Israeli Families as Promoters of Social Reform Nily Aharonov, Ozma October, 2006

Ozma - Who Are We? All volunteers NGO Only family members Struggles to stop exclusion, eliminate stigma, promote equitable care-giving to mental illnesses, viewing mind-body as an indivisible entity. Diverse actions Families can and should be partners in rehabilitation

Ozma was Highly Instrumental in the Formation of the Israeli Law for Rehabilitation of the Mentally Ill in the Community

Rehabilitation of Mentally Handicapped Persons in the Community Law - 2000 Establishes the right of every person who suffers from a medical disability due to mental condition to appeal to a regional rehabilitation committee in order to receive one or more services that are included in “the basket”.

Rehabilitation of Mentally Handicapped Persons in the Community Law – “The Basket” RANGING FROM HALF-WAY HOMES (HOSTELS) WITH 24 HOUR STAFFING TO SCATTER SITE APARTMENTS WITH DAILY STAFF CONTACT SUPPORTIVE HOUSING PREVOCATIONAL TO WORKSHOPS TO SUPPORTED EMPLOYMENT IN THE OPEN MARKET VOCATIONAL SERVICES SOCIAL CLUBS AND INTEGRATED PROGRAMMING IN LOCAL COMMUNITY CENTERS SOCIAL ACTIVITIES & LEISURE ACTIVITIES OPPORTUNITIES TO ACQUIRE BASIC REMEDIAL SKILLS AS WELL AS MATRICULATION AND PEER SUPPORT AT THE UNIVERSITY LEVEL EDUCATION CASE MANAGEMENT, PEER SUPPORT, HOME CARE, DENTAL CARE OTHER

Rehabilitation of Mentally Handicapped Persons in the Community Law – The Advisory Board The Advisory Board for Psychiatric Rehabilitation to the Minister of Health is an integral part of the law, with a mandate to oversee, develop and support the implementation of the law, two of its members being representative of our family organization.

Rehabilitation of Mentally Handicapped Persons in the Community Law – The Impact Within 5 years: Number of hospital beds: ~7000  ~3000 Rehab In the community: ~4000  ~13000

Our Methods Defining needs thru consultation with consumers and families Consultation with various human rights agencies Participation in workshops Presenting recommendations to legislators Letters to MPs and government members Writing a decree "We Cannot Wait Any Longer”

Our Work Reflected In the Law Our activity was focused from the start on insuring that rehabilitation will take place solely in the community We stressed that a person who suffers from mental illness can be rehabilitated We insisted on designated budget for rehabilitation, separate from the budget allocated for treatment We demanded fair representation of consumers and their families in the National Board for Rehabilitation We insisted that every time the word rehabilitation is mentioned it will be followed by the phrase “in the community”

Our Work Reflected In the Law – additional achievements Full disclosure of information in the Board for Rehabilitation Flexibility in ways to appeal for services A semi-yearly review of the individual’s rehabilitation program Inclusion of dental treatment Families included in the rehabilitation plan Implementing phrases that imply capacity for change and healing and abolition of stigmatic terms

Latest Difficulties The law Encounters Not enough access to psychiatric services in the community No adequate budget allocated after the initial 5 year period ~60,000 handicapped. 20,000 more baskets needed next years but government reluctant to increase funding. Government currently attempting to pass amendments that limit the number of new recipients according to a certain quota, contrary to the law and it’s spirit In the process of implementing the long awaited reform in psychiatric services in the community, government is cutting down the budget for rehabilitation Family oriented programs did not materialize yet

Some Practical Issues and Challenges Service development needs infrastructure investment (research, data processing, assessment of usefulness of technologies). How to avoid stagnation ,encourage [and measure] personal progress to less dependent functioning, especially for the relatively young. For the funding agencies, progress to less costly programs, frees some resources for newcomers to the rehabilitation system.

Declaration We call upon nations to enact progressive legislation, explicitly insuring the rehabilitation right of persons with mental health problems: Helping them by proper residence, employment, leisure and social activity IN THE COMMUNITY. Thank you