15 November 2014

BBC: The disabled children locked up in cages


by Chloe Hadjimatheou

Disabled people in Greece are often stigmatised and can struggle to get the support they need. Some disabled children who live in a state-run home are locked up in cages - staff say they want to improve conditions but money is short.

Nine-year-old Jenny stands and rocks backwards and forwards, staring through the bars of a wooden cage.

When the door is unlocked she jumps down on to the stone floor and wraps her arms tightly around the nurse. But a few minutes later she allows herself to be locked back in again without a fuss.

She is used to her cage. It's been her home since she was two years old.

Jenny, who has been diagnosed with autism, lives in a state-run institution for disabled children in Lechaina, a small town in the south of Greece, along with more than 60 others, many of whom are locked in cells or cages.

Fotis, who is in his twenties and has Down's syndrome, sleeps in a small cell separated from the other residents by ceiling-high wooden bars and a locked gate. His cell is furnished only with a single bed. There are no personal possessions in sight anywhere in the centre.

"Are we going on a trip?" is this wiry young man's hopeful refrain whenever he sees anyone new. But with barely six members of staff caring for more than 65 residents there is rarely an opportunity to leave the centre.

In the small staff room, an array of closed circuit TV screens flicker, permanently tuned into the large wooden boxes that dominate the upstairs rooms.

The poor conditions first came to the attention of the authorities five years ago when a group of European graduates spent several months at the centre as volunteers.

Catarina Neves, a Portuguese psychology graduate was among them.

On the first day there I was completely shocked… I could never have imagined that we would have this situation in a modern European country but I was even more surprised that the staff were behaving like it was normal," she says.

The volunteers wrote up their experiences in a document that they sent to politicians, European Union officials, and every human rights and disability rights organisation they could find. Occasionally they received replies thanking them for their email without any promise of action but mostly they were ignored.

Then in 2010 the volunteers' testimony came to the attention of the Greek ombudsman for the rights of the child who visited the centre and published a damning report in which he highlighted, "the degrading living conditions… the deprivation of care and support provided, the use of sedating medication, children being strapped to their beds, the use of wooden cage-beds for children with learning disabilities, the electronic surveillance, as well as the fact that such practices constitute violations of human rights."

He also referred to the fact that there had been several deaths at the centre due to a lack of supervision. A 15-year-old died in 2006 after choking on an object he had accidentally swallowed. Ten months later when a 16-year-old died, the post-mortem examination revealed his stomach was full of pieces of fabric, thread and bandages.

t was after these incidents that management of the centre decided that the staffing levels made it impossible to protect the children from harm. Their solution was to have the cages custom built for the residents.

However the ombudsman's report concluded that the cages and any practices employing long-term restraints "are clearly illegal and are in direct contradiction with the obligation for respect and protection of the human rights of the residents," and he urged the Greek government to take immediate steps to rectify the situation.

But after almost five years the only changes are superficial.

Some of the wooden bars have been painted and funding was found to turn the day room into a soft-play area - but there is still no-one to engage with the residents, who sit alone in the room on plastic mats rocking and staring at the walls while an assistant watches from the doorway.

There is only one nurse and one assistant per floor responsible for more than 20 residents - there is no permanent doctor at the centre.

When residents need to go to hospital, they are accompanied by one of the nurses which means more than 20 residents are left in the care of just one person.

"On a nightshift I was often left alone with three assistants, who are not even nurses, to care for more than 60 patients. If there were any medical problems with the children there was no one to ask for help except God," says a senior nurse who recently retired from the centre and spoke to the BBC on condition of anonymity.

She says the cages were necessary. "We fought to have those caged beds built to give the children more freedom. Before that the residents were permanently tied by their arms and legs to their beds.

"Anyway, the children are used to them now. They like them."

Local doctor George Gotis who has been volunteering his services at the centre for more than two decades also sees the cages in a positive light.

"I believe this is one of the best institutions for disabled children not only Greece but in Europe," he says.

"Many of these profoundly disabled children have lasted far beyond their average life expectancy and these expensive caged beds, which were built to help protect them from injuring themselves, have played a big role in that."

The new director of the centre Gina Tsoukala, who has not been paid for nearly a year, says she can't quit because she feels she owes it to the residents to stay and fight their cause.

"Obviously we shouldn't have cages here but it is impossible for us to manage without them when we have such low levels of staff."

"Some of the residents have self-destructive tendencies or are quarrelsome and so on the advice of a doctor we have to use these wooden partitions. But the children are still free to communicate and to some degree to interact with each other."

At lunchtime the children who are behind bars are fed inside their cages.

The director says only the very basic needs of the children can be covered by her staff. In one shift a nurse and assistant have to change the nappies of more than 20 residents, hose them down, spoon feed them and medicate them.

"We are doing everything we can but we do not have the resources to give anything else," says Tsoukala.

"More than two thirds of these children have been abandoned by their families and we do not have the time to give them the emotional support we would like, nor to give them the individual care they deserve."

But arguing that the cages are there for the safety of the children is wrong, says Steven Allen, of The Mental Disability Advocacy Center (MDAC) - an international human rights organisation for people with mental disabilities.

"The cages are there to protect the staff not the children," he says. "They are based on a model of care that is about coercion, restriction and making people with disabilities easy to manage, not treating them as human beings with rights.

"Being kept in a cage is seriously detrimental to the psychological health of patients, has no therapeutic value and can actually be physically dangerous. There have been cases [elsewhere] where the bars of cages have fallen on to patients and killed them," he says.

The MDAC says the only other countries which currently use similar caged beds are the Czech Republic and Romania.

The head of the Association for Families and People with Disabilities in Ilia, the local prefecture, Ioannis Papadatos, has his office in a huge state of the art centre designed to cater for people with disabilities.

Complete with swimming pool, physiotherapy and speech therapy facilities, and a large number of flats for semi-independent living, it was built with EU funds. But today it sits empty because the Greek state can't afford to staff it.

Ioannis Papadatos used to be on the board of trustees for the children's centre at Lechaina until last year. He says he battled to make conditions better at the centre - two girls with autism now go to a special school for a few hours a day.

But for many residents he says, "The only time they will really be released is when they die."

This is a subject close to his heart. His first child, 24-year-old Andonis, was born with Down's syndrome.

Andonis has visited the centre with his father and seen people with similar conditions to his own living behind bars. When asked about it he visibly shivers.

"Oh, don't talk about it! It gives me the chills," he says.

Sociable and confident, Andonis is unusual in that he was raised by parents who were proud of him and encouraged him to live as independent a life as possible, in a country where disability is still stigmatised.

Gina Tsoukala says the mothers of some of the residents do not even know of their existence. She believes that in some cases, when disabled children were born, the father and hospital conspired to tell the mother the baby had died.

There are about a dozen centres for disabled children and adults in Greece but getting access to them is difficult and it is unclear what conditions are like inside each of them. The BBC's requests to visit other institutions in Athens and Sidirokastro, in the north of Greece were refused.

But there are plans to improve the institution at Lechaina and other similar homes, says Efi Bekou, the general secretary in charge of welfare at the Ministry of Labour and Social Welfare

"At the moment there are 12 centres for disabled children and adults around Greece but we are opening increasing numbers of homes in the community and hope to eventually close all big institutions."

She says the economic crisis means that the Greek state is bound to rules set by its lenders in the EU and IMF, including a moratorium on hiring new staff - as a result, she says, it would be impossible to employ the number of staff needed at the centre.

But while she says the government is discussing the children's situation she admits, "I can't give you an exact time line for when those children will be transferred out of that institution."

The names of the children in this article have been changed.


24 May 2014

Forum for the Psychiatric Reform : European Election Manifesto 2014


We are users of mental health services, families and friends, facing a series of problems in our everyday life in Greece. We have formed associations and we cooperate in the Forum for the Psychiatric Reform because the situation in the field is dire and is getting worse day by day. This is not an exaggeration, what we as users and families are experiencing, are daily violations of our basic human rights as citizens of Greece, stigma, social isolation, cut in our benefits and lack of or increase of the prices of our medication. We are also completely excluded from any process of formulating, discussing, deciding and implementing mental health policies and plans. We are at the receiving end of various implementations that are against the effort of psychiatric reform.

We ask you to listen to us and help us protect our right to have a say on what is happening with our lives and families. We used to say “nothing for the users, without the users”, but the sad truth is that this is something that has never happened in Greece. Please do not ignore our plea and help us to be heard, we need you as an ally in this effort since we cannot afford to lose another chance.


Our basic human rights are violated. We face abusive behaviour by the police, which is the medium to submit us to a hospital, with no training and in most of the times under inhuman conditions that insult our dignity and human existence. We still have the inhumane privilege to be first in the EU on involuntary psychiatric submissions, and almost 60% of all of these submissions to psychiatric hospitals are involuntary. Promote individualised/personalized treatment/care in a community based system as a therapeutic means. Protect the human rights of people with mental health problems. 

Sectorization of the existing scarce and under threat psychiatric services has never worked, even though there was a related law dating from 1999. The committees most of the times were never active and they did not have users or family members on their compositions. Implement the sectorization of the psychiatric services and promote the active participation of users and their families in the committees.

Currently the psychiatric rehabilitation and deinstitulization is based mainly on the families of the users. The few community based programs are not sufficient, we need more. The huge economic and humanistic crisis that Greece is going thorough has made things even worse, we could say that in some instances we moved backwards and not forward. Family's rights and needs are being fragmented. The lack of social services and infrastructures, forces families to resort to private mental health clinics in order to receive and provide help for their relatives. The financial burden is immense on the already encumbered families. The social cohesion in Greece is in turmoil and the government is pushing users, families and mental health services to their limits, both psychologically and financially. Increase the community based programs, offer free and adequate social and mental health services and infrastructures of good quality, as well as access to adequate and affordable medication. Support the families. Make sure that people with mental health problems and their families have a minimum guaranteed income which covers their needs. Sensitize and include the communities and combat stigma and social exclusion. 

There is a huge threat for the existing chronic patients, people that have lived more than 40 years in the two major psychiatric institutions with the way that the government is violently trying to close them. These two institutions are also the gatekeepers for a huge load of acute psychiatric cases from all over Greece. We all want for these institutions to close, but by transforming the services and having the resources to increase the community based treatments. There is no plan and no answer on what will happen next. Just “sketches on maps”, but we are talking about vulnerable people and not pawns. Don’t close the two major psychiatric institutions before an effective transformation of the services is put in place with adequate resources to increase the community based treatments.

There is a clear threat that the mental health memorandum signed by Greece and EU, will become just an administrative tool for the government to proceed violently to a distorted view of what psychiatric reform, rehabilitation and recovery means. Many of the goals have not been met, no one is evaluating this process, we are excluded by it and the result so far is catastrophic. We are extremely concerned at what will happen after 2015, since every year the budget for mental health services is dangerously low. Monitor the process with external evaluators, not appointed by the Ministry of Health, with an objective evaluation process, so that it is clear whether the goals of the memorandum have been met in actual changes and implementations.

All of the above and many more aspects are the reality that we are facing in Athens. The situation in the county, in the islands, in the small cities or villages is far worse, since the only model that has provided adequate mental health services, the mental health mobile units, are also under threat. Take special care for the people with mental health problems who live out of Athens, in the province, the islands, the small cities and villages.

The delusion of the mental health experts that they have all the answers and hence they can speak on behalf of the users must be abolished. We should be on the centre stage, discussing and forming policies and strategies, we should be able to have a chance to a whole life, not just a life, in order to have the best opportunity for recovery, and that can only be achieved if a whole system is finally developed and implemented based on the actual needs of the people, thus improving their capabilities and autonomy. Promote the real participation of the users and their families in all processes.


One cannot mention the words deinstitutionalization and community based psychiatry if one does not support the notion that good quality community mental health services, work and continuing education are one’s nonnegotiable priorities. These are the most important tools for recovery and emancipation. This path begins with personal projects to change the culture of mental illness, and extends to the challenge of productivity and to the possibility of real social and work inclusion. All these cannot be achieved without the unanimous stand and support of Greece’s and Europe’s mental health policy makers and activists, that this is Greece’s last chance for recovery. Since it is not just a national matter, it is an international one, and it is not only a matter of mental health, it is a matter of basic human rights.

Forum for the Psychiatric Reform : syn-skepsi.blogspot.gr
email: synskepsi@gmail.com


22 February 2014

Tough austerity measures in Greece leave nearly a million people with no access to healthcare...

Tough austerity measures in Greece leave nearly a million people 
with no access to healthcare, 
leading to soaring infant mortality, HIV infection and suicide

Austerity measures imposed by the Greek government since the economic crisis have inflicted “shocking” harm on the health of the population, leaving nearly a million people without access to healthcare, experts have said.

In a damning report on the impact of spending cuts on the Greek health system, academics found evidence of rising infant mortality rates, soaring levels of HIV infection among drug users, the return of malaria, and a spike in the suicide count.

Greece’s public hospital budget was cut by 25 per cent between 2009 and 2011 and public spending on pharmaceuticals has more than halved, leading to some medicine  becoming unobtainable, experts from Oxford, Cambridge and the London School of Hygiene and Tropical Medicine (LSHTM) said.

Rising unemployment in a country where health insurance is linked to work status has led to an estimated 800,000 people lacking either state welfare or access to health services and in some areas international humanitarian organisations such as Médecins du Monde have stepped in to provide healthcare and medicines to vulnerable people.

The report, which is published today in the medical journal The Lancet, accuses the Greek government and the international community – which demanded swingeing cuts as a condition of bailing out the Greek economy during the debt crisis between 2010 and 2012 – of being “in denial” about the scale of hardship inflicted on the Greek people.

Health employees demonstrate outside the Health Ministry in Athens (Getty Images)

“The cost of austerity is being borne mainly by ordinary Greek citizens, who have been affected by the largest cutbacks to the health sector seen across Europe in modern times,” said senior author Dr David Stuckler, of Oxford University. “We hope this research will help the Greek government mount an urgently needed response to these escalating human crises.”

Greece was forced to make massive cutbacks to meet the terms of twin bailout packages, totalling €240 billion, offered by the European Commission, the European Central Bank and the International Monetary Fund, known as the Troika. Health spending was capped at six per cent of GDP.

Analysis of figures from the EU Statistics on Income and Living Conditions survey revealed a leap in the number of people with unmet health needs, the authors said. The cost of healthcare has been significantly shifted away from the state and towards patients, with new fees for prescriptions introduced and charges for out-patient visits to hospital raised from €3 to €5 .

Government disease prevention schemes have also been rolled back leading to the resurgence and revival of once rare infectious diseases – including malaria, which has returned to Greece for the first time in 40 years.

“There are a whole series of infectious diseases which have been kept at bay over the past 50 or 60 years by strengthened public health efforts,” Martin McKee, professor of European public health at LSHTM and one of the report’s co-authors, told The Independent. “If you lift up your guard, as the Greek example shows, they can very easily exploit those changes.

“The experience of Greece demonstrates the necessity of assessing the health impact of all policies carried out by national governments and by the European Union.”

People stand outside the "Polyklikini", one of the hospitals affected by overhaul of the health sector (Getty Images)

Prevention and treatment programmes for illicit drug users faced major cuts, with a third of street work programmes halted in 2009-10, the first year of austerity. Reductions in the numbers of syringes and condoms distributed to known drug users has led directly to a spike in the rate of HIV infections in this community, the report said – from just 15 in 2009 to 484 in 2012.

Although reliable data on the health impact on the wider population will take several years to emerge, the Greek National School of Public Health reported a 21 per cent rise in stillbirths between 2008 and 2011, which was attributed to reduced access to prenatal services, and infant mortality also rose by 43 per cent between 2008 and 2010.

The suicide rate has gone up from around 400 in 2008 to nearly 500 in 2011.

Alexander Kentikelenis, researcher in sociology at the University of Cambridge and the report’s lead author, said that the Greek welfare state had “failed to protect people at the time they needed support the most.”

“What’s happening to vulnerable groups in Greece is quite shocking,” he told The Independent. “It’s quite straightforward to measure what has happened, it’s much harder to quantify the long-term health implications for the long-term unemployed and uninsured…Leaving health problems to get out of hand ends up costing a state much more in the long run.”

The Greek Ministry of Health and Social Solidarity did not respond to a request for comment.

Case study

The Metropolitan Community Clinic at Helliniko in Athens was founded in December 2011. It is run by volunteer doctors and provides free healthcare to people without medical insurance

Co-founder Christos Sideris told The Independent: “The healthcare situation in Greece is, unfortunately, dramatic. We have helped more than 4,400 patients, with more than 20,300 appointments in 26 months of operation. We look after more than 300 children below the age of three, and have helped 126 cancer patients to receive chemotherapy, in collaboration with a public hospital. This is not done in an official capacity, but by the people working there, every Wednesday after working hours, with donated medicines.

We have three basic rules: we accept no money from anyone, we have no party politics, and we do not advertise anyone for the help they are offering us. We only accept money from our own volunteers – there are 250 of them at the moment. These volunteers do fundraisers and give money to the clinic. The local municipality also helps us. Our medicines are all donated. There are more than 40 community clinics and pharmacies like us across Greece. They cannot solve the problem – we’re only here because there is a need for us to exist. We cannot substitute a public health system and we do not want to.”


16 May 2013

To Whom It May Concern

Psychiatric Reform in Greece, after a period of struggles, nearly 30 years, is once again in a critical point.  Its viability is under threat and so is the viability of all the mental health units that have been created during this period. Regrettably, despite the very important work that has been achieved, the crucial deficits and the dysfunctions of the political and the health system, have never been addressed properly and with a specific operational design. As a consequence of that we have witnessed that the efforts of the transition from institutional to community based care have been disputed or even annihilated. In addition to that, the unstable, fragmented and manipulative applied policies regarding mental health have resulted to serious problems in the organization and the operation and planning of the services. As a consequence, all the stakeholders (the service users, the families, the experts) are “locked and lost” in a totally fragmented mental health system.

The peculiarity of the Greek case is that a significant proportion (approximately 35%) of the Psychiatric Reform has been implemented by NGOs-  legal entities operating under private law. The Ministry of Health has assigned the project of deinstitutionalization of patients from large psychiatric hospitals and of the creation of Mental Health Mobile Units, residential units and Day Centers in these scientific organizations (without though any special contract and any guarantee for the sustainability of the project), which meet the needs of approximately 30,000 patients. A correspondingly significant part of the Psychiatric Reform has been undertaken by public organizations and services. 

Despite these aforementioned problems, there are currently about 2700 people who live and receive services in about 450 housing structures, which provide services also in the user’s families and in the communities where they are located. And over 30.000 in total all over Greece who are using these services.

There are 24 Mental Health Mobile Units, which cover hard to reach and inaccessible areas in the mainland and many small islands, the population (children, adults and over 65) of which without these services will not have any mental health service to turn to. There are also, nationwide, 41 Mental Health Centers and 69 Day Centers which also service the needs of the local communities where they reside. It is worth mentioning here, that the geographical complexity of Greece (many small islands and secluded villages), is a major factor that contributes to the difficulty of the people to have access to health services, especially since there is no actual operation of the planned and divided (only on paper) mental health sectors. 

The harsh reality is that many of these mental health units, due to severe budget cuts, to the huge delays of their funding from the government, to being understaffed, in many cases poorly managed and planned and finally due to the complete absence of well-designed and operational mental health sectors, are dysfunctional or even worse not functioning at all.

The current situation oblige us to make the problem public, to formulate and open a discussion and also to act towards an un-negotiable goal: establishing the irrevocable of the Psychiatric Reform in Greece, for the benefit of all the mental health patients, people who will need some form of psychological support, their families and the communities in which they live and work.

For those of you who are not aware of the present reality in Greece, mental health is under attack and under threat, as a concept, us a function and us a system. Majorly due to the complete lack, on behalf of the policy makers (MPs and Prime Minister), to seriously discuss and implement solutions, and due to the will and inability of all the parts involved to work together and try together for this change. THIS HAS TO END, THERE IS NO TIME LEFT

Briefly we should mention that in Greece in the year 2013:

a.The unquestionable right, for all the citizens of all ages, to equal access to, at least adequate, health services, is questioned and infringed.

b.The rights of the mentally ill patients and their families are grossly violated in at least two levels: firstly because people are being negated the right to access or have functioning mental health services in the area that they live and secondly due to constructional deficiencies in their operation, co-operation and coordination. There have been recorded cases of patients burned alive strapped on their beds, deprived of their human rights, patients receiving very low quality care and so forth.

c.We have to underlie that, in these conditions where there is a breakdown of the social bonds and structures, where the welfare state is under huge crisis, where there are conditions of insecurity, of violent changes and deprivation, the first who are under major threat are the frail social groups. For example, due to the implemented policies, the mentally ill and their families are stripped of their basic welfare allowance, crucial to them, for living and covering their health care and medication. There is also a huge problem with the scarcity of certain cheap psychiatric medication which forces the patients to be burdened with the cost of other more expensive drugs.

d.The “difficult” and “demanding” patients (e.g. severely mentally retarded patients) stay for years or even decades to the psychiatric hospitals, due to the fact that the over-pressured and burned out system of mental health units cannot “cope” with them and properly treat them.

e.There is no integrated system of community care

f.Patients who are extremely vulnerable (unemployed, handicapped, poor and on well-fare) are excluded from some of these mental health services due to the fact that they have no insurance or their insurance partly covers the costs. They are also obliged, due to the aforementioned reality of the mental health system and policies dictated by the Government, to contribute from their penurious income for the living and functional costs of the residential units that they live in. At the same time their well-fare allowance has been stopped by the Government for over a year.

g.The 3000 people, who work at these NGOs (psychologists, psychiatrists, nurses, social workers etc.) and provide their services to the people and their communities for free, still remain unpaid for over  a period of 9 months, due to the lack of political decision making and planning. They are not willing to properly support and sustain these mental health services, although the E.U., all these years, has many times intervened and saved the whole project with extra funding.

h.At the same time, people who work at the public sector and the mental health services which cover that field are also under threat, under budget cuts, threats of mergers with other mental health units, and closures of functional mental health units. Former and latter, are still providing their services, devalued and financially overburdened and they are asked to look after people who have enormous needs psychically and physically. In a reality which at best someone can characterize it as complete wretchedness. In conclusion we have to underlie the specific nature of the profession and the psychological burdens, which mental health professionals who treat severely mentally ill patients, have to withstand and endure. All these in a very hostile external reality, where there is no support from the well-fare state in any level and each person is trying to struggle for his/her own survival. It is easily assumed by everyone, that in these conditions both patients and mental health professional are at high risk.


a.The survival of the psychiatric reform in Greece.

b.The safeguarding and the political confirmation of its irrevocable nature.

c.Sufficient funding for a comprehensive and integrated public mental health system, which will meet the needs of the Greek population and provide adequate services in a primary, secondary and tertiary level.

d.Complete restructuring and coordination of the mental health services (both NGOs and public sector) towards the community and gradual reformation of the psychiatric institutions. We need to preserve the existing services and create new out-patient units and mental health centers. All based on specific and scientific evaluating criteria.

e.Complete and immediate implementation of the sectoralization of the mental health services. It is of an outmost importance priority in order for everything else to function properly and effectively.


For more information and data please contact:
Email: synskepsi@gmail.com (http://syn-skepsi.blogspot.gr/)


21 April 2013

“Troika”- Mandated Austerity and the Emerging Health Care Crisis in Greece

“Troika”- Mandated Austerity and the Emerging Health Care Crisis in Greece:

An Open Letter to the Greek Government

To the Prime Minister of Greece and President of New Democracy Party, Mr. Antonis Samaras

To the President of PASOK, Mr. Evangelos Venizelos

To the President of the Democratic Left, Mr. Fotis Kouvelis,

To the Minister of Health, Mr. Andreas Lykouretzos,

This letter is an attempt by Greek scholars and physicians from diverse academic areas of specialization to raise our concerns regarding the current, dire, state of Health Care services in Greece.

Our country has fallen into a dismal state, and it is constantly challenged by extrinsic and intrinsic pressures, while the economic and social climate deteriorates further each day. The Greek government, in total obedience to the irrational demands of the Troika, focuses on the obligations of the citizens towards the state, and seems to forget or ignore its own obligations towards its citizens. The Government has imposed a brutal and self-defeating fiscal austerity; in a confiscatory manner, it tries to collect extra revenue from an already impoverished and afflicted populace, while it neglects its main role, as specified by the Constitution: The Protection of the Rights and the Welfare of the Citizen Body.

In three short years, governments comprised of the current coalition parties have managed to reduce the country’s GDP by 25%, leading Greece to the deepest and longest-lasting economic depression in the history of the modern Western world. During the same period of time, the public debt expanded from 109% GDP to 170% GDP, unemployment rose from 8% to 27%, and youth unemployment now holds the world record at 58%.  Incomes have been reduced by more than 40%, leading to a record number of families and individuals living below the poverty line. It is worth noting that the famous “haircut” (PSI), presented by the Government as a notable achievement, ultimately increased the public debt, while raiding the reserves of pension funds, reserves that were gathered painstakingly by the contributions of workers and pensioners.

One of the sectors that has been most hard-hit is Health Care. The Public Health system in Greece is now collapsing at all fronts. Having signed a memorandum of understanding with the unelected and unaccountable troika to reduce public health expenditures from 9.8% GDP (pre-crisis) to 6% GDP (the shrunken post-crisis GDP), the Greek government has instituted a number of measures which seriously undermine the health of the population. Removing health coverage from thousands of unemployed is definitely guaranteed to increase mortality in this segment of the population.

This policy of subservience to the Τroika’s demands has led to the closure or downgrading of Hospital units.  For example, the hospital of the town of Kymi “Georgios Papanikolaou”, the hospital of the city of Thebes and many others in the provinces and in metropolitan centers have seen their medical personnel reduced, the staff remained unpaid for long periods of time, their medical equipment in progressive deterioration, and laboratories with increasing shortages in all kinds of consumables (syringes, bandages, reagents etc.).  Patients now have to pay for consumables, for medical tests, and for surgeries. This is all on top of what they already paid through their insurance funds. Those who suffer from chronic diseases, such as chronic obstructive pulmonary disease, are forced to pay a 25% deductible for the cost of their medication, while prior to the crisis this deductible stood at 5%. Cancer and kidney failure patients suffer not only due to the increased costs of specialized treatments, but also the general rundown of these facilities, loss of key personnel and dramatic shortages in medications; unable to receive treatment at home anymore, they have to travel far away for dear life, and wait in endless queues in the corridors of bureaucratic health-insurance offices and/or hospital clinics. Patients in mental health units, such as Dromokaitio, face every day the alienation and indifference of a state that fails to support them. The staff and the resources in most psychiatric clinics are decreasing rapidly, while the number of patients is increasing (as this crisis is taking its toll).  Psychiatric hospitals in Greece can no longer perform at the level required to provide even basic treatment to patients diagnosed with serious mental illnesses.

Furthermore, the establishment of a "standard rate" for surgeries is forcing patients to pay in advance approximately 20% of the value of materials and services.  This “standard rate” makes both emergency and elective surgeries virtually unapproachable for a broad segment of the population. For example, on the basis of the newly introduced pricing, the cost for a hip replacement surgery at a public hospital approximates €1000; this cost is further increased by the remuneration of the surgeon, the anesthesiologist and other essential staff. Thus, the cost of this common surgery is currently unaffordable by an elderly patient with a basic pension of less than €600; such retirees would be unable to secure the funds, having to prioritize purchasing of basic foodstuffs, paying for rent and utilities, securing funds for heating, acquiring their regular medication, and affording sundry living expenses (and often this small pension supports an additional family member). 

Beyond these specific destructive measures, one can easily figure out the impact on public health of the consecutive decreases in pensions and the confiscatory tax measures. Many poor pensioners have no choice but to forgo basic, life-saving drugs and healthcare monitoring, in order to afford just food and heating (the Government’s devastating policies in heating fuel are duly noted here).  The pricing of basic goods has increased (not only by inflation but also by the drastic increases in VAT for even basic items), while incomes have been drastically reduced.  The imposed increase of 500% or above on deductibles for drugs and doctor visits are simply making it impossible for many pensioners to maintain their assigned treatment.  Certainly, the consequences here, especially for persons with serious and chronic diseases, are increased morbidity and mortality.

This rapid decline in the quality of care administered is complemented by the hemorrhaging of highly trained individuals; more than 4,000 highly trained Greek doctors have emigrated abroad because of their frustration with the degradation of the system and the successive cuts in wages, overtime remuneration and benefits. It is worth noting that the National Health System (ESY) in our country has operated efficiently, provided exceptional services and constituted an important achievement of our society prior to the onset of the crisis. It was the hard work of the doctors, the nurses, the pharmacists, the laboratory scientists and technicians, the administrators and the ancillary personnel of ESY that advanced the status of the public health in the country. This system is now bereft of basic resources, besieged at every level and plundered with your consent.  Its members are fleeing in increasing numbers.

In this context, we call on the Greek government to keep and defend the value of health. There should be no cuts on funds required for the normal operation of the hospitals in Greece, both for those located in major metropolitan centers and for those in the islands and other remote areas of our country. We ask that you do not downgrade regional hospitals to just health centers. Such health centers will provide limited services and result in the collapse of public health in the provinces. Do not let these regional/provincial hospitals remain understaffed, manned simply by general practitioners or pathologists, bereft of key specialized personnel; your policies will degrade terminally what has been the key strength of these regional hospitals, a strength that contributed significantly to the improvement of public health in Greece in the last few decades.  If your policies were fully enabled, key specialized personnel would only be found in large, crowded hospital conglomerates in metropolitan centers. Such a policy would force Greeks who need special attention, to travel farther and farther from home in order to secure proper care (thus further increasing the already unbearable costs), assuming that they can even afford it, a dangerous assumption  in this current economic climate.  The additional costs and the absence of timely specialized care would undoubtedly lead to increased morbidity and mortality in the provinces.  A welfare state that respects its institutions and history, and cares about its continued existence in the future, should not even contemplate such drastic cuts in public health. Such actions can be expected by foreign-installed, occupation governments, not by a government of Greeks for Greeks.

Thus, we request the following actions by the Greek government: 

1.The proper staffing, maintenance, and modernization of existing hospitals in the country, especially in the provinces and the islands.
2.The restoration of proper medical coverage of population groups, the collective health of which is specifically under threat by the current economic crisis.  These groups include the long-term unemployed, the working poor, low-income pensioners, and others.  For these population groups, you must introduce a substantial rollback of the increases in the cost of health care that you have instituted.
3.The creation of policies and incentives that will assist in the proper geographic allocation of physicians and nursing personnel of all specialties in order to avoid needless and counterproductive concentration of qualified personnel (often unemployed) in metropolitan centers.
4.The proper remuneration of physicians, nurses, laboratory scientists and technicians to avoid further depletion of these key personnel through emigration.  The drastic cuts in wages, salaries and overtime pay must be rolled back.  Otherwise, the exodus of qualified personnel will turn into a stampede, with disastrous consequences for public health.
5.The introduction of policies that will assist in the ready availability of pharmaceuticals, consumables, laboratory supplies, and devices.  The government should forgo unconvincing public releases about primary surpluses and regularly pay suppliers and pharmaceutical companies the full amount owed.

As the government of Greece, you have the responsibility for our country’s survival and the welfare of its citizens. You have no right to obtain credit by degrading the health of your compatriots and by sending to an early grave the most vulnerable among us.  You are obliged to say NO to the demands of the unelected members of the “troika”, when obedience to these demands has devastating consequences for our country. If saying NO to Troika’s destructive demands means exiting the Euro Zone, then you must do so.  Many of us believed in a united Europe, but the Euro Zone proved to be only a means of exploitation of the weaker nations by the stronger ones. The consequences of our continued participation in the common currency have become obvious by now. Along with the impoverishment of our country, you have made us forget not only the meaning of the word “pride”, but also the meaning of “dignity”.  Despite the ongoing crisis, record unemployment, the rapid decline in GDP, the dramatic increase in poverty and hunger, the deteriorating health of the population, the sharp decline in birth rates, the wave of suicides and total loss of hope, you cling tenaciously to your policies of supplication and subjugation, while continuing to sell off public property and public companies at rock bottom prices.

The disastrous policies that undermine even the basic health of the Greek population must come to an end.  As Greeks, we are able to survive the crisis and rebuild. However, to do so, having our physical health is a prerequisite.


1.Medical and support staff of the Metropolitan Social Clinic of Elliniko, GREECE.
2.Akritas Alkis, Professor, CS / KU, USA.
3.Albrecht-Πηλιούνη Ευφροσύνη, Ph.D., International Programs, Foy Hall 316, Auburn University, Auburn, AL 36849, USA.
4.Almpoura Efstratia, MSc Developmental Psychologist, IED-Paris8, Vincennes-Saint Denis, Paris, & Harvard ES, Cambridge MA, Athens, GREECE.
5.Anastassopoulou Ioanna, Professor, School of Chemical Engineering, Department of Material Science and Engineering, Athens, GREECE.
6.Andreatos Antonios, Professor, Department of Computer Science, Department of Air Science, Air Force Academy, Athens, GREECE.
7.Antikas Theodoros, Ph.D., GREECE.
8.Apostolaki Aggeliki, MSc Psychologist, A.U.TH. Faculty of Philosophy, Department of Psychology, Thessaloniki, GREECE.
9.Argyrokastritis Ioannis, Associate Professor, Agricultural University of Athens, GREECE.
10.Argyropoulos Giannis, PhD, AT&T Labs
11.Aroniadou-Anderjaska Vassiliki, Ph.D., Associate Professor of Neurosciences, Bethesda, Maryland, USA.
12.Valaskakis Kimon, Ph.D., Ambassador of Canada (Ret), Professor of Economics (Emeritus), University of Montreal, CANADA.
13.Vallianatos Evangelos, Ph.D., Associate Professor, Pitzer College, USA.
14.Vartholomaios Tasos, MD, PhD, MFHom, GMC, UK, Registered Consultant Pathologist, Member of the Faculty of Homeopathy,UK
15.Vartholomaiou-McLean Athina, Ph.D., Professor, Sociology, Anthropology and Social Work, Central MI University 48859, USA.
16.Vichas George, Cardiologist, Head of the medical team of the Greek Metropolitan Social Clinic of Elliniko, GREECE
17.Vigot Jacques, DNSAP, in Plastic Arts, ENSBA, Paris. Artist-Painter, Educator in Painting and Drawing, Animation Center Les Halles-Le Marais, Paris Τοwnhall of the 1st Arr., Paris, FRANCE.
18.Vogiatzis Alexander, Former Associate Professor, University of Macedonia, GREECE.
19.Burriel Angela R., Professor, Veterinary Microbiology, University of Thessaly, GREECE.
20.Bucher Matthias, PhD, Assistant Professor, University of Crete, Chania, GREECE.
21.Georgopoulou Lito, Educator, GREECE.
22.Giannaki Efrosyni, Surgeon Dentist, Dental School of the National and Kapodistrian University of Athens, GREECE.
23.Spiro Yannacopoulos,  Ph.D., P.Eng., Associate Dean and Director, School of Engineering, University of British Columbia, Okanagan Kelowna, BC, CΑΝΑDA.
24.Panagiotis Giannopoulos, Associate Professor, Department of Civil Engineering, University of Patras, GREECE.
25.Giannoukos Konstantinos, M.Eng., Doctoral Candidate, Faculty of Engineering, Division of Materials Mechanics and Structures, The University of Nottingham, UK.
26.Giannoukos Stamatios, M.Eng., Research Assistant and Doctoral candidate, Department of Electrical Engineering and Electronics, University of Liverpool, UK.
27.Giokaris Nikos, Professor, Department of Physics, University of Athens, GREECE.
28.Gatzoulis Nina, Languages, Literature and Cultures University of New Hampshire, USA.
29.Dascalopoulos Stella S., MD, MSc, DIC, PhD, Assistant Professor in Medicine, Director, Vascular Health Unit, Department of Medicine, Division of Internal Medicine, McGill University, CANADA.
30.Dokos Socrates, Ph.D., Associate Professor, Graduate School of Biomedical Engineering, University of New South Wales, Sydney 2052, AUSTRALIA.
31.Dritsas Margarita, Emeritus Professor of Economic History, Greek Open University (Hellenic Open University), GREECE.
32.Eleftheriades George Savva, PhD, OAM, GCSCG, CETr, JP.  – ExarchOSETrAu, New South Wales, AUSTRALIA.
33.Eleftheriades Evgenia, CLETr, CSH; - Sydney, New South Wales, AUSTRALIA.
34.Evangeliou Christos C., Professor of Philosophy, Honorary President of IAGP, Towson University, Towson MD, USA
35.Prof. Dr. Panayiotis Zavos, Dr., Professor, Director & Chief of Andrology, Andrology Institute of America, President & CEO, ZDL, Inc. USA, P.O.Box 23777, Lexington, KY 40523, USA
36.Zerva Evgenia, M.Eng., Doctoral Candidate, Process and Environmental Engineering Research Division, University of Nottingham, UK.
37.Dr. Vassiliki Zotou, Language and Linguistics in Education, University of Thessaly, Volos, GREECE.
38.Zografopoulos Gregorios, Dentist,Dental School of the National and Kapodistrian University of Athens, Florina, GREECE.
39.Ifestos Panagiotis, Professor, International Relations-Strategic Studies, University of Piraeus, Department of International European Studies, GREECE.
40.Theocharopoulos Anthony, Ph.D., Lecturer in Dental Technology, Cork University Dental School and Hospital, Wilton, Cork, IRELAND.
41.John Petros, Ph.D., Electrical Engineering, University of Southern California, Los Angeles, CA 90089-2562, USA.
42.Kaimara Polyxena, MSc School and Evolutionary Psychology, MSc Public Health Specialization in Counseling and Guidance, Physical Medicine and Rehabilitation Center Florina, GREECE.
43.Kakouli Thomae, Ph.D., Lecturer in Biosciences, Department of Science and Health, Institute of Technology Carlow, Carlow, IRELAND.
44.Kakoules Theophilos, Emeritus Professor, University of Athens, GREECE.
45.Father Lambros Kamperidis, Concordia University, Montreal Classics, Modern Languages and Linguistics, CANADA.
46.Anastassios Carayannis, PhD, Professor, Department of Applied Human Sciences, Concordia University, Montreal, CANADA.
47.Caranastassi Irini, PhD, Assistant Professor, Department of Greenhouse Crops and Floriculture, School of Agricultural Technology, TEI of Messolonghi, GREECE.
48.Karan Panayiotis, Professor of Parasitology and Anatomy, Medical School, University of Cologne, 50937 Cologne, GERMANY.
49.Katsifarakis Costas, Professor, Department of Civil Engineering, Aristotle University, Thessaloniki, GREECE.
50.Panagiotis Kelandrias, Associate Professor, Department of Translation and Interpreting, Ionian University, GREECE.
51.Keromnes Luce, (CCI) School of Nurses-Managers of Pitié -Salpêtrière, Senior Manager of Health - retired, Paris, FRANCE.
52.Kontos John, Professor Emeritus, NKUA, GREECE.
53.Kopatou Stamatina, Professor of French in the French Institute of Athens (INFA), Greece. University of Languages ​​and Literature Grenoble 3. Athens, GREECE.
54.Constantine Koudounas, Graduate Department of Physics UoA, MSc Marketing & Communication, Gold Coast, QLD AUSTRALIA.
55.Koutselini Mairi, Professor, University of Cyprus, CYPRUS.
56.Kranidioti Maria, Associate Professor, School of Law, University of Athens, GREECE.
57.Kriara Fenia, MSc Cultural Informatics and Communication, Aegean University, GREECE.
58.Kyriakou George, Professor, Demokrition University of Thraki, GREECE.
59.Koletis Theophilus M., Professor of Cardiology, University of Ioannina, GREECE.
60.Comodromos Petros, Lecturer, Department of Civil & Environmental Engineering School of Engineering, University of Cyprus, CYPRUS.
61.Kostantatos Demosthenes, Ph.D., M.Sc. M.B.A., Greenwich CT, USA.
62.Father Konstantelos Dimitrios I., Dr F. D.TH, Emeritus Professor of Byzantine History and Theology, Stockton College of New Jersey, Galloway, New Jersey, USA
63.Kostas Antigone, Doctor of Psychiatry, Greenwich CT USA
64.Christina Lazaridis, Ph.D, retired from Dupont Company, Wilmington DE, USA (and Heraklion, Crete, GREECE)
65.Lazaridis Anastasios, Eng.Sc.D, Professor Emeritus, Widener University, Chester PA, USA (and Heraklion, Crete, GREECE)
66.Lampropoulou Venetta, Professor, Special-Deaf Education, President of the International Congress on the Education of the Deaf, Deaf Studies Unit, Department of Primary Education, University of Patras, GREECE.
67.Lekanidou P., Emeritus  Professor,  UoA, GREECE.
68.Loutridis Abraham, MSc, PhD Candidate, Antenna and High Frequency Research Centre, Dublin Institute of Technology, Dublin, IRELAND
69.Μanios Ioannis, National and Kapodistrian University of Athens, Faculty of Dental Surgery, Surgeon Dentist, Athens, GREECE.
70.Melakopides Kostas, Associate Professor of International Relations (ret.), University of Cyprus, Nicosia, CYPRUS.
71.Michalakopoulos George, Assistant Professor, Department of Translation and Interpreting of the Ionian University, GREECE.
72.Costas Moulopoulos, Associate Professor, Department of Physics, University of Cyprus, Nicosia, CYPRUS.
73.John E. Batzakas, Lecturer, University of the Aegean, GREECE
74.Bacalis Naoum, PhD, Institute of Theoretical and Physical Chemistry, National Research Institute, Athens, GREECE.
75.Baloglou George, Associate Professor Emeritus (SUNY Oswego), Thessaloniki, GREECE.
76.Balopoulos Victor, Assistant Professor Department of Civil Engineering, Democritus University of Thrace, GREECE.
77.Blytas Κ. George, Ph.D., Physical Chemistry/Chemical Engineering, Research Consultant, Royal Dutch  Shell, retired, President, GCB Separations Consulting, Founder: The Hellenic Professional Society of Texas, Author:  The First Victory, Greece in the Second World War, 2009, USA.
78.Bougas Ioannis, Professor of Statistics, Montreal, CANADA.
79.Briasouli Eleni, Professor, Department of Geography, University of the Aegean, Mytilene, Lesvos, GREECE.
80.Moraitis L. Nicholas, Professor of International Relations - Comparative Politics, University of California, Berkeley.
81.Negreponti-Delivani Maria, Ph.D., ex Rector and Professor of University of Macedonia, GREECE.
82.Notopoulou Julia, MSc Developmental Psychologist, IED-Paris8, Vincennes-Saint Denis, Paris. MFA Film and Film / Video, IED-Paris8, Vincennes-Saint Denis, Paris, Athens, GREECE.
83.Octeau Anne-Pascale, DNSAP, in Plastic Arts, ENSBA, Paris. Artist-Painter, Educator in Painting and Drawing, Paris, FRANCE.
84.Panoskaltsis Basil P., MS, MA, Ph.D., GREECE.
85.Papavasileiou-Alexiou Joanna, Assistant Professor of Counselling and Guidance University of Macedonia, Department of Educational and Social Policy, Thessaloniki, GREECE.
86.Papagiannis Gregorios, Ph.D., Byzantine Philology, Demokrition University, Thraki, GREECE.
87.Papadopoulos Nikos T., Emeritus Professor of Medicine Aristotle University, Thessaloniki, GREECE.
88.Papadopoulou Maria, CLETr, MSc, Civil Engineer, Larissa, GREECE.
89.Papathanasiou Maro, Professor in the Department of Mathematics, University of Athens, GREECE.
90.Papamarinopoulos P. Stavros, Professor, University of Patras, GREECE.
91.Paparodopoulos Nikolaos, former Lecturer, University of Aegean, GREECE.
92.Paul P. George, Associate Professor, Department of Electrical and Computer Engineering, Polytechnic School of Xanthi, University Campus Xanthi Kimmeria, Xanthi, GREECE.
93.Péré-Pasturel Sandrine, MSc Psychologist, IED-Paris8, Vincennes-Saint Denis, Paris, Varcheny, Nursing-Nurse Manager at Creche au Pont, Rhône-Alpes, FRANCE.
94.Leonidas Petrakis, PhD, Chairman and Senior Scientist (Retired), Department of Applied Science, Brookhaven National Laboratory, Now residing in California, USA.
95.George Pirgiotakis, ex Associate Professor, GREECE.
96.Retzios Anastassios, Ph.D., President, Bay Clinical R&D Services, LLC, San Ramon, California, USA.
97.Riga Aikaterini, Ph.D. Director of Nematology Laboratory and Senior Scientist, Verdesian Life Sciences, Pasco, WA, USA
98.Peter Roussos, Assistant Professor, Agricultural University of Athens, GREECE
99.Sakatcheff  Veronique, MSc Cognitive-Behavioral Psychologist, IED-Paris8, Vincennes-Saint Denis, Paris, Toulon, FRANCE.
100.Sarri Maria, Surgeon Dentist UMFT Victor Babes, Athens, GREECE
101.Stamboliadis Elias, Professor, Department of Mineral Resources Engineering, Technical University of Crete, GREECE.
102.George Stavropoulos P., Cytologist, University of Athens, Athens, GREECE.
103.Mika Stavropoulou, Research Faculty, UoA
104.Stavropoulou Georgia, MA, MPhil. Los Angeles, CA, USA.
105.Stylianakis Vasilis, University of Patras, GREECE.
106.Tzamtzis Stavros - Dionisios, Psychologist, graduated from Aristotle University, Thessaloniki, GREECE.
107.Dr. George Tsobanoglou, PhD Sociology, Carleton, President, International Sociological Association, Research Committee on Sociotechnics & Sociological Practice (ISA-RC26), Associate Professor, University of the Aegean, Dept. of Sociology, Mytilini, Greece
108.Anna Tsirka, pediatric cardiology, Assistant Professor, Tufts University School of Medicine
109.Tsoutsoulopoulou A.M., EEDIP I English School of Humanities, University of Thessaly, GREECE.
110.Flessas George P., Professor, Department of Information & Communication Systems Engineering, Department of the Aegean, Karlovassi, Samow, Greece.
111.Evangelia Floros, Professor, Tel & GL Larissa, Department Decorators / Graphic Designers, Maintainers art, Design Free / Linear and specificity School of Architecture University of Thessaloniki, Larissa, GREECE.
112.Katerina T. Franzi, Associate Professor of Informatics, Department of Mediterranean Studies, University of the Aegean
113.Fridas Stavros, Professor of Parasitology Immunology-AUTH, Thessaloniki, GREECE.
114.Halamantaris Pantelis, Ph.D., Ed.D. (HC), Professor Emeritus, Brandon University, Deputy Director, the University of Manitoba Centre for Hellenic Civilization, Brandon, Manitoba, CANADA.
115.Hamilos I. Apostolos, Surgeon Dentist, Dental School, Athens, GREECE.
116.Hamilou A. Ioannou, Surgeon Dentist, Univerzita Karlova v Praze-Charles Univeristy, Prague, Athens, GREECE.
117.Hatzis Aristotelis, A.U.TH. – N.K.U.A., Dentist, School of Dentistry, Aristotle University of Thessaloniki, ATHENS, GREECE.
118.Hatzis Labros ,MD, PhD, BPlast, Fellow, St John's College, Cambridge University, UK. S. Lecturer Royal College of Surgeons in Ireland, Dublin, IRELAND.
119.Hatzopoulos N. Ioannis, Professor, University of the Aegean, Department of the Environment, Mytilene, GREECE.
120.Nikoletta Christodoulou, Lecturer, Curriculum and Teaching, School of Education, University Frederick, Nicosia, Cyprus
121.Theodore Christou, Ph.D., Assistant Professor, Queen's University, Faculty of Education, CANADA.

16 December 2012

Mental Health Europe: Worrying cuts in funding by Greek government - investing in Mental Health services must be a priority in times of crisis

Boulevard Clovis 7, B-1000 Brussels, Belgium
Tel +32 2 280 04 68 - Fax +32 2 280 16 04
E-Mail: info@mhe-sme.org

Brussels 27 November 2012

Sir, Madam,

Re: Worrying cuts in funding by Greek government - investing in Mental Health services must be a priority in times of crisis

Mental Health Europe (MHE) is a  non-governmental organisation committed to the promotion of positive mental health and well-being, the prevention of mental health problems, the improvement of care, advocacy for social inclusion and the protection of the human rights of (ex)users of mental health services and their families and carers. MHE represents associations, organisations and individuals active in the field of mental health and well-being in Europe, including (ex)users of mental health services, volunteers and professionals of many disciplines. MHE is a widely represented European body comprising a membership of more than 70 organisations in 30 European countries including Greece.

The Board of Directors of MHE met on the 14th of November and was at this occasion informed in depth about the situation in Greece, in terms of the impact of the current austerity measures on the provision of mental health services. These measures have resulted in enormous cutbacks in financing of mental health services, rising up to 55%. The non-governmental organisations that rely on this funding to offer psychosocial rehabilitation services in the community struggle to maintain their operations, although these services are often the only viable alternatives to people with mental health problems to maintain a dignified life and be included in the community. MHE is seriously concerned about this situation, as investing in social services and health care should be a priority, and particularly in times of crisis when the demand for support and services increases.

There is a clear link between unemployment and mental health problems. With the current crisis, more and more persons have become unemployed, or are at risk of losing their job, which leads in all too many cases to mental health problems. In addition, the fact of having a mental health problem is sometimes the cause for losing a job, unless there are appropriate services provided which can help the person return to a more stable situation. Unless priority is given to these services, the number of persons who are active and contribute financially to society will decrease, which will further aggravate the already alarming financial situation in Greece.

Furthermore, it is indispensable to focus on primary care, including prevention and mental health promotion measures in order to avoid secondary problems, which have detrimental effects on the individuals affected the most, but which also imply a much bigger long-term cost for society.

In Greece, existing structures to provide support have  proven to be effective, especially the model of the Mobile Psychiatric Units (outreach units), which has inspired the rest of Europe. With the current cuts in funding of these structures, there will be an increased risk of relapse among patients,  with dangerous consequences for their lives and well-being, and with a large number of employees  who benefited from these structures who lose their jobs and entire geographic regions of the country remaining without mental health care services. This may lead to serious consequences, such as homelessness and/or re-institutionalisation of persons who previously had the opportunity to live in society with the appropriate support services.

Also, returning to a system where institutions are the predominant means for providing care to persons who live with mental health problems would be a dangerous step backwards for human rights in Greece. In addition, institutions are in the long run more expensive than community-based services. Very serious Human Rights abuses in Greece were made known publicly in the 1980’s, both on the island of Leros and within the psychiatric system generally. Thanks to European support, as well as EU interventions and additional support from NGOs, this outdated system was reformed, and mental health care has been substantially improved and better provided through community-based services. MHE is concerned that the current measures taken by the Greek Government could lead to a situation in terms of human rights abuses and living conditions for persons with mental health problems that becomes as serious as was the case 30 years back in time. No modern society can afford such exclusion. Investing in social and health care services are essential in times of crisis, and MHE trusts that the Greek Government will take the necessary measures to break this vicious cycle, in order to prevent a complete collapse of the Greek mental health service support system.

On behalf of the MHE Board of Directors,

Yours sincerely,

Nace Kovac, President