Liberation from Institutional Living in Kyrgyzstan

Jerôme and Nurbek* are dark-haired men of average stature, in their mid-thirties with friendly brown eyes. They both have schizophrenia. Yet Jerôme and Nurbek live very different lives.

Jerôme rents a one-room apartment in Lyon, France. He works at an organization that provides help and support to people with mental health problems. He has a girlfriend with whom he often goes to parks and museums in the city.

Nurbek, on the other hand, is a patient in a large psychiatric institution in Chymkorgon, a remote village in Kyrgyzstan. He has not been outside of this institution for over a year now and never sees his family members. Nurbek does not know what medications doctors at the institution give him, let alone about his fundamental right to the highest attainable standard of health.

While Kyrgyzstan adopted a number of international and national protections guaranteeing the rights of people with mental health problems and intellectual disabilities—including free choice, nondiscrimination, access to information, safety, privacy, and confidentiality—the overwhelming majority of people in Kyrgyzstan with mental health problems find themselves in a situation similar to that of Nurbek. But if they, and Nurbek, were born in France, they could live a life similar to Jerôme’s.

In 2011, the Open Society Mental Health Initiative and the Soros Foundation–Kyrgyzstan’s Public Health Program supported a joint project initiated by two civil society organizations, Habitat for Humanity Foundation–Kyrgyzstan and Family and Society. The project’s goal is to help people with mental health problems and intellectual disabilities integrate into society by providing decent housing and outpatient psycho-social support.

Habitat for Humanity’s team is involved in construction of housing while the Family and Society team—consisting of a psychologist, social worker, psychiatrist, and children’s psychiatrist—focuses on helping people with mental health problems and their families at home. As of today, 49 families with a family member with a mental health problem or intellectual disability have received both psycho-social support and home renovations and repairs to heating systems, insulation, roofs, plaster, hot water, and plumbing. The project operates in Bishkek, Chuy, and Issyk-Kul, with plans to spread the program to other cities in Kyrgyzstan.

Evidence suggests that simple, safe, and decent housing decreases the number of epileptic seizures, depression levels, and anxiety levels among patients with mental health problems and intellectual disabilities. It also adds to the effectiveness of interdisciplinary interventions such as those provided by Family and Society.

The Habitat for Humanity and Family and Society model is a real rights-based, cost-effective alternative to the dysfunctional, Soviet-style institutions common throughout Kyrgyzstan. The model is one that the Kyrgyz government could adopt as a means of putting into practice the obligations it has ratified to protect the rights of people with mental health problems and intellectual disabilities. These programs allow citizens like Nurbek to liberate themselves from institutionalization, live at home, receive psycho-social support, work, and enjoy their lives to the fullest.

 * Jerôme and Nurbek are pseudonyms.

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