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Society

The Toll Greece’s Crisis Took on Mental Health Care

February 17, 2019

ATHENS — More than 8 ½-years-long, Greece’s economic crisis shows signs of abating, but not the cost of it, especially in the despair that, combined with near-destitution for people suffering pension cuts, wage reductions and slashed benefits, has perpetuated another in mental health care.

That was illustrated in a New York Times feature showing the often irreversible, and deadly, effects for those who couldn’t cope and became victims of depression, and, in too many cases, suicide.

That was case for a woman the paper identified as Anna, 68, whose husband, a retired bus driver, killed himself in a park two years after repeated pension cuts perpetuated by the ruling Radical Left SYRIZA after Prime Minister Alexis Tsipras said he would halt them.

“He kept saying, ‘I’ve worked so many years. What will I have to show for it? How are we going to live?’” said Anna, who spent the time after her husband’s death in therapy and now is volunteering to help others struggling with mental health issues.

The mental health crisis has slipped under the radar under the weight of the country’s trying to deal with an invasion of refugees and migrants, unrelenting political and financial scandals and infighting, a coming election and Tsipras’ claims he’s bringing a recovery.

Depression and suicide rates rose dramatically during the crisis that began in 2010 when Greece sought what turned into three international bailouts of 326 billion euros ($367.37 billion) that came with brutal pay cuts, tax hikes and slashed pensions.

Austerity say health care budgets cut back too, with public hospitals not even having toilet paper or paper towels, patients needing to hire private nurses and psychiatric hospitals overwhelmed and understaffed.

“Mental health has deteriorated significantly in Greece, with depression being particularly widespread, as a result of the economic crisis,” Dunja Mijatovic, the Council of Europe’s commissioner for human rights, said in a November report, the paper noted.

That has led to overcrowding at psychiatric hospitals and clinics and a 40 percent increase in suicides from 2010 to 2015, the report said with few safety nets for those who don’t know how to handle what’s in their heads.

The Greek Mental Health Research Institute found links between austerity and depression, the news site VICE reported in July, 2015, six months after Tsipras took over and with his government then locked in intense negotiations with European creditors for what turned into a third bailout, this one for 86 billion euros ($96.95 billion) – and more austerity.

In 2008, only 3.3 percent of the population showed symptoms of clinical depression, which is a state that needs to be treated with medication. In 2008, that percentage was doubled. By 2013, 12.3 percent of the Greek population had shown symptoms, it was reported.

The mental health organization Klimaka reported a 30 percent rise in calls to its suicide hotline last year, and a comparable rise in visits to its day center. “The financial crisis has increased people’s vulnerability to suicide,” Kyriakos Katsadoros, Klimaka’s Director told The Times. “Some even ask about euthanasia.”

Suicide was a rare occurrence in Greece and even with the spike during the crisis it is relatively low in Europe, with five per 100,000 people compared with a region-wide average of 15.4, according to World Health Organization data for 2016. But the rate of increase is high, jumping from 3.3 per 100,000 to 5 between 2010 to 2016.

The biggest jump came during the tumultuous 2015 when Tsipras vowed to create a Leftist revolution throughout Europe and the country seemed headed for an exit from the Eurozone which could have brought even more devastating consequences for the populace.

THE CHURCH VIEW

Many suicides in Greece go unreported because of the Orthodox Church’s reluctance to provide burial services to those who take their own lives, although the church’s stance is changing, nongovernmental organizations said, according to the paper.

The Greek Health Ministry set up a committee of mental health experts in November to prepare awareness campaigns, as well as plans to train general practitioners to better detect depression and other mental health issues, the extent of the state’s help.

At Evangelismos, one of the capital’s largest state hospitals, dozens of patients were being treated in the corridors of the psychiatric ward during a visit in April, “an unacceptable situation,” the Council of Europe’s anti-torture committee said in a report published in June.

In the summer, the hospital’s workers’ union complained to a prosecutor that the clinic was accommodating twice the maximum capacity, with fold-out beds set up in corridors and in doctors’ offices.

“It’s like a stable,” Dr. Ilias Sioras, President of the union told the paper,, adding that people in all states — “catatonic and psychotic” — were being treated in the same space.
Dromokaiteio Psychiatric Hospital in Athens saw admissions jump 12.3 percent in 2017 with weary staff members going on fruitless strikes to protest conditions.

At Dafni, the Attica Psychiatric Hospital, which takes only serious cases, “The impact of the economic crisis is reflected in the admissions,” the Director, Spiridoula Kalantzi, citing a 9.6 percent increase in 2017 told the paper.

The Council of Europe noted that “unemployed persons, bankrupt businessmen, or parents who have no means of taking care of or feeding their children” were among new admissions to psychiatric units, most age 40 and older with no previous signs of mental illness.

The Health Ministry ran a pilot program at hospitals in Athens last year to insure major areas of the Capital had at least one psychiatric hospital or clinic operating as a walk-in center at any given time, helping admissions to “stabilize” at Dafni and Dromokaiteio last year. Three new clinics opened in Greek hospitals in 2018, the ministry said, and there are plans for 16 more.

In the meantime, much of the burden falls to Greece’s three main psychiatric hospitals — Dafni, Dromokaiteio, and the Psychiatric Hospital of Thessaloniki — which in addition to providing health care fills the void left by cuts to social services.

“Apart from the psychiatric cases, we have social cases, too,” said Dr. Nektarios Drakonakis of Dafni. “People come, they say, ‘I don’t have a home, I don’t have papers, I don’t have relatives, I don’t have anywhere to go.’”

What the government did provide, crucially, was free access to health care for uninsured patients has been an invaluable safety net, said Ms. Kalantzi, the Dafni director.
“When the delirium begins, many lose control of their finances, and then lose their insurance,” she said.

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