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Labour market inclusion of people with disabilities: Paper presented at the 1st Meeting of the G20 Employment Working Group

INTERNATIONAL LABOUR ORGANISATION (ILO)
ORGANISATION FOR ECONOMIC COOPERATION AND DEVELOPMENT (OECD)
February 2018

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A common understanding of how to approach the employment of persons with disabilities in a way that respects social justice, human rights and decent work as a key element of more inclusive economies and societies is sought. Having the employment of persons with disabilities on the G20 agenda is also a reflection of the increased attention to the rights of persons with disabilities both at a national as well as at an international level. The contribution focuses on one particular group of people with disabilities, namely those who may have been born with disabilities or may have developed some during their lives, but either way have remaining work capacities and are at working age. 

Employment-to-population ratio statistics for persons with and without disabilities are provided for some of the G20 countries. Economic and social determinants of low employment rates of people with disabilities are discussed.

 

Policies across G20 countries for the labour market inclusion of persons with disabilities are discussed

  • demand side - promoting disability inclusion within the private and public sector
  • supply side - ensuring that persons with disabilities have the skills as demanded by the labour market
  • making the environment more enabling 
  • mental health as a special challenge
  • measurement and quality data to inform evidence-based policies

 

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PETERSEN, Inge
et al
February 2017

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The aim of this study was to identify key governance issues that need to be addressed to facilitate the integration of mental health services into general health care in the six participating "Emerald" countries (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda).  The study adopted a descriptive qualitative approach, using framework analysis. Purposive sampling was used to recruit a range of key informants, to ensure views were elicited on all the governance issues within the expanded framework. Key informants across the six countries included policy makers at the national level in the Department/Ministry of Health; provincial coordinators and planners in primary health care and mental health; and district-level managers of primary and mental health care services. A total of 141 key informants were interviewed across the six countries. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesised at a cross-country level.

Mental health and human rights : Report of the United Nations High Commissioner for Human Rights

OFFICE OF THE HIGH COMMISIONER FOR HUMAN RIGHTS
January 2017

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"The present report, mandated by the Human Rights Council in resolution 32/18, identifies some of the major challenges faced by users of mental health services, persons with mental health conditions and persons with psychosocial disabilities. These include stigma and discrimination, violations of economic, social and other rights and the denial of autonomy and legal capacity.

In the report, the High Commissioner recommends a number of policy shifts, which would support the full realisation of the human rights of those populations, such as the systematic inclusion of human rights in policy and the recognition of the individual’s autonomy, agency and dignity. Such changes cover measures to improve the quality of mental health service delivery, to put an end to involuntary treatment and institutionalisation and to create a legal and policy environment that is conducive to the realisation of the human rights of persons with mental health conditions and psychosocial disabilities"

A/HRC/34/32

Human Rights Council, Thirty-fourth session, 27 February-24 March 2017

Mad studies: Intersections with disability studies, social work, and mental health

INTERSECTIONALITIES, A GLOBAL JOURNAL OF SOCIAL WORK, ANALYSIS,RESEARCH, POLITY AND PRACTICE
December 2016

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A special issue of the online journal "Intersectionalities - A Global Journal of Social Work Analysis, Research, Polity, and Practice", Vol 5, No.3 (2016) providing 10 articles on the theme of Mad studies. Titles of papers included are: 

Doing Mad Studies: Making (Non)sense Together; 

An Introduction to Anti-Black Sanism; 

Why Mad Studies Needs Survivor Research and Survivor Research Needs Mad Studies; 

Recovery-as-Policy as a Form of Neoliberal State Making; 

“About Nothing Without Us”: A Comparative Analysis of Autonomous Organizing Among People Who Use Drugs and Psychiatrized Groups in Canada; 

Too Young to Be Mad: Disabling Encounters with 'Normal' from the Perspectives of Psychiatrized Youth; 

Relocating Mad_Trans Re_presentations Within an Intersectional Framework; 

A Desire to be ‘Normal’? A Discursive and Intersectional Analysis of ‘Penetration Disorder’; 

Racialized Communities, Producing Madness and Dangerousness; 

Psy-Times: The Psycho-Politics of Resilience in University Student Life

Improving Ghana’s mental healthcare through task-shifting-psychiatrists and health policy directors perceptions about government’s commitment and the role of community mental health workers

AGYAPONG, Vincent
et al
October 2016

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The aim of this study was to examine the perceptions of psychiatrists and health policy directors about the policy to expand mental health care delivery in Ghana through a system of task-shifting from psychiatrists to community mental health workers (CMHWs). A self-administered semi-structured questionnaire was developed and administered to 11 psychiatrists and 29 health policy directors. Key informant interviews were also held with five psychiatrists and four health policy directors. .

Globalization and Health (2016) 12:57

DOI 10.1186/s12992-016-0199-z

Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review

Roxanne Keynejad
Maya Semrau
Mark Toynbee
Sara Evans-Lacko
Crick Lund, Oye Gureje
Sheila Ndyanabangi
Emilie Courtin
Jibril O. Abdulmalik
Atalay Ale
Abebaw Fekadu
Graham Thornicroft
Charlotte Hanlo
October 2016

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Background

Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs.

Methods

We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review.

Results

Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors.

Conclusions

This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed quantitative and qualitative approaches.

The economic impact of inclusion in the open labour market for persons with disabilities

BEYER, Stephen
BEYER, Annie
2016

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"This study looks into the inclusion of persons with disabilities and its impact on the economy. Persons with disabilities have been included in mainstream, specialist and active labour market programmes over the years in the EU. During the first decade of 2000s, many countries have used the "Work First Approaches", which led people to work before any training. The work first approaches have during the previous times provided good employment without people having the skills. In recent times, an activation approach has been developed in order to ensure that people with more complex disabilities are included in the labour market. This created inclusion programmes that assist people in the job search process, like individual counselling, vocational rehabilitation etc". The report provides an extensive overview of studies and research on the economic impact inclusion in the open labour market for persons with disabilities can have for governments and public authorities and a more general overview assessing impact on businesses and individuals. This study provides a review of the relevant literature. Using standard methods, relevant articles in the English language (or with English language abstracts) were identified, published between 1980 and 2016. 
 

Disability framework : one year on : leaving no one behind

DEPARTMENT FOR INTERNATIONAL DEVELOPMENT (DFID)
December 2015

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“The DFID vision is a world where no one is left behind. A world where people with disabilities have a voice, choice and control over the decisions that affect them. Where they participate in and benefit equitably from everyday life, everywhere. Our first Disability Framework was launched in December 2014. It focused on inspiring their colleagues to do more, with support from civil society partners…This updated Framework reflects lessons they have learned over the past year and outlines the next steps we will take as an organisation to deliver their vision”

Treated worse than animals : abuses against women and girls with psychosocial or intellectual disabilities in institutions in India

SHARMA, Kriti
December 2014

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This in-depth, illustrated report on the abuses of female patients with psychosocial or intellectual disabilities at institutions in India found that patients experience widespread neglect and abuses of their rights, including denial of legal capacity, a lack of community-based support and services, verbal and physical violence as well as involuntary treatment and admission. It recommends that “India undertake urgent reforms to guarantee the legal capacity of people with psychosocial or intellectual disabilities and take steps to shift from institutional to community-based care and services for people with disabilities”, with specific recommendations for central and state government level, national and state commissions and international donors

 

Note: Easy-to-read version, summary and video also available

Women and girls with a disability in India

HUMAN RIGHTS WATCH (HRW)
December 2014

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This easy-to-read summary uses simple language and clear illustrations to succinctly present the key principles of the full report: “Treated worse than animals: abuses against women and girls with psychosocial or intellectual disabilities in institutions in India”. The report found that female patients with psychosocial or intellectual disabilities at institutions in India experience widespread neglect and abuses of their rights

 

Note: Full report, summary and video also available

Women institutionalised against their will in India

HUMAN RIGHTS WATCH (HRW)
December 2014

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This short video highlights the situation of female patients with psychosocial or intellectual disabilities at institutions in India. In conjunction with the report by Human Rights Watch, it calls for the better treatment of women and girls in institutions and increased de-institutionalization

 

Note: Full report, summary and easy-to-read version also available

Access to services for women with disabilities who experienced violence

MANDL, Sabine
et al
October 2014

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This final short report summary encompasses the main findings of the Daphne III project “Access to Specialised Victim Support Services for Women with Disabilities who have experienced Violence.” The project aimed to assess the range of different experiences of violence against disabled women and their use of support structures. In addition specialised victim support services were interviewed about their experiences and capabilities in terms of counselling and accommodating disabled women. The project focused on three components: (1) Assessing the legal and policy framework (2) Generating extensive empirical data by surveying disabled or Deaf women (focus group discussions, in-depth-interviews) and service providers (online survey, interviews with staff members) and (3) Developing good practice examples and recommendations. For each component national reports and an associated comparative report was prepared, identifying the most prominent issues including the commonalities and differences between the four countries issues.

 

Note: the main findings of the projects (including the final short report, recommendations for service providers and a brochure for disabled women) are available to access in easy language, sign language and audio files from the following link http://women-disabilities-violence.humanrights.at/publications

Disability and the Global South, 2014, Vol. 1 No. 2 - Special issue: Globalising Mental Health or Pathologising the Global South? Mapping the Ethics, Theory and Practice of Global Mental Health

2014

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Articles include:

  • EDITORIAL Globalising Mental Health or Pathologising the Global South? Mapping the Ethics, Theory and Practice of Global Mental Health
  • How ‘evidence-based’ is the Movement for Global Mental Health?
  • Reciprocity in Global Mental Health Policy
  • Culture, Politics and Global Mental Health
  • Globalizing psychiatry and the case of ‘vanishing’ alternatives in a neo- colonial state
  • Faith Healing in India: The Cultural Quotient of the Critical
  • Mental Health Care, Diagnosis, and the Medicalization of Social Problems in Ukraine
  • Passive-Aggressive: Māori Resistance and the Continuance of Colonial Psychiatry in Aotearoa New Zealand
  • Neurasthenia Revisited: Psychologising precarious labor and migrant status in contemporary discourses of Asian American nervousness
  • Tools for the journey from North to South: A collaborative process to develop reflexive global mental health practice’

Old age, disability and mental health : data issues for a post-2015 framework

SAMMAN, Emma
RODRIGUEZ-TAKEUCHI, L. K
May 2013

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"This Background Note focuses on inequalities associated with old age, disability and mental health. It argues that these should be considered salient sources of group-based difference, given the numbers of people affected, their marginalisation and vulnerability, and their relative neglect in international agreements to date. This note identifies a lack of data as a particular concern, but one that can be addressed through revisions to standard household surveys. To this end, the paper discusses the available data and their limitations, constraints to better data collection and efforts needed to adjust key international survey instruments -the World Bank’s Core Welfare Indicator Questionnaire (CWIQ) and Living Standards and Measurement Survey (LSMS), Macro International’s Demographic and Health Survey (DHS) and the UNICEF Multiple Indicator Cluster Survey (MICS)- to collect reliable data on these issues. It sets out technical adjustments that would enable these surveys to broaden their coverage, collect richer information and improve their identification of these three groups. It concludes by commenting on how measures to address the inequalities that affect these groups could be incorporated within a new post-2015 framework agreement"
ODI Background note

Towards preventing torture and ill-treatment in health-care settings

MENDEZ, Juan E
February 2013

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"The present report focuses on certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment. It identifies the policies that promote these practices and existing protection gaps. By illustrating some of these abusive practices in health-care settings, the report sheds light on often undetected forms of abusive practices that occur under the auspices of health-care policies, and emphasizes how certain treatments run afoul of the prohibition on torture and ill-treatment. It identifies the scope of State's obligations to regulate, control and supervise health-care practices with a view to preventing mistreatment under any pretext. The Special Rapporteur examines a number of the abusive practices commonly reported in health-care settings and describes how the torture and ill-treatment framework applies in this context. The examples of torture and ill-treatment in health settings discussed likely represent a small fraction of this global problem"
A/HRC/22/53

Common European guidelines on the transition from institutional to community based care|Guidance on implementing and supporting a sustained transition from institutional care to family-based and community-based alternatives for children, persons with dis

THE EUROPEAN EXPERT GROUP ON THE TRANSITION FROM INSTITUTIONAL TO COMMUNITY BASED CARE (EEG)
November 2012

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These guidelines "provide practical advice about how to make a sustained transition from institutional care to family-based and community based alternatives for individuals currently living in institutions and those living in the community, often without adequate support. The Guidelines are aimed primarily at policy and decision makers in the European Union and the neighbouring countries with responsibility for the provision of care and support services for children, people with disabilities and their families, people with mental health problems and older people"

Toolkit on the use of European Union funds for the transition from institutional to community based care

THE EUROPEAN EXPERT GROUP ON THE TRANSITION FROM INSTITUTIONAL TO COMMUNITY BASED CARE (EEG)
November 2012

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This toolkit "aims to explain how European Union funds can support national, regional and local authorities in designing and implementing structural reforms aimed at facilitating the development of quality family-based and community-based alternatives to institutional care. It addresses primarily the desk officers of the European Commission, managing authorities, intermediate bodies, monitoring committees and project promoters in the EU Member States and in acceding, candidate and potential candidate countries; and any other donors investing in services for children, people with disabilities, people with mental health problems or older people"

Mapping exclusion

KOZMA, Agnes
PETRI, Gabor
November 2012

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This is a comprehensive report on the state of deinstitutionalization from institution-based services towards community-based services in the mental health field in Europe. The report consists of a comparative analysis of trends and policy changes in Europe based on a survey, and 32 country reports are presented in the annex covering issues crucial in the context of community care, such as data about institutional and community-based services, national mental health and deinstitutionalization strategies, information on guardianship and involuntary admission policies
Note: The report is in English, summaries are available in Dutch, French, Hungarian, Polish, Spanish, Romanian and Swedish

Mental health in post-crisis and development contexts

PÉGON, Guillaume
September 2012

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This brief provides an overview of Handicap International's activities in mental health in post-crisis and development contexts. Handicap International’s mental health projects specifically address the mental health of people with psychosocial and mental disabilities or with intellectual disabilities
PP brief No 3

Minds that matter : report on the consultation on human rights, mental health and addictions

ONTARIO HUMAN RIGHTS COMMISSION
2012

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"Minds that Matter reports the findings from the Ontario Human Rights Commission’s (OHRC) province-wide consultation on the human rights issues experienced by people with mental health disabilities or addictions. It provides a summary of what we heard from more than 1,500 individuals and organizations across Ontario. Many people with mental health issues or addictions don’t know they have a legal right to be free from discrimination under the Ontario Human Rights Code"

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