Support for Greece's mentally ill disintegrates as money dries up

This story was updated on April 12, 2012. 

 There is a bed on Asklipiou Street, in the center of Athens, and it is oddly clean. Throughout the day, Christos, who claims the bed, obsessively picks up the litter left nearby by pedestrians, while quietly talking to himself. 

“He’s one of the many mentally ill people that are now living on the streets of Athens,” says Thodoris Megaloikonomou, a physician at the Psychiatric Hospital of Attica (Dafni), on the periphery of Athens  “In the past, you wouldn’t see so many. There’s a huge increase – now, they’re everywhere.”

Two years of austerity cuts have brought Greece's state-run health care system to its knees, and the mental health sector is among the hardest hit. Twenty-five years of progress in the system are in jeopardy and staff shortages and facility closures have left many of Greece's mentally ill stranded on the streets, doctors say. Many of the mentally ill are there because their families can’t afford to help them anymore. 

The social welfare system that existed in Greece prior to the economic crisis wasn't comparable to those in Sweden or Norway, but whatever there was before is now falling apart. 

Until the early 1990s, Greece's psychiatric wards were commonly overcrowded. Thousands of patients lived as outcasts, locked away from society in psychiatric hospitals. The situation at the asylum on Leros Island – where inpatients suffered inhumane conditions, walking around naked and getting bathed in large groups with a hose – garnered international attention in 1989, finally spurring the European Union to send financial support, after which the system made substantial strides forward.  

But when the European debt crisis erupted in 2009, some of the reforms, namely deinstitutionalization, were not finished. After three decades of housing the mentally ill in hospitals, the plan was for patients to be moved either to smaller shelters or boarding homes or back to their own homes with the intent of reintegrating them into society. They were slated to receive care through nearby mental health centers, some of them homes where the patients lived, others outpatient facilities where patients just stopped in. The facilities, created so that only people suffering emergency and very serious cases of mental illness had to live in hospitals, were financed by the EU until 2007, after which the Greek government had agreed to take over the funding.

“The problem is that despite the 25 years of financing from the EU, there was never a plan by the Greek state on how to carry on with the reform,” says Mr. Megaloikonomou.  “Deinstitutionalization never happened. There was only trans-institutionalization: patients were sent from big institutions to smaller ones. So, chronic patients were taken from psychiatric hospitals to centers that were often using similar methods.”

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