Moving mental patients out of institutions and closer to the community

AS MANY as one in five people could be suffering from some sort of psychological disturbance, a leading psychiatrist said yesterday. Although usually mild, some of those will suffer acute disturbances, which have been attributed to genetic, biological and social factors.

The statistics are worldwide, but according to the chairman of the Mental Patients’ Supervisory Committee, Dr. Christodoulos Messis, the island usually follows similar trends.

In order to deal with growing psychiatric disabilities more effectively, the Committee yesterday outlined plans to close down Nicosia’s Athalassa Psychiatric Hospital in five years’ time, to be replaced by other specialised units, such as improved district general hospital psychiatric wings and community mental health centres, refuges and day centres.

“Psychiatric and neurological disturbances affect 450 million people worldwide. Severe depression is now the main cause of impotency and ranks fourth in burdening state health services. In 20 years time it is expected to reach second place. Moreover, depression is the leading factor in one million annual suicides and a further 15 million suicide attempts,” he said.

Mental health sufferers were usually treated with a combination of drugs and psychosocial support, he said. The majority of Cypriot patients, afflicted with stress or behavioural disorders and depression, were monitored through outpatient systems both in the private and public sector. A smaller group of patients, suffering from schizophrenia or manic depression, sometimes needed hospital admittance during periods of crisis, Messis said. A very small minority are hospitalised by court order if they are deemed a danger to themselves or society.

Based on European research, the committee – which acts as an advisory body to the Health Ministry – said it wanted to move away from treating mental disorders in large asylums so that patients could be more easily reintegrated into society. Athalassa hospital had already managed to treat and release most of its 700 patients and was now left with 100 acute cases who were undergoing intense psychiatric treatment and had hopes of living within local communities, he said.

Health Minister Frixos Savvides yesterday confirmed more was being done to help the quality of life of mental health patients.

“All general hospitals have already set up psychiatric wings and there are already a few mental health community centres in Nicosia,” said Savvides. “Now we want community centres and half-way houses in all towns.”

And the committee said it had plans to implement in-patient hospital psychiatric care for children and adolescents.

“Makarios hospital offers support to this age group on an out-patient basis, but we want them to be able to stay in for treatment if deemed necessary. In order to do this we need more bed space and a separate unit,” said Messis. In fact, all hospitals would soon be able to accept serious mental health patients for intense treatment sessions when necessary and from there they could move to halfway houses or stay in mental health communities, he added.

But, although these specialised centres should already have replaced Athalassa hospital, a lack of funds and objections from local communities often got in the way, Messis said.

“Reintegration into society has been difficult because of the stigma that exists around mental health patients and the lack of centres to house them following their release from institutions.

“Because of this, a number of them have them have even ended up in old age homes or jail and find themselves inside institutions where they do not belong.”

Savvides said a psychological support unit had already been set up in the central prison and there were plans to set up a more specialised high-security protection unit offering intense psychiatric support.

“Some criminals are also mental health patients and are in jail because they have broken the law. However, we are setting up a system whereby they receive help so that upon their release than can also be reintegrated,” he said.

“Also, a number of mental health communities are currently being set up in Nicosia and will be operating shortly. We have not publicised the plans so as to avoid locals trying to prevent them,” said Savvides. “However, we have a number of them already in operation; they are very effective and local residents do not even notice their existence.”