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.

LISTEN TO US AND SUPPORT OUR DEMANDS

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.

THE SITUATION IS CRITICAL WE NEED YOUR SUPPORT!

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.

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Forum for the Psychiatric Reform : syn-skepsi.blogspot.gr

email: synskepsi@gmail.com

  

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.”

The Independent 

 

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.

PLEASE SUPPORT OUR EFFORTS FOR:

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.

PLEASE INVESTIGATE AND PUBLICIZE THIS EXTREMELY IMPORTANT ISSUE, SINCE THE LOCAL MEDIA IN THEIR MAJORITY HAVE “DECIDED” TO UNDERMINE AND DEVALUE IT BY SILENCING AND BLOCKING OUR EFFORTS

For more information and data please contact:

Email: synskepsi@gmail.com (http://syn-skepsi.blogspot.gr/)

  

  

“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.

Signatures,

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.

  

The Complete Dissolution of Mental Health in Greece

PSYCHIATRIC DEREGULATION

We are working in the field of psycho-social care in Greece. The situation for 1600 residents in hostels, housing structures and boarding schools, over 30.000 served daily, approximately 3.000 employees after two years implementation of the Memorandum in our country is tragic. The prevention treatment and rehabilitation of mental illness is hanging by a thread. The Psychiatric Reform has collapsed, the welfare state and Ministry of Health is treated by the government as a luxury that has to be removed.

The rights and lives of patients are violated as a result of closures and mergers care units and structures, because of the brutal cut in resources and Ministry of Health professionals.  The ones listed in an official document of the administration of the State Psychiatric Hospital of “Leros” bring the news yet again the memories of 1989.  From the 5th June, 2012, inform MHSS (Ministry of Health & Social Services) that the State Mental Hospital of “Leros”, unable to feed their 350 patients, because of the debts of the institution of suppliers who have stopped deliveries of food.  Expression 'humanitarian crisis' is not enough to describe the mass extermination which expelled because of repeated measures, the whole –and the most sensitive - population. Indeed, the most difficult period, the economic crisis, serious mental illnesses such as depression are increasing dramatically, the Welfare State rather than enhanced is repealed.

At the same time unpaid workers lift the burden of keeping a rudimentary supply of mental health services for adult patients in and out of housing structures, and for children and adolescents. Salaries of 1000 and 900 euro, not even paid, are cropped. From 2005 onwards, when European funding ceased, we are left unpaid for periods up to 9 months(!). Finally, the reduction of 55% of the budget as last year decided for this year is actually ‘gravestone’. The necessary funds have never been given; the existing funds have long since vanished.

An example is the Mental Health Center ‘Perivolaki’ (private entity, that provide services to children with autism, childhood psychosis etc., and their families under the ‘Psychargos’ program). The administration manipulated arbitrarily and without any transparency the closure of two of the three structures, depriving a population served: A) Day Centers, B) The unique in Greece short-stay hostel and C) Team Diagnosis and Assessment. Handed part of scientifically trained and experienced staff of MHSS with two empty buildings by equipment without work piece, leaving in the air (exposed) 43 employees. The Ministry of Health revoked the operating license of two of these structures, essentially punishing workers instead of imposing sanctions on the administration itself, admits though his letter (5/10/12, Y5β/Γ.Ποικ.96328) that all actions were and are in violation of given instructions. This is the present and the future of Psychiatric Reform in Greece. Disaster services, employer arbitrariness, impunity in terms of political leadership.

Both the Ministry of Health and the governments do not seem willing to defend the essence of Psychiatric Reform, neither our services and nor the people who benefit from them. The absence of serious central planning is complete, and in conjunction with the brutal budget cuts lead with mathematical precision in padlock to their bodies, workers unemployed and recipients of services in conviction.

As workers we believe that these services are not surplus to the community. The funding provided by the European programs and the Greek state for infrastructure and planning was to provide continuity of essential services.

The policies of the Memorandum are making poorer and kill people in the name of salvation, but disregarding us.  

Association of Workers at ‘Perivolaki’
  

Greece 2012: Social Work in Austerity

The following documentary film describes, by the social workers’ point of view, the situation in Greece.

Three social workers from different agencies -NGO, Semi-Public Agency and State Sector- describe the reality of the users and the one of the social services in the era of crisis, austerity and poverty that domain in Greece the last two years after the entrance of IMF….

It’s an attempt for spreading the “voice” of the “front-line” social workers from Greece but it is also an attempt of revealing the reality of the Greek people as well as the attempts and initiatives for resistance and solidarity.

  

Mental health workers continue the occupation of the Ministry of Health

                                                                                                                                        

WE CONTINUE THE OCCUPATION AT THE MINISTRY OF HEALTH

WE NEED EVERYONE’S SUPPORT

The workers and those sacked from Mental Health and Special Support participated in the 48-hour General Strike and decided to continue the occupation of the Ministry of Health until Sunday 12/2 at noon, which is when we will hold another assembly to decide on the continuation of our mobilisations.

We demand:

-Immediate funding of the structures for the coverage of current needs (wages, insurance funds, running costs etc).

- The cancelling out of the decision to reduce the budget by 55% (40 instead of 85 million) for 2012, which practically means the collapse of the services and the Psychiatric Restructuring.

- Obstacle-free, regular funding of Psychiatric Health and Special Support from the state budget.

- No to lay-offs, mergers, the flexibilisation/ intensification of labour and the reduction in wages which by default lead to a shrinking of the services and the devaluation of their quality.

- Holistic design for a Mental Health that will be public and free, to cover the ever-increasing needs of the society for support and help. Only with the participation of the workers and the recipients through our won structures shall proposals emerge for a true solving of the pending issues.

- Setting out of a common legal framework for Special Support.

- No to the alteration of pensions and benefits of patients for the coverage of permanent running costs of the structures.

- Re-employment of all who have been sacked, because none of us is consumable.

We call all unions and workers attacked by the memorandum’s politics of impoverishment and trashing of the social net to support practically our occupation and to take similar incentives in their own workplaces.

This is the largest mobilisation ever in our workplace and an unprecedented opportunity to co-ordinate our actions, with this occupation being a starting and reference point!

All together we can make it; the occupation needs everyone’s support!

We will meet on Sunday 12/02 at noon at the Assembly to decide the continuation of our mobilisations, and at 6pm at Syntagma.

Workers at Mental Health and Special Support

www.occupiedlondon.org

         

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

  

Social Firms Europe (CEFEC): Declaration of Support and Solidarity

  

   

Evidence on health effects of financial crisis in Greece

      

NEWS RELEASE: Evidence on health effects of financial crisis in Greece

    

  

FEARP: "Apropos of Political Measures in the Greek Economical Crisis"

 

DECLARACIÓN: 

A PROPOSITO DE LAS MEDIDAS POLITICAS ANTE LA CRISIS ECONOMICA EN GRECIA.

  

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