How to?  Preconditions of community support systems and specific support services, before DI

DI presupposes the presence of an inclusive psychosocial ecosystem in all areas of human habitation, neighbourhoods and in communities.  However, governments do not support creation of community support systems and specific community services.  Specific services are needed for persons with disabilities to be able to access generic services. In LMIC countries, specific support systems and services are non existent, leading to significant negative impact on persons and their families. Planning strategies for preventing DI is also a critical policy making step.  For this, inclusive communities must be enabled.

Worldwide, a number of initiatives designed and led by persons with psychosocial disabilities and persons with intellectual disabilities and their families have been developed and sustained over the decades, often without any government support.  Governments must support these efforts.  Such support services include Circles of care, Hearing voices support groups, Intentional peer communities, independent peer zones, online support communities, arts and spirituality-based support circles, self-advocacy peer support groups, etc. These are independent community development initiatives not linked to mental health services.  Developing inclusive community support systems may be done using a variety of methodologies such as fostering support groups, respite care for families, enabling participation in cultural, sports, indigenous practices and performances of arts, leisure and overall improving participation and access to social capital at the community and neighbourhood level.

Specific psychosocial  support systems include active listening networks and ‘sit and talk’ hubs, ‘tell your story’ cafes, ‘Just Being’ centers, befriending and companionship services, personal assistance, mindfulness and yoga centers,  club houses, online support systems especially for young people and those contemplating suicide,  retreat spaces without regimented schedules or expectations / compulsions to ‘move on in life’, places of nature for healing,  altruistic spaces with warmth and nourishment for the homeless and persons without family support…. These and more practices will help realize the full inclusion of persons with disabilities.  These are ‘ways of life’ in many cultures; however, the genuine support function of ‘community’ may have to be redefined and reclaimed in several cultural and geographic contexts.

How to?  Access to generic services after De-Institutionalization

Often, when it comes to persons with mental, intellectual and psychosocial disabilities, addressing the medical and rehabilitation aspects of impairment takes center stage.  Or, mainstream services link providing a service with taking medication or treatment.  Access to trainings, skill development, improving employability, housing options, supports needed to live independently and resources for living a life with adequate standard of living, remain forgotten.  For de-institutionalization to be safe for the de-institutionalized persons and for them to have the outcome of inclusion, there must be improved access not only to specific services, but to generic services.  This includes a vibrant educational environment for lifelong learning, respect for diversity in social and economic life, employability and skills development, housing, social protection, opportunities for participation in community life, leisure, recreation, grooming, sports, spiritual pursuits, friendships and relationships and play.   Legal barriers to enjoying personhood, political and civic participation must be removed, and the process eased for obtaining personal documentation for citizenship, disability cards, pensions and other entitlements.   A compensation package to support people in the immediate time after DI will help a lot to help them to recover their lives and live with adequate standard of living in open settings without fear and insecurity. Access, use and communication of mainstream services should be accessible to persons with disabilities and reasonable accommodation should be ensured in a way that it respects the person and preserves their identity and personal information.