Mental Health Policies in Central and Eastern Europe and the Former Soviet Union

Historically, government policies across Central and Eastern Europe and the former Soviet Union have segregated people with mental disabilities in long-stay residential institutions where the living conditions are often in clear violation of basic human rights. Membership in, or candidacy for membership of, the European Union has done little to promote the social inclusion of people with mental disabilities. In the member states of the European Union, new institutions for people with mental disabilities continue to be built despite the fact that some governments have stated their intent to close institutions.

While there are pockets of high-quality community-based services in the region, and while a number of governments have stated their intentions to move toward a community-based model, tens of thousands of people with mental disabilities are still living in institutions. There is little prospect for change in their lifetime, unless action to shift the provision of care away from the institutions is taken now. Thus, despite many positive political and economic developments across the region in the last fifteen years, the situation for people with mental disabilities is largely unchanged. This lack of forward movement is due to a number of factors:

• Governments continue to institutionalize people with mental disabilities.
• Too often, governments respond to the exposure of severe human rights abuses in institutions by attempting to improve the institutional environment.
• Donors commonly fund short term “solutions” rather than investing in systemic change.

The Mental Health Initiative of the Open Society Institute believes that institutions have no place in civil and open societies. Institutionalization without justification perpetuates the social exclusion of people with mental disabilities and is, in itself, a violation of human rights. Segregating people, barring them from access to education and employment, denying them the right to choose where and how they live and who they associate with, solely on the basis of a mental disability label is unacceptable. The nature of institutions is, in itself, dehumanizing. The existence of institutions is anathema to the concept of a civil and open society in which the rights of all citizens are respected.