Implementing WHO-Quality Rights Project in Tunisia: Results of an Intervention at Razi Hospital

Abstract

Background: The aims were: 1) to measure the attitudes of learners (and future trainers) before and after a course on WHO-Quality Rights (QR); 2) to evaluate a psychiatric ward, by previously trained staff on QR, comparing it with a previous evaluation and discussing an improvement plan. Methods: 1) Training sample: 19 subjects (8 males), 41.4±10.6 years, including jurists/lawyers, health professionals, and experts. The QR team developed the 26-item tool to assess the knowledge and attitudes of participants. 2) Evaluation of quality of care and respect for human rights in the ward was carried out on 20 staff representatives, 20 family members and 20 users with QRToolkit. Results: 1) Learning in QR has partially changed the knowledge and attitudes of trained people. 2) The evaluation shows significant delays in the implementation of the rights advocated by the United Nations Convention on the Human Rights of Persons with Disabilities (CRPD). In Themes 1, 3, 4 and 5, the evaluation shows no differences compared to 2014, but in Theme 2, the level was lower than four years before. Conclusion: The scarcity of resources due to the economic crisis that Tunisia is going through, cannot be considered the only cause of the delays highlighted. However, it is likely that in a context of uncertainty for the future, scarcity of resources and a decrease in staff (i.e., professionals dedicated to psychosocial intervention) may have demotivated the team towards recovery. The improvement in knowledge and attitudes of many staff members after the training may open future positive scenarios.

Quality of mental health services and rights of people receiving treatment in inpatient services in Finland: a cross-sectional observational survey with the WHO QualityRights Tool Kit

“…However, there are large deviations between wards in terms of adopting alternatives. There is still room for further development in inpatient psychiatric services as the total mental health workforce is high in Finland, [ 17 ] and no scarcity of resources was found in our study, unlike in many other countries [ 8 , 11 ].…”

“…The Tool Kit is designed for use in LMIC and high-income countries, as it is an essential resource, not only for putting an end to past neglect and abuses but also for ensuring high-quality services in the future [ 5 ]. To date, the Tool Kit has been used for reviewing mental health facilities in many areas around the world, [ 6 ] including Egypt, [ 7 ] Tunisia, [ 8 ] Greece, [ 10 ] the Czech Republic, [ 11 ] Chile, [ 12 , 13 ] and India. [ 14 ] These reports reveal a variety of deficits in mental health services, both in LMIC and in high-income countries, beginning with the poor physical state of the hospitals, [ 11 ] service users not being able to live independently in society, [ 9 , 13 ] and a lack of preventive measures to avoid maltreatment and cruelty [ 13 ].…”

“…Authors have also concluded that informants may have been too afraid of punishment to share the true state of services, which has resulted in an overly optimistic picture of the quality of the care and fulfilment of human rights [ 7 , 10 ]. Scarcity of resources was also evident in many countries [ 8 , 11 ].…”

Human rights of people with mental illness diagnosis: perceptions among service users, family members and health professionals in Tunisia

“…There are examples of training interventions which have succeeded in decreasing stigma among health professionals (Villani and Kovess-Masfety, 2017). A training course on the CRPD and the QualityRights toolkit was organized in Elrazi after this study and showed significant differences in the awareness of rights by the participants before and after the one-week course (Carta et al , 2020). It is important to underline, however, that even though training the staff, the service users and their families on human rights is necessary, it is not enough to change the situation.…”

Validação do módulo \"Strategies to end seclusion restraint/Estratégias para acabar com o isolamento e a contenção\" do ToolKit >i<QualityRights>/i<

“…Este é o tipo mais amplo de métodos de revisão de pesquisa, permitindo a inclusão simultânea de pesquisas experimentais e não experimentais, a fim de entender melhor um fenômeno preocupante (WHITTEMORE;KNAFL, 2005). Esta revisão passou pelas seguintes etapas, adaptadas do modelo de Whittemore e Knafl ( 2005 (BRASIL, 2015;CARTA et al, 2020).…”