Human rights conditions and quality of care in ‘Independent Living Homes’ for adults, who have intellectual and/or psychosocial disabilities, in Vilnius : analysis of good practice examples, systemic challenges and recommendations for the future

• Autor(a) principal: Grigaitė, Ugnė
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10362/26693
• topic: Mental Health; Human rights; Psychosocial disability; Intellectual disability; World Health Organization; Lithuania; Saúde mental; Direitos humanos; Incapacidade psicossocial; Incapacidade intelectual; Lituânia; Ciências Médicas

ABSTRACT: Within the broader context of related major paradigm shift taking place across the world, Lithuania is currently undergoing its own deinstitutionalization of social care and mental health services. The above mentioned paradigm shift from the bio-medical towards a more comprehensive bio-psychosocial model has been brought about internationally with the adoption of the UN Convention on the Rights of Persons with Disabilities over a decade ago. Lithuania ratified this human rights treaty in 2010 and over the following years started implementing its provisions and principles in national legislation, policies, plans, programmes and practices. As a major part of the deinstitutionalization process, new community-based services, such as two ‘Independent Living Homes’ in Vilnius, were established. It has been planned that these new services will eventually replace the long-term residential care, which is presently predominant and rooted in institutional culture. The main questions addressed by this study examine the actual effectiveness of such new services, the quality of care provided in them and the level of compliance with international human rights standards on the ground. This thesis explores the critical need to ensure that the human rights based approach is at the core of any new developments and delivery of community-based services, and of deinstitutionalization in general. Based on the comprehensive literature review, as well as the unique empirical research findings herein, obtained by implementing the WHO QualityRights Assessment in two Municipal ‘Independent Living Homes’ in the capital city of Lithuania, this study points to both the good practices, as well as the gaps in these services’ provision. Additionally, it discovers the deeply-rooted systemic issues that surround and restrict the current and potentially the future development, effective delivery and improvement of community-based services for the most vulnerable individuals in our society. This thesis suggests that there is a great need to critically review the current direction of the deinstitutionalization in Lithuania. It is crucial to ensure its compliance with the international human rights standards and evidence-based best practices. At the same time it is important to truly involve persons, who have mental health problems, intellectual and/or psychosocial disabilities, as well as their families, and representing organizations, in all stages of such a review and also of planning for the future of community-based support and services in the country.