform-oriented professionals pointed out that these places has no real connections with local communities. Introducing outreach services are obviously important steps towards community care but if these services are working with the attitude of traditional mental health institutions, new services will be rather extension of institutionalization instead of promoting community integration.
3 Social work in Hungary was reborn in 1989 after 40 years pause. Having a history of 25 years we hardly can talk about real traditions.
4 The influx of large number of immigrants since the 1960’s (mostly from Surinam, the Dutch Antilles, Morocco and Turkey), and temporary workers from the Eastern European countries since the turn of the millennium (most of them coming from Poland), has led to a ‘mixed society’. Integration is a major issue, requiring ‘new comers’ to learn the Dutch language and adapt to the Dutch culture. A culture, however, which itself has become very ‘mixed’, being influenced by both globalisation and immigration. Tensions with regard to integration have been enforced by extreme right wing politicians, who feed negative attitudes towards people with an Islamic background.