On 27 January, ENIL’s Policy Officer Ines Bulic took part in a seminar on deinstitutionalisation in Nicosia, Cyprus, as part of ENIL’s involvement in the European Expert Group on the Transition from Institutional to Community-based Care (EEG). ENIL-ECCL has been an active member in EEG since its establishment in 2009 (when it was called the Ad Hoc Expert Group on the Transition from Institutional to Community-based Care) and has been one of the group’s three co-chairs since June 2015.
The Cyprus seminar was co-organised by the Ministry of Labour, Welfare and Social Insurance of the Republic of Cyprus and the European Commission, and focused on the situation of disabled people. Alongside ENIL, EEG was represented by Magdi Birtha from COFACE – Families Europe and Valerija Buzan from the European Association of Service Providers for Persons with Disabilities (EASPD). The aim of the seminar, as highlighted by Jiri Svarc, the Head of Unit for Greece and Cyprus at the European Commission (DG Employment), was to put deinstitutionalisation higher on the Government’s agenda and to gain a better understanding of the situation in Cyprus. Having ratified the UN Convention on the Rights of Persons with Disabilities (CRPD) in 2011, Cyprus is about to be reviewed by the Committee on the Rights of Persons with Disabilities (CRPD Committee), thereby providing a good opportunity for formulating actions to advance Article 19 CRPD – the right to live independently and being included in the community.
Among the speakers was Christakis Nicolaides, the President of the Cyprus Confederation of the Organisations of Persons with Disabilities. Along with Helen Hadjittofi, from the Office of the Ombudsman and Human Rights, they presented some of the main challenges when it comes to progress towards deinstitutionalisation in the country. These included:
- Lack of vision and an absence of legal framework to facilitate deinstitutionalisation; deinstitutionalisation has not been included as an objective in the relevant strategies, policies and laws pertaining to disabled people (incl. people with mental health problems);
- Lack of political will to move ahead with deinstitutionalisation, and the lack of coordination among the relevant Ministries and departments; currently, 3% of disabled people live in institutional care, but many of those living in the community are also isolated from the wider community;
- It is unclear whether those people that have moved from institutions into the community have the necessary support to live independently; there is a concern that they are still living in isolation and unable to make decisions about their lives;
- People with the higher support needs are left out of the process of deinstitutionalisation;
- The cost of institutional placement is more easily covered than the cost of home care, thus creating a financial incentive for institutionalisation;
- Disabled people face major stigma and many are considered as dangerous;
- Disabled people rely, by an large, on their family and friends for support; this is linked to the misconception that they are their family’s ‘responsibility’;
- The medical model is still predominant in Cyprus; disabled people are treated as recipients of allowances and support, not as rights holders;
- The economic downturn has had an impact on the provision of community-based services;
- Very low salaries in the social care sector influence the quality of care and support;
- There is no legislation on the functioning of community-based services, therefore no standards to ensure that the residents are able to make decisions about how they wish to live their lives;
- Although daily care is provided in community-based settings, it is not personalised, and there is no support to live independently; disabled people are therefore institutionalised both in institutions, and in their own homes;
- There are no comprehensive data about the situation of disabled people in Cyprus; a study had recently been launched to address this problem, and will be needed when it comes to Structural Funds planning.
We learned during the seminar that Cyprus was criticised by the Council of Europe, the EU and the UN for the treatment of disabled people in the Athallasa psychiatric hospital. Some of the alternative services in the community were presented, though it is questionable to what extent these are in line with Article 19 CRPD. For example, one of the protected housing units consists of 2 rooms for the residents and 3 rooms for the staff, and is located on the outskirts of Nicosia. It employs housekeepers, cooks, psychiatric nurses, different types of therapists, and has a daily routine that the residents follow.
Looking forward, Mr. Nicolaides suggested some of the following actions:
- The need to ensure that deinstitutionalisation includes all disabled people, and does not exclude people with mental health problems or people with intellectual disabilities;
- The need for a comprehensive deinstitutionalisation strategy;
- No further investments into institutional care; all resources should go into the development of community-based services;
- The system of personal assistance needs to be put in place, and disabled people should have a right to choose their personal assistant;
- Existing legislation should be revised to comply with Article 19 CRPD;
- Quality of the services provided should be monitored, to ensure services are in line with the CRPD.
To this, EEG representatives added to need to revise the relevant Operational Programmes, to ensure that the European Structural and Investment Funds (ESIF) can be used to support the transition from institutional care to living in the community, in Cyprus, and the opportunity for the Cypriot Government to use the CRPD review to accelerate deinstitutionalisation, and implementation of other CRPD rights.
Note: Interestingly, it has just been announced in the Cypriot media that a new psychiatric hospital is to be built to replace Athalassa – which accommodates 59 people – while the existing facility will be renovated to make it suitable for living. Therefore, as highlighted by the Ombudsman’s Office, closing Athalassa does not seem ‘feasible’ at the moment.