Community living

Why is the right to community living an MDAC goal?

In many parts of the world, people with disabilities have been institutionalised on a massive scale. Often these institutions are large and remote, and do not provide a satisfactory level of care. Many exist to warehouse rather than rehabilitate. The material conditions of institutions in some countries have been improved over the last decade, but in others are still deplorable and hardly fit for human habitation. Whilst therapy, care and rehabilitation are the stated aims of institutions, in most of them people are subject to receiving anti-psychotic medication whether or not they have diagnoses of psycho-social disabilities. Negative effects of forced medication can be long-term and serious. In many countries significant funding is being pumped into institutions, yet few resources are being diverted to establishing and maintaining a range of services in community settings.

How is community living a human rights issue?

Although one can create arguments under pre-existing human rights treaties for the right to live in the community, Article 19 of the UN Convention on the Rights of Persons with Disabilities is asserts for the first time in binding international law an explicit right that people with disabilities have the right to community living. This means that each person be given the opportunity to chose their place of residence and should not be obliged to live in a particular living arrangement. Article 19 is about choice, which links in with the right to legal capacity. It is also about specific services for people with disabilities, and equal access to regular services. Seen in this way, the right to live in the community is as relevant for lower-income countries where there are fewer institutions as it is for countries in central and eastern Europe in which an abundance of people live in psychiatric and social care institutions.

What MDAC is calling for?

• A legal right to live in the community
• No new admissions to long-term residential institutions designated for people with intellectual or psycho-social disabilities
• Closure of large residential institutions
• Legally enforceable choice as to where and with whom to live
• Available and accessible community-based supports for people with disabilities – person-centred, responsive and based on principles of choice and self-determination
• Access to services available to the public, based on principles of universal design and delivered with reasonable accommodation

What impact has MDAC achieved?

Over the years MDAC has taken some classic ‘mental health law’ cases which have sought to challenge unlawful detention in psychiatric hospitals, limit the time which people spend in them and maximize available safeguards. Our Stanev case against Bulgaria before the European Court of Human Rights is the first in Europe to challenge exclusion in a social care institution.