Mental health policy and practice across Europe: an overview

44 Mental health policy and practice
annual human rights report that included, for the first time in 2003, a chapter
on the rights of disabled people.
This determination is evident culturally as well as politically. As part of the
European Year of Disabled People 2003, an Austrian disability organization
developed a project to commemorate resistance to the Nazi so-called ‘euthanasia’
programmes. At Schloss Hartheim in Upper Austria 70,000 people with
psychiatric or learning disabilities, criminals, prostitutes and orphans were
murdered and/or used for experiments. A few people spoke out courageously
against this, including architect Herbert Eichholzer, sculptor Walter Ritter
and painter Anna Neumann. In 1943 Eichholzer was killed for his resistance
activities and Neumann imprisoned. In 2003, Klump wooden toys, designed by
Eichholzer and Ritter and painted by Neumann, were made again, this time by
people with learning disabilities, thereby giving a powerful symbolic message
on the importance of resistance.
However, where inclusion activities have focused only on improving the
rights of the least powerful – for instance, challenging coercive mental health
laws – progress has generally been slow, and has certainly not extended beyond
the institutions in which people are incarcerated. A society is more likely to
stop treating classes of people inhumanely when that group comes to be seen
as equals. Then a new spotlight may be thrown on laws and practices that
degrade them. As Nelson Mandela put it in relation to prisons, ‘prison conditions
would not change until the country changed’ (Mandela 1995). As long
as the public perception is that mental health service users are ‘psychos’ there
will be little public outcry. The challenge is to go beyond objecting to gross
abuses – important as that is – and push forward, for the positive benefits of
participation.
Evidence also tells us that because discrimination is a persistent phenomenon,
attempts to counter it in one area merely mean it pops up again in
another guise, like a many-headed hydra (Link and Phelan 2001). Initiatives
need to be multi-faceted and multi-level.
Reducing discrimination and exclusion
Link and Phelan (2001: 367) argue that ‘stigma’ (discrimination), 2 ‘is entirely
dependent on social, economic and political power’. This has huge implications
for determining which approaches and types of programme are most likely to
create change. They argue that it is not enough to label and disparage another
group for them to become ‘stigmatized’: psychiatric service users may label
some clinicians ‘pill pushers’ and treat them differently from other clinicians.
This does not make these clinicians a stigmatized group, because patients ‘simply
do not possess the social, cultural, economic and political power to make
their cognitions about staff have serious discriminatory consequences’.
Anti-discrimination work must either change the deeply-held attitudes and
beliefs of powerful groups that lead to labelling, stereotyping, setting apart,
devaluing and discriminating; or it must limit the power of such groups
(Link and Phelan 2001); or both (Sayce 2003).
The problem with much anti-stigma work in Europe is that it has not