Foster a culture of service based on human rights
Social and mental health services must have a shared vision of service based on human rights in order to offer care that is truly oriented towards the person's recovery and that guarantees their rights. The World Health Organization (WHO) offers a set of tools through QualityRights to help in this improvement and transformation of services.
Service culture comprises the values, beliefs, norms and practices shared by the different members of a service. The core values (equality, well-being, participation, etc.) must allow not only the service workers, but also the people served and their families, to identify with and commit to them, and must be aligned with human rights.
This service culture is influenced by different elements:
- Visible factors . Structures and signs of the physical, psychological and social environment of the service that, despite being easily observable (the design of the spaces, clothing, language, etc.), are sometimes difficult to interpret.
- Declared values , which may or may not be aligned with human rights. They are not directly visible but are usually expressed in writing (in informative or regulatory documents of the service) or orally.
- Underlying assumptions . They are usually invisible, as they are a series of beliefs, ideas and attitudes, often unconscious, that are taken for granted and that determine feelings, ideas, perceptions and behaviours.
To move towards a positive and recovery-oriented service culture, it is necessary to be able to influence all these elements and bring them closer to a rights perspective.
This transformation is not without its challenges and it is necessary to understand the power dynamics within the service, the underlying reasons and how they influence the delivery of the service to people and its impact, in order to be able to improve or change. Power imbalances will often lead to resistance to change .
QualityRights: the definitive push towards change
How to implement changes in services
To develop and implement an improvement plan to change services and orient them towards recovery and rights, it is important to involve management and also facilitate the participation of all stakeholders (professional teams, people served and families). This plan should incorporate:
Evaluation of QualityRights in the service
The evaluation must be based on the five topics raised by this tool:
- The right to an adequate standard of living.
- The right to enjoy the highest attainable standard of physical and mental health.
- The right to exercise legal capacity.
- The right to personal liberty and security, protection against torture and cruel, inhuman or degrading treatment, and against exploitation, violence and abuse.
- The right to live independently and be included in the community.
Identification and prioritization of problems
You can't do everything at once, so you need to prioritize the problems you've identified to define the immediate priority areas and the medium- and long-term priority areas. Actions will need to be taken for the immediate priority areas, as poor performance in these areas can:
- Be harmful or have a negative impact on the people being treated.
- Cause deterioration in their physical and mental health.
- Causing people to want to leave the service or preventing others from using it
Strategy development
In order to address the area of improvement that has been prioritized. This strategy must reflect the vision and core values of the service.
Planning of activities or actions to be carried out
The QualityRights assessment report can help decide what the most appropriate actions to initiate for each strategy might be. Each activity should include expected dates, budget and people responsible for its implementation.
Evaluation
It is necessary to evaluate the positive impact expected to be obtained and also the possible negative impacts, as well as define performance indicators and ways to control them. It is also advisable to repeat the QualityRights assessment after a while.
Monitoring of strategic action
It must be ensured that the improvement process is incorporated into the daily practice of the service and that all interested parties feel ownership and responsibility for it. The results of the process must be reported and shared with all parties, including the management and positions of responsibility of the service, the team of professionals, the people served and the families.
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