Mental health plan freeze

Hundreds of deinstitutionalization units in the Psychargos program face serious underfunding. Many foresee being forced to close or merge with other places of residence. For its part, the Health Ministry states that not one of the residents in the units will return to an institution, and lays the blame on poor initial planning for the program. An estimated 422 reintegration units (hostels, protected apartments and guest houses) are in operation, most of which have been established since 2001 as part of the Psychargos program. Health Ministry statistics show that 193 such units have been opened since 2003 with the help of Third Community Support Framework funds, either by state hospitals or private clinics. The units house a total 1,832 residents and employ 2,227 staff. However, as Anastassios Venitis, president of the Argos Psychosocial Rehabilitation and Mental Health Agencies Network told Kathimerini, funding presents a serious problem for the units. The period of co-funding by EU and national funds has ended for most of the units and their running costs must be drawn from the regular budget, which is insufficient to cover needs, so running costs are being met by inflows from one-off grants. According to the Health Ministry, in 2005 a sum of 21 million euros – that later grants raised to almost 34 million euros – was allocated in the budget to cover the needs of psychosocial rehabilitation units that belong to non-government, profit-making organizations. The corresponding sum in 2006 was initially 22 million euros, rising to 46.2 million euros to cover 75 percent of the gap between the budgeted sum and real expenditure. This year the initial sum is 23 million euros, and unit heads have asked for 70 million euros to cover their running costs. «The organizations that have undertaken to run these units are sounding the alarm,» said Venitis. «Workers have not been paid for 4-5 months, and neither have suppliers.» He pointed out that these expenses cannot be postponed because they concern food for the residents, rent and current bills. As Venitis sees it, a commitment is imperative: «The state has to decide whether it wants psychiatric reform or not. The patients cannot go back to mental hospitals; that would be like dying.» Bad planning «Patients who are in residence at psychosocial rehabilitation units will not return to asylum-type establishments,» Maria Tsohani, the Health Ministry’s special secretary for mental health and social integration told Kathimerini. She did admit that there was some difficulty with the flow of funds. «The program was badly designed, since nobody looked into how the state budget could support the units when co-funding came to an end.» she noted. Tsohani said that the option of buying instead of renting the premises had not been examined, and that the operating permits for the units had not been issued, which means that the procedures for inspecting how they operate and the quality of services they provide have not been activated. Nor has there been any balanced development of deinstitutionalization units or a network of community services (such as mental health centers, doctor education centers and psychiatric departments in general hospitals). What is the solution? Tsohani pointed out that the draft bill for hospital supplies contains a provision for a special tax of 2 percent on goods – which translates into 45-50 million euros a year – to be made available for mental health and social support. Moreover, procedures have been activated to issue permits for the units and special emphasis is being given to the creation of a network of services in the community. Humanity before money Michalis Madianos, professor of psychiatry and president of the World Association for Psychosocial Rehabilitation, traced the history of psychiatric reform in Greece. «It began after the scandal of the [unacceptable conditions in] Leros mental asylum in 1981. Since then Greece has made great progress in dealing with people with psychiatric illnesses, since of the 4,000 inmates of 1981, fewer than 1,000 remain in the state psychiatric hospitals.» However, said Madianos, «the whole endeavor will collapse if it moves away from humanitarianism and into the attitude of there not being enough money.» He also noted that there are 2 million homeless in the USA since the collapse of the deinstitutionalization project there for lack of money.

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