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28 Απριλίου 2014

28/04/2014: Συνάντηση με τον Ευρωπαίο Επίτροπο László Andor

Συνάντηση με τον Ευρωπαίο Επίτροπο κ. László Andor, αρμόδιο για την Απασχόληση, τις Κοινωνικές Υποθέσεις και την Κοινωνική Ένταξη, είχε στις 28/04/2014 στα γραφεία της Ευρωπαϊκής Επιτροπής στην Αθήνα αντιπροσωπεία του Φόρουμ για την Ψυχιατρική Μεταρρύθμιση, το οποίο απαρτίζεται από λήπτες, οικογένειες και επαγγελματίες ψυχικής υγείας από διάφορους χώρους, στα πλαίσια συνάντησης για θέματα κοινωνικής οικονομίας.  Οι εκπρόσωποι του Φόρουμ, Βάσω Τσώνου και Στέλιος Κυμπουρόπουλος, εστίασαν στις Κοι.Σ.Π.Ε. και στα προβλήματα που αντιμετωπίζουν οι λήπτες υπηρεσιών ψυχικής υγείας και οι οικογένειές τους στην Ελλάδα, και παρέδωσαν στον Επίτροπο την ακόλουθη επιστολή, συνοδευόμενη από σχετικά έγγραφα. Ο Επίτροπος δέχτηκε το αίτημα του Φόρουμ να πραγματοποιηθεί μια συνάντηση για να συζητηθούν αποκλειστικά θέματα ψυχικής υγείας, στα μέσα Ιουνίου. 




Athens, 28th of April 2014
Dear Commissioner Andor,
            We are a group of representatives from users associations, families and relatives in Athens. We have decided to write to you and request a meeting during your stay in Athens since the situation in the mental health 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, against the terms of your memorandum with the Greek Government. We are at the receiving end of various implementations that are against the effort of psychiatric reform. We would be more than grateful if you could find the time to meet with 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.
Specifically we would like to draw your attention to a few key points:
        I.            Our basic human rights are being violated. We had deaths of patients, a patient was burned alive strapped on a psychiatric bed in a psychiatric hospital and two others died in a fire in a residential house, 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. That means that the police is the medium to submit us to a hospital, with no training and in most of the times under inhumane conditions that insult our dignity and human existence. That means that hospitalization in a community based system as a therapeutic means is still a myth. We will not get into details but there numerous examples of these abusive behaviors.
     II.            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.
   III.            Following the previous point, us users and family members, although we exist in the memorandum that Greece signed with the EU, we exist in the laws and the formulations for the psychiatric reform, we are completely excluded. Everything for the users without the users.
  IV.            The fact is that in 2014 in Greece, the psychiatric rehabilitation and deinstitualization 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. How long will the already encumbered families continue to be affected? 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. In situations like this the rights of the users will continue to be violated.
     V.            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. We all want for these institutions to close, but by transforming the services and having the resources to increase the community based treatments. We urge you to visit them, in order to have a clear and objective view of the damage being done. These two institutions are also the gatekeepers for a huge load of acute psychiatric cases from all over Greece. There is no plan and no answer on what will happen next. Just “sketches on maps”, but commissioner Andor, we are talking about vulnerable people and not pawns.
  VI.            There is a clear threat that the 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. Do not let that happen, please monitor the process with external evaluators, not appointed by the Ministry of Health. Things are not progressing as they are presented to you by the government. There is no objective evaluation process, there are no data and there are still many questions that remain unanswered: who is following the procedure? Have the goals of the memorandum been met, not on paper but in actual changes and implementations? What will happen after 2015, since every year the budget for mental health services is dangerously low?
VII.            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.
In 2012, the report from the Sixty-fifth World Health Assembly urged member states and the WHO director-general to take bold corrective actions. Mental health has arrived on the global health agenda; establishing it as a priority at the highest level is essential to match aspiration to need, some of the objectives of the WHO’s Comprehensive mental health action plan 2013–2020 are:
        i.            to strengthen effective leadership and governance for mental health;
      ii.             to provide comprehensive, integrated and responsive mental health and social care services in community-based settings;
    iii.            to implement strategies for promotion and prevention in mental health;
    iv.             to strengthen information systems, evidence and research for mental health
It seems that Greece is dangerously adrift and far away from even formulating, not implementing these objectives. We are in dire need of support. The situation is critical and in need of an intervention in many levels.
Helps us to avoid making the mistakes of the past, since from now on, users and their families must play an important role in all processes. 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 center 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.
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.  

Sincerely Yours

Forum for the Psychiatric Reform
 

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