In any ways defined, disability or illness is familiar to every society. Each state, according to its level of development, priorities and opportunities, generates social and economic policies for people with disabilities. During the last twenty five-thirty years, the world has established stable trends and mechanisms of disability policies. Moreover, support of the governments of various countries in the development of approaches to address this social group and assist state and public institutions in the definition and implementation of policies addressed to people with disabilities was applied (Quinn & Degener 2012).
Basic principles of disability policy, developed by the world community in the last decades are:
The State is responsible for remedying the conditions that lead to disabilities, and to resolve issues related to the consequences of disability;
The State provides the opportunity for people with disabilities to reach the same standard of living with their fellow citizens, including the field of income, education, employment, health and participation in public life;
People with disabilities have the right to live in the society; moreover, society is to blame the isolation of persons with disabilities. Society strives to create the conditions for independent life of persons with disabilities (self-realization, self-sufficiency in everyday life, barrier-free environment);
The rights and responsibilities of persons with disabilities are recognized as the rights and responsibilities of other citizens of the society. The states competence is ways of recognition, security and the rights and obligations of persons with disabilities as members of society;
The state is committed to fairness social policies for people with disabilities throughout the country, regardless of where persons with disabilities live (in rural or urban areas, province or capital);
The individual features or groups of persons with disabilities should be taken into account when implementing disability policy: all persons with disabilities due to the specifics of their illnesses are at different starting conditions, therefore, wide and unique range of activities are held to ensure the rights and responsibilities of citizens in respect of each disability group.
Currently, state policy remains the primary mechanism for the public in identifying, categorizing and legalization of disability and continues to be an essential element in the design and maintenance of the dependent status of people with disabilities. In this sense, the situation of people with disabilities in a number of countries hardly tied with the underdeveloped and not always effective in the legal context of the implementation mechanisms, which are being provided by the relevant legislation and the responsible departments for its implementation.
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Established social protection of disabled people in developed countries include a number of interrelated elements, which are presented in normative fixation of disability rights, the rights and responsibilities of government agencies, public and charitable organizations, forms and methods of their activities in this field. In the UK, almost 100% of new-borns are screened for hereditary diseases as a result of the implementation of national programs for the prevention of child disability, which allows timely identification of these diseases, specifically to treat and avoid gaps in child development. Legislation of Western countries is also applied to institutions of social security of disability, range of government bodies involved and responsible for the implementation of these programs to protect citizens or coordinating social protection of persons with disabilities is also defined.
However, despite all the law, social and ethical implementations, British disabled are still not the full members of society they live in. According to findings, poverty and non-ability to work are the main stop factors for people with disabilities development. Thus, almost half of people with disabilities do not have any job. This is a problem of modern society in terms of disability as a constant, rather growing, aspect the society has count with. Moreover, 32 percent of disabled in the UK are workless or living in poverty having problems to get any services, goods, etc. Those also have lower practice skills comparing to other part of society. Plus, 22 percent of people with disabilities are in difficult living struggles since of their lives control and choice absence (HM Government 2010).
Nevertheless, the figures mentioned above do not prove any careless politics but show that there is still a process continuing to set higher living standards for people with disabilities since a half of century back not a single current legislation was set. Therefore, these results are somewhat proofs of what is being done to erase any barriers the disabled can face while enjoying their lives.
a) The questionnaire applied had not any intention to reveal the sex, age or wealth of a person, who were asked. Instead, the questionnaire held few questions related to schizophrenia. Such approach was set to minimize time terms for researcher and people asked as well. Moreover, researcher suggested that yes or no options for population were not valuable. Therefore, the interviewed gave own answers and views on the problem. In this regard, researcher intuitively was right that answers being different by words showed a great similarity and that let its further grouping and statistics building.
The interviewing consisted of less than ten questions, main of which were directed to know whether the society knows what schizophrenia is, the way it influences people who suffers it and the conditions the services to fight this disease are. After answers analysing the researcher applied the results through the prism of Care Value Base to determine the current level the relevant treatment services operate with.
Thus, the vast majority of interviewed revealed rather adequate understanding of a state schizophrenia leads to. The answers presented this disease as one is based on gradually increasing disorder in the activity of neurotransmitter systems in the brain. Based on the responses, the disease is genetic and can be passed from parents or from other related generations. Population also defined schizophrenia as a characteristic abnormal thinking, mood or behaviour. Researcher finds difficulty of the same definition of schizophrenia giving due the broad meaning of it that almost everything that is not like the other person or what he/she considers abnormal may fall under this definition. Some persons told that schizophrenia is a kind of soul splitting.
Concerning the scale and the issues of schizophrenia, local representatives agreed that this point should not be deprived of thorough attention of both government and volunteers forces. They also noted that the large share of the budget is spent on the patients stay in care centres, where they are protected. However, interviewed also believe that in most cases such a long stay is not only unnecessary, but harmful. According to them, the idea that schizophrenics should be isolated from society is incorrect because the patients are dangerous only in rare cases, but often themselves become targets of attack. Prolonged stay in psychiatric hospital locals considered demoralizing. They claimed that many patients in such hospitals are just given pills and offered to watch TV instead providing them with psychological help. Therefore, many believe that the methods of treatment in care centres lead to deterioration of the health of patients and the entire system of care for people with this disease requires a radical revision.
b) Regarding the facilities three care centres were discussed, each of these are almost the same differentiating only by the bed places quantity or by free internet access. Those three are Vibrance-2/3 Orchard Close, Rook Lodge and Vibrance-16 Sylvan Road (Carehome). The options these centres provide are quiet places to rest, specialist to care, gardens to walk and kitchenettes to food prepare. No extra positive or innovative care or treatment is evidenced at their services. That is the point the interviewed mentioned.
However, these centres provide services in the Care Value Base framework. This is due to managers and stuff working there, who promote anti discriminatory practice supporting everybodys rights to safety and independence. Actually these people protect patients or better say needed of any possible abuse from the society. They also try to treat everyone individually and confidentially. By large, these care centres do their work sufficiently but effective communication is somewhat lacked. Obviously, the services these centres provide are within the countrys legislation as well.
There are some other options the needed may get; they are available for people with any mental health issues not only with schizophrenia diagnosed. This is an opportunity to be back-to-work. The essence of this support is to let patients feel equal getting any job they like. However, this option was heavily criticised since the programmes implemented were trying to engage everyone in job activity the people did not want to do (Redbridge Concern for Mental Health 2014). Moreover, getting job means benefits cuts. As the other minuses, people with mental disorders complained about worsening in confidence and health after engaging with this activity.
To narrow the aspects and reveal any existed changes in mental healths government monitoring the researcher chose the matter of schizophrenia struggling. Moreover, the analysis discusses the world scale programme where the UK alongside with other countries takes part. The World Psychiatric Association (WPA) has organized and operates a worldwide program, which is aimed against the stigma and discrimination associated with schizophrenia (Opendoors 2014). The authors of the program suggest that there are reasonably valid issues for creating and implementing it.
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The aim of the program is to conduct combat to prejudice the society against the mentally ill in all areas of life since such prejudices reduce the quality of life of patients with schizophrenia and their families and prevent them from living and working among healthy.
Psychiatric public of a number of countries already involved in the implementation of this program and psychiatric journals publish related materials. WPA distributed materials containing survey information that is useful for organizing the work to combat stigma.
Patients with mental disorders themselves often accept the stereotype of their painful condition. Numerous studies have shown that psychiatric patients have the same negative view of mental illness, as well as the general population does. Often, patients learn stereotypes as incompetent and worthless person, thereby becoming social withdrawal, dependent on the help of others, adapting as invalid, which leads to the aggravation of social maladjustment.
State program being aimed at de stigmatization has the following objectives:
Increase public awareness about the nature of schizophrenia and the right choice of treatment;
Improve the population's attitude towards patients with schizophrenia and their families;
Organize activities, which are aimed at eliminating discrimination and prejudice.
Tools the program will use are a variety of materials to be used and adapted for use as a local and international level in order to:
Create a public information program;
Develop programs to promote community involvement;
Increase knowledge about the professionals providing care to patients with schizophrenia and its treatment;
Train and support of family members and friends of patients;
Change the law and to ensure impartial medical assistance.
Program is being constantly developed by experts from many countries, in collaboration with several professional organizations, with the government and associations of patients and their families. The Steering Committee of the program is chaired by N. Sartorius, president of the WPA. The program also includes four technical committees:
The Committee on the treatment of collecting information regarding the diagnosis and treatment of disease (headed by W. Fleischhacker-Austria);
Committee on reintegration, taking care of patients with schizophrenia reintegration into their families and the community (headed by J. Leff, United Kingdom);
Committee on stigma, creating materials and proposals aimed at combating discrimination and stigma at the community level (headed by R. Wainer, USA);
Steering Committee, which will collect all materials to provide a clear strategy for the program (headed by H. Hafner. Germany).
For reducing stigma and discrimination the work needs to be aimed at all stages:
Therapeutic intervention to reducing symptoms of the disease with minimal side effects provided;
Education that includes knowledge of what schizophrenia is, which is aimed at fostering positive attitudes and increase the acceptance of the patient;
Educational, social and legislative measures, which are aimed at reducing discrimination and improving the integration of patients.
This program is unique since it is aimed not only at improving the education of psychiatrists and mental health workers dealing with the disease and its treatment, but also to change the position of prejudice treatment against people with schizophrenia in countries around the world. In connection with the program's objectives of particular interest are studies in which data showed positive changes in the attitude of the population toward the mentally ill as a result of work. In such a difficult and seemingly promising rapid strides problem the existence of such data reveals a positive outlook.
It should be noted that this program must be carried out being based on scientifically established data; it also requires a certain delicacy, balance, diligence when referring to specific examples, otherwise uncertain events can turn opposite to the expected result. This is even more to consider, as are expected to participate in the program of the users of mental health care to the public. Therefore, there is no doubt that the implementation of this program is extremely important.
The most important etiologic and pathogenetic problem of young people with limited learning abilities is hospitality. This refers to the emergence of a large group of patients with often, constant hospitalization. Statistics analysis of repeated hospitalization is necessary to resolve various issues. However, the most accurate and reliable these data are in assessing the severity of the disease and treatment. The use of these data will help to reduce the influence of closed institution factors and, thus, to reveal the real adaptive capacities encouraging young people for more adequate adaptation to life.
Mental deprivation is associated with a lack of attention, emotional deprivation, and sometimes with the abuse of children, especially topical in recent times being a common phenomenon. Consequences of deprivation are psychogenic disorder leading to impaired psychosocial development of the child, delayed intellectual development, combined with a violation of the formation of emotional and personality traits such as affective anxiety, instability, behavioural disorders, impaired adaptation, mental infantilism. These syndromes often occur with early organic CNS development and may lead to the formation of inadequate behaviour and psychopathy in the future limiting learning abilities.
Great interest in this regard is a rehabilitation centre in London for children with cerebral palsy in combination with epilepsy and intellectual deficits, which provides long-term stay patients from 6 to 19 years. Treatment at the centre is combined with studies (with extensive use of computers), vocational training, and diverse cultural program with a maximum adaptation to the reality of life. Children themselves are planning a budget, buy food, and cook. The stuff of the centre includes neurologists, psychologists, psychiatrists, speech therapists, teachers of high quality. There are self-help groups, emergency telephone service, special education programs.
Here is appropriate to recall the concept of institutionalism of Wing and Brown that this phenomenon is understood more broadly than hospitality. Approaching the issue from purely sociological positions by the institutionalization they understand of the process of changing interpersonal relations arising from any person entering into a relatively isolated community. It is a question that each person is surrounded by a network of social relationships that determine its function in society. With the weakening of these ties, especially for longer stays in the hospital, sanatorium or special school, the patient has a peculiar phenomenon depending on which has become his/her familiar environment.
Of particular importance is family influence. Emotional tension in the family affects the frequency of persisting. As a weak spot in the family a child often causes family tensions and conflicts. In this case, the appearance of hospitalization permission is absolutely right thing to do. Thus, return to the family for some patients is a contributing factor to return to the hospital. Some perceive the hospital as a safer place than the society due to increased nervousness, and intra-personal conflicts, other desires can arise from lack of social support, lack of communication, and a sense of loneliness. Finally, the conditions of life in the community may be worse than in the hospital. For some patients, a constant hospitalization may turn into lifestyle.
General impression is that long time ago one should add iatrogenic and acquired learning disabilities to its classification, which was formed as a result of pre-, and postnatal exposure to iatrogenic (wrong treatment, the lack of adequate treatment), hospital and post-hospital illness, sociopaths, spiritual and physical poverty, mental and spiritual, psychological and emotional, sensory and motor deprivation and other factors usually acting together. Obviously, this tragic form of mental issues in the present social structure of society is practically incurable. One thing is certain that in these difficult times, the number of such patients increases dramatically.
Unfortunately, the focus of professionals and parents are movement disorders in children with learning disabilities. Tying to heal the most obvious manifestations of the disease, one cannot lose sight of other disorders that impede the adaptation of these patients. The resulting effectiveness of treatment depends not only on the availability of correction of functional deficits, but also on successful retention of impact start of its development in the future ontogeny provisioning equal opportunities in family and society, i.e. depends on the solution of a number of psychosocial problems.
Social rehabilitation is a separate and yet little-studied trend in rehabilitation of patients with learning disabilities and other diseases of the nervous system, updating of which is determined more clearly, the essence of which is an early and effective correction of emotional and volitional spheres, instilling in children and adolescents suffering from motivations to life, autonomy, treatment, to prepare them for the social adaptation to the characteristics of the disease, the structure of the motor, speech and mental defect. Such training should be actively pursued since the first years of life, but especially towards the end of the first decade, when the areas of searching the future professional opportunities of each young person can be identified. This way is more important than giving the patient a number of technical devices to facilitate his/her life at this time, but with no summon the will and desire for independence.