Greek woes drive up suicide rate to highest in Europe

   

Experts attribute rise to the country's economic crisis following release of statistics that show a 40% jump since last year 

A homeless man begs for money in Athens. 

The suicide rate in Greece has reached a pan-European record high, with experts attributing the rise to the country's economic crisis.

Painful austerity measures and a seemingly endless economic drama is exacting a deadly toll on the nation. Statistics released by the Greek ministry of health show a 40% rise in those taking their own lives between January and May this year compared to the same period in 2010.

Before the financial crisis first began to bite three years ago, Greece had the lowest suicide rate in Europe at 2.8 per 100,000 inhabitants. It now has almost double that number, the highest on the continent, despite the stigma in a nation where the Orthodox church refuses funeral rights for those who take their lives. Attempted suicides have also increased.

"It's never just one thing, but almost always debts, joblessness, the fear of being fired are cited when people phone in to say they are contemplating ending their lives," said Eleni Beikari, a psychiatrist at the non-governmental organisation, Klimaka, which runs a 24-hour suicide hotline.

Klimaka received around 10 calls a day before the crisis; it now gets more than 100 in any 24-hour period.

"Most come from women aged between 30 and 50 and men between 40 and 45 despairing over economic problems," said Beikari. "In my experience it's the men, suffering from hurt dignity and lost pride, who are most serious."

As poverty has deepened, unemployment has hit an unprecedented 18% (with over 42% affecting the 25 to 40 age group) and crime has skyrocketed in a country heading for a fifth straight year of recession. Greece's social fabric is fraying in ways once unthinkable. With the homeless now exceeding 20,000 in central Athens alone, funding cuts disproportionately affecting welfare services and drug use on the rise, the economic crisis has morphed increasingly into one of mental health with depression, neuroses and cases of self-harm also surging, according to experts. Psychiatrists have reported a 30% increase in demand for their services over the past year with most patients citing anxiety and depression brought on by financial fears for the decision to seek help.

Child helplines have similarly been deluged by calls. "The crisis is clearly aggravating family relations," Katiana Spyrides, another psychotherapist, said. "In particular we've seen increases in the stress levels of children and adolescents who face new problems, such as seeing their parents imprisoned for economic crimes, or who because of the situation have had to compromise their emotional and other needs."

Psychiatrists say the alarming rise signals an urgent need for a national suicide prevention policy in a nation that until now had discounted the need for one.

"Preventative strategies have to be increased," said Beikari. "Teachers, prison guards, priests, police, professionals in a position to spot those who might be suicidal, need to be sensitised. This is an issue that can no longer be ignored."

Most suicides, attempted and real, have occurred in the greater Attica region surrounding Athens and on the island of Crete where a number of businessmen with no prior history of mental illness have taken their own lives over the last 18 months.

The Guardian

  

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Greece: Experts warn against cuts in mental health

     

Mental healthcare experts on Tuesday cautioned against funding cutbacks to psychiatric facilities, invoking a study which found that 22 percent of people facing financial difficulties suffer from some form of mental distress and that the unemployed are at much greater risk than people who work of presenting symptoms of depression.

The findings of the study, which was conducted over the course of 2010, were presented on Tuesday by Stelios Stylianidis, a Panteion University social psychiatry professor and president of the World Association for Psychosocial Rehabilitation, in a special interview organized by the Argos network of mental health organizations.

The network was responding to a decision by the Finance Ministry in August to slash funding to the 210 state mental healthcare facilities operating in Greece by some 45 percent, from 82 million euros to 45 million euros, which experts say will inevitably lead to the closure of most of these units.

Stylianidis stressed that providing psychological support is crucial, especially during a financial crisis. In fact, recent data published in July found that the number of suicides in Greece had increased by 40 percent between 2007 and 2009, while the report cited by Stylianidis also suggested that 12 percent of people facing financial difficulties or ruin had expressed a “death wish.”

The July study, published by British and American researchers in medical journal The Lancet, found that Greece was among several crisis-hit countries experiencing a spike in suicides.

“Countries facing the most severe financial reversals of fortune, such as Greece and Ireland, had greater rises in suicides,” said David Stuckler, a sociologist at Britain’s Cambridge University, who worked on the analysis.

Meanwhile, Argos announced that it will be organizing a protest rally on Wednesday at 10 a.m. at the Health Ministry near Omonia Square, and that it has lodged an appeal against the government’s decision with the European Commission, the Greek Ombudsman and mental healthcare foundations around the world, among others.

Article from the Greek newspaper kathimerini

Children with Disabilities in Greek Institutions

Read the full report here

Advocacy and social exclusion in mental health: A global challenge *

 

Recently,  another  “scandal”  emerged  from  the asylum’s  labyrinth  of  Mental  Hospital  of Dromocaiteion  in  Athens:  Violation  of  human rights  of  mentally  ill  persons,  limitation  of  their contractual  power  as  workers  in  a  small  social firm, decrease of the quality of care and treatment for socially excluded people suffering from mental disorders. We  are witnessing  an  “as  if”  situation where  the  gap  between  the  declarations  and practices of human  rights  is once again widening. Yet,  it  is not  just another  local “as  if” situation.  It is  remarkably notable  that 53% of  the psychiatric admissions  in  Greek  mental  health  hospitals  are involuntary  and  therefore  this  leads  one  to  admit the  existence  of  a permanent  national  scandal  for our country.

During  the actual economic crisis  in Greece, new phenomena  appear  challenging  the  limits  of  the public and psychiatric system of care: a constantly growing population,  a  “no man’s  land” people  in the  centre  of  the  metropolitan  area  of  Athens living  in  extremely precarious  conditions  as well as a dramatic increase in psychiatric admissions in mental  health  hospitals  for  homeless people with no present mental disorder.

In  the  early  70s,  under  the  influence  of  radical ideologies,  psychiatry  was  defined  through  its scientific  object  as  “the  knowledge  and  practice dealing with  the singularity of  the others, without violating the recognition and respect of the dignity of  the  suffering  person”  (B.  Doray,  Ethique  et Psychiatrie, MIRE Paris, 1985).

The  key  strategy  of  a  progressive  mental  health movement  of  this  period was  the suppression  of the  old  asylums  and  their  transformation  in  a comprehensive,  accessible  and  effective community  –  based  mental  health  system, covering the needs of the population.

The  questions  actually  raised,  in  the  era  of globalization  and  domination  of  neo  –  liberal market – oriented culture, are the following:

•  How  should  the  wider  field  of  mental health  including  psychiatric  practice  and PSR services  change,  in  order  to  respond better  and  more  accurately  to  the  mental health needs and new complexity of urban suffering,  social  exclusion, poverty,  social discrimination, lack of dignity and hope?

•  Why  do  we  raise  the  matter  of  ethical principles of psychiatric practice when the basic civil and political  rights are violated and denounced? Why is there no integrated   part  of  today’s  struggle  and  process  to improve  mental  health  care,  combining advocacy  issues  with  good  practices  and evidence  promoting  recovery  and  full citizenship? It seems that the answer of both questions ought to be the same: The core of the psychiatric scientific community  denies  these  new  realities  or underestimates  the  huge  impact  of  social determinants  on  mental  health  (Patel,  Saraceno, Kleinman 2006).

Despite  the  general  statements  of  most psychiatrists  in  favor  of  a  “bio-psycho-social model”  of  understanding  and  treating  mental illness,  there  is a huge mental health gap between official statements and strategies to promote social inclusion and defend human  rights of people with mental  health  problems  and  the  real  today’s practice.

According to the World Health Organisation (2005) “Advocacy  is  an  important  means  of  raising
awareness  on  mental  health  issues  and  ensuring that  mental  health  is  on  the  national  agenda  of governments. Advocacy can lead to improvements in  policy,  legislation  and  service  development.” Promoting  advocacy,  empowerment  and  social inclusion  requires a  radical change of  the existing psychiatric  culture  of  bio-medical  model  and  a shift  to  a  new  paradigm  of  understanding  and promoting  mental  health  under  a  global perspective.

This  change  should  include,  among  other  issues, an  in-depth  transformation  of  medical  and
psychiatric  curricula,  an  active  participation  of mental  health  professionals,  users,  families  and other  stakeholders  to  a  process  of  an  inclusive, involving  and  accountable  governance,  new political  and  social  alliances  in  order  to  promote communication  and  active  interaction  of  health, mental health and social services  in education and training,  in employment opportunities,  in housing rights,  in  transport,  in  leisure  and  cultural activities  and  the  active  protection  of  civil  and human  rights.  Involuntary admissions are a major and  thorny  issue  in  the  protection  of  human  and civil  rights.  The  way  the  psychiatric  services operate,  results  in  the  reproduction of stigma and social  discrimination  for  people  who  constantly reside in the chambers of a mental health hospitals through  a  “revolving  door”  phenomenon.  The legal  mechanisms  of  defense  of  the  human  and civil  rights  should  also  be  empowered  through good practices such as the Observatory for Human Rights or the Ombudsman.

Consequently,  if we  are  set  to  implement  its  full meaning  it  has  to  be  integrated  as  an  attitude  in today’s  practice  with  person-centred  services, recovery  oriented  services,  with  active involvement  of  users  and  families.  As professionals, we  should  invent  feasible ways  to
increase  government  budget  for  mental  health which  is  significantly  low  to non-existent  in most of  the  countries worldwide  (Mental Health Atlas, 2005). Additionally,  the  poor  existing  budget  for mental  health  should  be  wisely  spent  in  the direction  of  Psychiatric  Reform.  We  should promote deinstitutionalization and enhance the use of  local  resources  to  serve  the  needs  of  the  local population with  the existing means  for  this. Mass media  should  be  on  our  side.  The  matter  of publicity  is  an  important  one  and  our  advocation  towards  it,  should  be  aware  of  the  local  and national trends.  

Last but not  least, nothing  is ever good  if  there  is no  monitoring  and  evaluation.  WHO  refers  to evidence and ethical based practices which are not partial  but  part  of  a  whole  life-whole  system approach.  Thus,  monitoring  and  evaluating  the process of change  is absolutely vital  to ensure the success  of  our  work.  WAPR’s  challenge  is  to advocate towards a change of the political agenda of  International  Organisations  emphasizing  on  a better  mental  health  care  and  respect  of  human dignity.  

S. Stylianidis
VP of WAPR, Greek Counterpart for mental health in WHO,
Ass. Prof. of Soc. Psychiatry, Panteion University

*Editorial, WAPR (World Association for Psychosocial Rehabilitation) Bulletin, December 2010