An open door for the mentally ill: Psychiatrist explains new concept

In recent years, there has been a growing number of halfway houses for people who have mental illnesses and who, for social and psychiatric reasons, cannot live alone. In other countries, such units have functioned successfully for decades but in Greece they are relatively unknown and in many cases have met with opposition from local residents. The only excuse for this opposition is ignorance, a lack of information, and not any objective problems arising from these places themselves. This article attempts to explain how these halfway houses work, in the hope of erasing some of the prejudice and fear resulting from that ignorance. A person with a serious mental illness may be admitted to a psychiatric clinic for treatment. After the treatment is completed, patients usually resume their normal lives. However, in a few cases, whether because of a particularly serious condition, frequent relapses, or lack of family support, it is difficult for the former patient to readjust to society and they remain hospitalized purely because there is nowhere else for them to go. Instead of solving their problems, a protracted stay in the hospital only exacerbates the difficulties of readjusting to the outside world and turns the psychiatric institution into an asylum instead of allowing it to function as a modern hospital. As a result, developed countries have set up units outside the hospital environment, within the community, where these people can live and readjust to society as quickly as possible. The residents of these halfway hostels (usually about 10 people to a unit) are carefully chosen and prepared for the resident’s transfer to a more independent home or even to the homes of relatives. These people are not dangerous – their only problem is their inability to provide for themselves. They might be people who only a few months previously were part of the work force. They are kept under continual observation by the hostel’s support team, consisting of a psychiatrist, psychologist, social worker, occupational therapist and resident nursing staff. The only concern is that when they are absent from the home they could fall victim to deception by «mentally sound» people, and not that they could themselves pose any danger. It is a medically proven fact that the crime rate among the mentally ill is the same or lower than that of the general population. Perhaps this is because the main characteristic of their psychopathology is that they cannot stand up for themselves, not that they are a threat to others. For example, they are often the victims of the exploitation of their property by their «healthy» relatives keen to administer it «properly.» In a few cases, where a person suffering from a serious mental illness behaves dangerously, this is usually due to the failure to take medication and lack of any supportive environment. As long as medication is provided in these halfway houses and the support framework is there, it is no exaggeration to say that the residents of these homes are among the «safest» of all people. So it should be clear that these halfway homes are safe as long as they are occupied by carefully selected and supervised people, something which naturally does not happen in any other home in the community. Sometimes we are surprised to hear that a neighbor whom we thought was above suspicion is responsible for any number of anti-social acts. Prisons are full of «normal» people. We all have a duty to give our support to these hostels, because acceptance of people with mental illnesses and providing them with equal opportunities are the best ways to deal with mental illness. Let us not forget the saying that «there, but for the grace of God, go I,» or any member of our own families, for that matter. (1) Alexandros Haidemenos is a psychiatrist.