ATHENS -- "People who suffer from severe mental disorders do not even realize that they might have rights," said Niki Darmogianni, a Greek psychologist and member of a new mental health advocacy office. "They need to know that even if they suffer from something serious, this does not cancel their whole life -- they still have a right to work, to education, to their family."
Health services in Greece have suffered repeated budget cuts during the years of financial crisis. The care of patients with mental health disorders is among the hardest-hit fields.
Against this grim background, the nonprofit Social Psychiatry and Mental Health Scientific Association launched a pilot program to protect and promote the rights of those with mental health disorders. Over three months ago, the association opened Greece's first office dedicated to advising mental health patients on legal issues.
"When people first saw our promotional spot on TV, everyone called," Darmogianni said. "So, in the beginning we had to make clear what mental health advocacy is all about."
The advocacy office consists of lawyers and clinical psychologists, as well as a social worker, who mainly offer legal assistance to people who have been diagnosed with mental health disorders and their caretakers. They handle cases ranging from property and insurance rights to "judicial protection" for those who can't represent themselves in court. One of their main challenges is to decide whether those people are in a position to pursue legal action or need clinical treatment first. The group also provides assistance to mental health professionals.
The project is supported by two nongovernmental organizations, the Hellenic National Commission for Human Rights and the Mental Health Institute for Children and Adults. It is funded by European Economic Area Grants under the mantle of the We Are All Citizens program.
“People who suffer from severe mental disorders ... need to know that even if they suffer from something serious, this does not cancel their whole life -- they still have a right to work, to education, to their family.”
- Niki Darmogianni
According to a survey by the University of Ioannina, anxiety and depression are on the rise in Greece. Some 1 in 6 Greeks between the ages of 18 and 70 has developed some kind of mental disorder, and 1 in 12 have a serious mental disorder. Perhaps the most shocking finding is that 75 percent of those in need of treatment never receive it. Mental illness remains a stigmatized topic in the country, and patients are marginalized.
Darmogianni said that the problems in mental health services had been brewing long before the financial crisis. "In Greece, the so-called psychiatric reform did not happen properly in the last 30 years," she said, referring to policies to de-institutionalize mental health patients and facilitate social integration by moving care from hospitals to community centers.
Vlassis Tomaras, associate professor of psychiatry at the University of Athens and head of an independent committee that advises the Ministry of Health on mental health issues, said that reform has been obstructed by such factors as a lack of psychiatric units in general-care hospitals, a lack of oversight of private and public facilities, a shortage of community mental health centers, and a range of administrative obstacles. He said that the main problems are structural, not financial, but that the economic crisis has forced many patients away from private psychiatrists and into public institutions.
Those public health facilities have been severely strained by the continuous budget cuts. According to Antonis Sakellaris, special adviser to the minister of health, existing institutions are understaffed and overcrowded, and there are no resources to build new facilities or train more personnel.
Some of the patients who have fallen through the cracks end up at the advocacy office. Darmogianni gave the example of a woman who used to see a psychiatrist in private practice but can no longer afford the visits. Now she doesn’t know how to get her medications. “We help people find and access suitable mental health structures in situations like this,” Darmogianni said.
In the first three months alone, as people poured in looking for help, the advocacy office took on 100 cases.
“It turns out the needs are bigger than we thought,” said Alexandros Lountzis, a lawyer and coordinator for the office.
The program’s limited timespan ― it’s scheduled to end in April 2016 ― affects the kinds of cases it is able to accept. For complex problems like violations of medical confidentiality or involuntary hospitalization, it usually refers clients to the services of the Greek Ombudsman, an independent public authority that looks into complaints from individuals who have been failed by the government.
“We cannot take a case when we know the trial will probably take place in three years, as is so often the case with Greek courts. This program only runs until next April,” Lountzis explained.
It’s striking how common some of these violations are. “Sixty percent of all incidents of hospitalization in public mental health hospitals are involuntary, ordered by the prosecutor, while the average percentage in EU countries does not exceed 9 percent,” Lountzis said.
Before its time is up, the office aims to publish a concise guide to the rights of mental health patients, with practical advice on legal issues and services, and to organize a series of seminars to educate lawyers, judges, police officers and others.
“If any of this helps people get a little closer to the issues of mental health patients, then we would be somewhat pleased,” Lountzis said.
The office hopes that by April 2016, the Greek government will recognize the need to extend its services permanently. “Unless there is someone who believes that these problems will miraculously cease to exist next year,” Lountzis said.