This report provides a compendium of good practices to promote voluntary measures in mental health care and support. It draws from practices submitted to the DH-BIO Secretariat by delegations representing the 47 Member States of the Council of Europe (COE) as well as civil society stakeholders. The compendium fulfils the aim set out in the DH-BIO Strategic Action Plan on Human Rights and Technologies in Biomedicine 2020-2025 to:

assist member States [by developing] a compendium of good practices to promote voluntary measures in mental healthcare, both at a preventive level and in situations of crisis, by focusing on examples in member States.

 

The practices may directly aim to reduce, prevent, or even eliminate coercive practices in mental health settings, and others will indirectly result in similar outcomes by advancing the general aim to promote voluntary mental health care and support.

The compendium is not meant as an exhaustive list of leading practices in COE Member States. Instead, it is meant as an initial step toward compiling practices aimed at promoting voluntary mental healthcare and support, and reducing and preventing coercion in mental health settings. More generally, the materials promote compliance with the Convention on the Rights of Persons with Disabilities (CRPD), notwithstanding debates about coercion in mental healthcare which will be noted in Part 1(B) of the report.

Back Hugarafl – Iceland

Hugarafl (which roughly translates as ‘Mindpower’) is a non-profit, peer-run, non-government organisation in operation in Reykjavík since 2003 (Submission 22). According to its website:

Hugarafl [translation: Mindpower] is an Icelandic peer run NGO founded in the year 2003 by individuals with a vast personal and professional knowledge of the mental healthcare system. These individuals had the common goal of wanting to change the mental healthcare system in Iceland and make it better. Everything that Hugarafl does is decided upon and done by people with lived experiences of emotional distress and/or professional background working as equals. Participating in the work of Hugarafl is for everyone working on their mental health on their own terms.

Hugarafl might be described as an ‘advocacy and capacity-building organisation’. It is engaged in various activities, including peer-led self-help groups, peer support, counselling, activism and mental health promotion in education. Hugarafl takes an active role in forming and giving feedback on policy reforms relating to mental health, housing, health care, social services, education and employment. Hence, they are focused on building the capabilities of service users, professionals, and beyond that, government services and systems. Under pandemic conditions, the health ministry have asked Hugarafl to meet them regularly to discuss how they could help the public and prevent psychological distress (Submission 22).

Hugarafl still provides individual support, including ‘robust vocational rehabilitation for people working on their personal recovery following a mental health crisis’, which is also overseen by a psychologist and occupational therapist (Submission 22). According to Hugarafl representatives:

Due to the flexibility of Hugarafl’s practice (no set time boundary, no need for referrals, no cost to members, no need for diagnosis), we tend to catch those that fall between the cracks in conventional practice settings. This has led to our vital role as a follow-up and connection to people once they have exhausted or been discharged from traditional service providers. (Submission 22).

The group have several aims:

  • To eradicate prejudice related to emotional and psychological challenges in Icelandic society.
  • To safeguard the human rights of individuals with lived experiences of emotional distress.
  • To strengthen the role and full, active participation of people with lived experience of emotional distress in Icelandic society.
  • To have a positive impact on the Icelandic mental healthcare system.
  • To promote and work according to Empowerment (by Judi Chamberlin) and the Empowerment Paradigm of Recovery Healing, and Development (by Daniel Fisher and Laurie Ahern). (Submission 22)

Staff members comprise of occupational therapists, a psychologist, a person with psychology training and education, ‘Neuro-Linguistic Programming coach’, Gestalt therapist, trauma-focused counsellor, yoga teacher and people with lived experience of emotional distress. This team works in unison with volunteers who collectively make the day-to-day working of Hugarafl. Participation in Hugarafl is free and open to all people over 18. A person neither requires an Icelandic residence nor a referral or diagnosis to participate. (For more information see Hugarafl website; Hermannsdóttir, 2017; Hrannarsdóttir, 2017).

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