Greek mental care failures exposed

By Chloe Hadjimatheou BBC World Service, Athens

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Twenty years after a scandal erupted over the appalling conditions in which psychiatric patients were kept in Greece, the BBC has seen evidence that in some parts of the system little has changed.

The European Commission has warned Greece that if it does not come up with roadmap for psychiatric reform by next month, EU funding will be cut from social projects across the board.

As I approach the women's clinic at the Dromokraitio Psychiatric Hospital in Athens I assume it is a disused building, with its crumbling walls and broken shutters hanging from windows.

But inside I see patients in bare rooms, lying in their beds staring into space, as the minutes tick by.

Dromokraitio is home to around 300 patients, and is one of the two main psychiatric hospitals in Athens.

"If I had a dirty room in my house I might want to hide it from visitors," says Dr Yiorgos Astrinakis, a resident psychiatrist at the hospital.

"But this hospital belongs to the public and they have the right to know where they might end up if they get sick."

Like a dog you tie up to stop it wandering off…this could be considered the veterinary approach to psychiatry Dr Yiorgos Astrinakis, resident psychiatrist at Dromokraitio hospital

As we walk through the women's clinic I notice wide leather straps and buckles lying beside the beds.

"We have to keep some patients tied at night to prevent them wandering around and waking the other patients," Head Nurse Maria Makraki explains.

Dr Astrinakis interrupts her: "Just like a dog you tie up to stop it wandering off… this could be considered the veterinary approach to psychiatry."

He points to buckets below the beds that act as make-shift toilets.

A woman sits with her head in her hands. Around her leg I see a belt tying her to her bed.

"Whenever she's left loose she becomes aggressive towards the other patients," says Nurse Makraki.

"She needs constant supervision and so we're forced to keep her tied all the time because we simply don't have the resources to look after her properly."

Nurse Makraki tells me that staff shortages mean that there are usually only two nurses caring for around 30 patients.

That is half of what is required to provide basic care.

Stella Galianos, a psychologist, estimates that in every clinic at Dromokraitio hospital there are around three to four people tied to their beds.

I ask her if the woman I saw could end up tied to her bed for years.

"Yes definitely."

'Island of the damned'

In 1989, the world was shocked by pictures of patients chained up and naked in a Greek psychiatric hospital on the island of Leros.

The Dromokraitio hospital is in a state of disrepair

Dubbed the "island of the damned" it was regarded as the worst mental institution in the whole of Europe.

Shamed into action, Greece enacted numerous reforms, helped by EU funding and an army of foreign mental health experts.

But that progress seems to have slowed and even begun to reverse itself in recent years.

The European Commissioner for Social Affairs, Vladimir Spidla warns that Greece can not let its progress continue to decline.

"The system is in a state of reform, but I have to say that if patients are attached to their beds for hours or days, that's totally unacceptable. For me it's sad that this exists in the European Union."

Dr Pavlos Theodorakis, who represents the Greek ministry of health at the World Health Organization, admits that there are many doctors who do not follow the guidelines set out by the European Commission on restraining psychiatric patients.

"There are huge problems in terms of culture and mentality among health care professionals," he told me.

"But it's important to remember how far Greece has come in the last 20 years."

Athina Residential Home is just one example of those changes.

Here there are 25 members of staff looking after just 15 residents.

The director of the residential unit, Petroula Dimitropoulou, tells me that they never tie patients under any circumstances.

"There are other approaches. If a patient becomes violent you can ask them to sit in their room and discuss their feelings with a member of staff."

The government doesn't care about us. It's not right Jimmy

But according to the non-governmental organisations that run these projects, the ministry of health funding meets less than half their necessary costs.

Last year Athina came in danger of closing when the staff went unpaid for six months.

Dr Theodorakis admits that there have been unacceptable delays in paying professionals working for NGOs like Athina.

But he says the government has been struggling to provide full financial support since European Union funds ended last year.

"It makes me very angry," say Jimmy, one of the residents at Athina Residential Home.

"The government doesn't care about us. It's not right."