Indicator 2(E): Are day services provided that can support people with mental disabilities to stay in the community?
Conclusion:
Yes, some day care services are available, however these are scare and not accessible to all.
Explanation:
Day care services are provided for people with mental health issues from the age of 18 and for people with intellectual disabilities from the age of 3. People with mental disabilities can spend the whole day in day care centres where food is provided for them.[57] Day care provision includes the provision of personal care, and services are based on ‘self-help’. In 2012, 7,125 people with disabilities accessed day care services provided by 277 day care centres.[58]
Support services are provided for people with severe intellectual disabilities. The aim of the support services is to provide care for people with severe intellectual disabilities in their local community, mainly to assist them in accessing public services and providing them specialist support at home.[59] Services include assistance in accessing public transport, social and health care provision, and gaining employment and social assistance.[60] These services are mostly provided by local governments, as well as by churches and NGOs, and are predominantly state funded.[61]
Community care is provided for people with mental health issues. This can be a long-term service providing care and rehabilitation on a voluntary basis,[62] with the aim of promoting reintegration.[63] Over time, these services have been expanded away from just providing community psychiatric services to also include education, employment and housing support. However, the limited community care services that are in place are underdeveloped.[64]
In general, there is a wide geographical variance in the provision of services in the community, meaning that little to no services are provided outside towns and cities.[65] As of 1 January 2009, local governments are not obliged to provide support services for people with intellectual disabilities or community care services for people with mental health issues.[66] Instead of strengthening and expanding these services, the government has actually rolled back services in smaller conurbations across the country. Legislative changes meant that only conurbations with over 10,000 residents are required to provide day care services. Prior to this, local governments had to provide day care services in conurbations exceeding 3,000 residents.[67] 80% of families with a person with an intellectual disability said they were unable to access services.[68] Those who are not provided community-based services are significantly more likely to end up placed in institutions.[69]
[57] Section 65/F of Act III of 1993 on Social Management and Social Benefits.
[58] Hungarian Central Statistical Office, Szociális Alap- és Nappali Ellátás (Social basic and day care).
[59] Ibid., at section 65/C(1).
[60] Ibid., at section 65/C(3).
[61] The performance of duties delegated to local governments is regulated in sections 120-122 of Act III of 1993 on Social Management and Social Benefits.
[62] Ministry of Social and Family Affairs Decree No. 1/2000 (I. 7.), section 39/F, paragraph (1).
[63] Section 65/A of Act III of 1993 on Social Management and Social Benefits.
[64] Community care is provided in 37-38% of the required settlements and only 13% of the settlements have day care services. Hungarian Central Statistical Office, Statistical Mirror, Volume III, Issue No. 189 (18 December 2009). There were only 82 registered community care services in 2010.
[65] Tamás Verdes, Ágota Scharle and Balázs Váradi, Intézet helyett ("Instead of Institution"), (Budapest: Budapest Intézet/Budapest Institute, 2012), 12.
[66] Hungarian Disability Caucus, Disability Rights or Disabling Rights?, CRPD Alternative Report, August 2010, 125, available at http://mdac.org/sites/mdac.info/files/english_crpd_alternative_report.pdf (last accessed: 23 September 2014).
[67] Ibid.
[68] Ibid, at p. 124. According to a survey in 2006-2007, 80% of families with a family member with an intellectual disability said that they had no access to any of the services which local governments are required to provide.
[69] Based on a report of the State Audit Office, in 2006, only 17% of the residents of the institutions had received basic social services before and this figure dropped in 2007 to 13.9%. State Audit Office, Report on the audit of the utilisation of financial means of municipality hospitals and residential social institutions appropriated on nursing and care, July 2008, available at: http://www.asz.hu/ASZ/jeltar.nsf/0/24CB3F07C598D096C1257497004B40FE/$File/0820J000.pdf (last accessed: 23 September 2014).