7.5 Mental health
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The Strategic Plan of the Ministry of Health (Sağlık Bakanlığı Stratejik Planı) has emphasized the importance of providing health services to individuals with special needs in terms of mental health, by adopting the objective of better meeting the needs of individuals with special needs due to their physical, mental, social, or economic conditions by ensuring easier access to appropriate health services. The performance criteria to measure the success of this strategic objective has been set as “the percentage ratio of individuals with special needs due to their mental disability, who are in need of health services but who cannot utilize from such services”.
In the context of the Law on Disabled People (Engelliler Hakkında Kanun), dated July 1, 2015 and numbered 5378, protected workplaces technically and financially supported by the State and decorated in a special way are foreseen to be established in order to provide occupational rehabilitation to individuals with mental or psychological disabilities, and to create employment opportunities for these people who can hardly be integrated to the labor market. In the context of the same law, organizing habilitation and rehabilitation activities for people with mental disabilities, together with individuals with other types of disabilities, is also foreseen. In addition, in the article titled “Early and Protective Services” of the same Law, it is stated that “Ministry of Health shall be in charge of planning and conducting the works related to the monitoring of physical, audial, social, pyschological and mental development of all children including the ones in neonatal phase, early childhood phase and other phases of childhood; ensuring early diagnosis of genetic diseases and diseases that may cause disability; preventing disabilities; minimizing the severity of existing disabilities to the extent possible and ensuring that they do not progress.”
The General Directorate of Services for Persons with Disabilities and Elderly People under the Ministry of Family and Social Policies has issued the National Action Plan for Persons with Autism Spectrum Disorder (ASD) (Otizm Spektrum Bozukluğu (OSB) Olan Bireylere Yönelik Ulusal Eylem Planı) covering the period of 2016-2019. Care services for individuals with disabilities are carried out by the Ministry of Family and Social Policies. Care services have been designed based on an approach to provide the services at home and accompanied by the family as much as possible. Providing care in institutions is considered to be a model to be implemented only in cases when there is no other choice. Focusing on protective and preventive service models enable that individuals with ASD are supported in their home environment, without excluding them from their natural environment, and that the risk of being excluded from social life is minimized. Care services are carried out either in care and rehabilitation centers (state-owned institutions offering boarding/day care services), in private care centers, and at home. For the first time in Turkey, a special center addressing individuals with ASD has been opened in İstanbul under İstanbul Care and Rehabilitation Center in the context of society based services. The center named “home of hopes (umut evi)” is based on home-type care model, and the use of this model is intended to be extended. The mentioned action plan has set forth six priority areas to enable that individuals with ASD benefit from the services in an equal manner with other individuals, and facilitate their participation in every area of social life independently. The related areas of priority are as follows:
1. Awareness Activities and Inter-Institutional Cooperation
2. Establishing the Chain of Early Diagnosis, Treatment and Intervention
3. Development of Services for Families
4. Development of Educational Evaluation, Special Education, Supportive Education, and Rehabilitation Services
5. Employment Processes and Business Life
6. Participation to Social Services, Social Aid and Social Life
Based on the National Psychological Health Policy issued by the Ministry of Health in 2006, a National Action Plan on Psychological Health (Ulusal Ruh Sağlığı Eylem Planı) covering the period between 2011-2023 has been drafted with a view to establishing a service network allowing the provision of psychological services, which are focused on the needs of individuals, in an adequate manner and through an appropriate method. Drafted in line with this goal, the Plan aims to adopt a patient oriented approach in the treatment and care of people with psychological diseases, and to integrate the service model of community-based psychology in Turkey.
In 2006, the Ministry of Health issued a document namely “National Psychological Health Policy” based on the seven psychological health policy modules proposed by the World Health Organization (WHO) and the contemporary requirements in this field. The basic recommendations outlined in the policy document are as follows:
- Adopting a community-based psychological health system, and its integration to the general health system and primary health services,
- Conducting community-based rehabilitation works,
- Increasing the funds allocated to the field of psychological health,
- Increasing the quality of psychological health services,
- Enacting the laws related to the field of psychological health,
- Advocating patient rights against profiling,
- Increasing the training and research activities as well as labor force in the field of psychological health.
In the context of the Youth Projects Support Programme (Gençlik Projeleri Destek Programı) conducted by the Ministry of Youth and Sports, support was provided in 2016 to two civil society organizations carrying out works related to children and young people with autism spectrum disorder.
In the context of the National Action Plan for Persons with Autism Spectrum Disorder (ASD) (Otizm Spektrum Bozukluğu (OSB) Olan Bireylere Yönelik Ulusal Eylem Planı), the Ministry of Family and Social Policies have printed and distributed 1,000 copies of “Informative Guide for Families” addressing the families in which there are individuals with autism. The Literature Book on Autism Spectrum Disorder has been printed and distributed in 1,000 copies. The Family Training Guide Kit consisting of five books (Hearing-Disabled Children, Sight-Disabled Children, Mentally Disabled Children, Children with Problems about Motor Functions, Children with Psychological and Emotional Disorders), aiming to inform and raise awareness among individuals with disabilities and their families about the issues of disability and people with disability, was printed and distributed in 10,000 copies.
The principles and procedures regarding the provision of the technical equipment required for the protected workplaces foreseen to be established addressing people with mental and psychological disabilities, who are hard to be employed by the open labor market, have been set forth in the provisions of the Draft Law on the Amendment of the Statutory Decree on the Organization and Duties of the Ministry of Family and Social Policies, and Certain Laws (Aile ve Sosyal Politikalar Bakanlığının Teşkilat ve Görevleri Hakkında Kanun Hükmünde Kararname ile Bazı Kanunlarda Değişiklik Yapılmasına Dair Kanun Tasarısı), and the related law was accepted by the Grand National Assembly of Turkey (GNAT) on Fenruary 6, 2014. In the context of the Protected Workplaces (Korumalı İşyerleri) project launched in cooperation with the Institution of Providing Jobs and Employees (İŞKUR) with the aim of providing job opportunities to heavily disabled people, who are hard to be employed by the labor market, grant support is provided to protected workplace projects addressing people with mental, psychological and emotional disabilities; and the wage costs of disabled workers are covered in the first one year period.
The Free Transportation of Students with Disabilities was covering only the groups with mental disabilities and autistic individuals in he academic year of 2004-2005. Then, the scope of the program was expanded in the academic year of 2005-2006 to cover all types of disabilities (sight, hearing, orthopedic, autistic, mental, and special education classes).
Promoting Services for People with Disabilities Project: Beneficiaries of the project conducted with the technical support of the World Health Organization in the context of the “Institution Building Component of the Instrument for Pre-Accession Assistance (IPA)” were the Ministry of Family and Social Policies, the Turkish National Public Health Agency, and the Public Hospitals Administration of Turkey. In the context of the 4 million Euro budget project, which was completed on April 28, 2014, an international conference titled “Transformation of Care Services for Individuals with Mental Disabilities in Turkey: Improving the Rights, Opportunities and Social Integration” was jointly organized with the World Health Organization. In addition, another international conference titled “Community Psychological Health Services: On the Way to Social Inclusion” was held in Ankara between October 2-3, 2013. Many other meetings, training activities and events were also held throughout the project.
Besides, in order to improve the mental and psychological health of young people, the National Action Plan on Psychological Health has begun to be implemented, and in line with this, psychological health services have been improved through a community-based approach and a total of 50 Community Psychological Health Centers have been established in 44 provinces.