Abolition of chronic disease departments of three National Health Service psychiatric hospitals with deinstitutionalization of patients admitted to these departments, development of services for people with Alzheimer’s disease and related disorders, the further development of psychiatric and child psychiatric departments in general hospitals, and the reduction of involuntary admissions to state mental health institutions, which are characterized as an “open wound” of the Greek mental health system, are among the actions described. V National Mental Health Action Plan 2021-2030. Last Friday, the plan was put up for public comment, which will last until February 23.

The plan is under review, according to the responsible deputy minister Zoe Rapti, is “a seal of transition from asylum psychiatry to efforts to reform the country and respond to the needs of today.” It is formulated as a network of policies with ten axes, with actions worth €374.5 million to launch new structures and €362.2 million per year to operate them further (funding sources Resilience and Recovery Fund, NSRF, Public Investment Program, regular budget ). In particular, the national plan envisages the completion of the abolition of inpatient care with the abolition of the departments of chronic patients in the remaining psychiatric hospitals of the National Health Service (Dafni, Dromokaiteo and Psychiatriko Thessaloniki) and private psychiatric clinics. Today, it is estimated that more than 300 chronic patients have been treated for decades in the three surviving public psychiatric hospitals, and approximately 1,200 patients are treated in private psychiatric clinics that were never included in the decolonization plan. The plan mentions the need for gradual transfer of patients to community decontamination centers after appropriate training by trained psychiatric staff in the community.

The National Mental Health Action Plan is under review until 23 February.

Involuntary hospitalization

One of the goals of the national plan is to reduce the number of involuntary hospitalizations to levels approaching the EU. In Greece, approximately 75% of admissions to psychiatric hospitals and psychiatric wards are estimated to be involuntary. 60% of beds are occupied for involuntary admission, compared to less than 20% in Germany and the UK. It is proposed, among other things, to modernize the legislative framework and introduce outcome indicators for involuntary hospitalization, the creation of early psychosis care units, the development of preventive measures in PHC, as well as the creation of a psychiatric unit in EKAB, with staff trained in the management of psychiatric cases.

Finally, the plan highlights the need to reform the forensic psychiatric services, including through the establishment of four independent high security forensic psychiatric clinics in Athens, Larisa, Patras and Heraklion. As mentioned in the national plan, about a year ago, when proposals for inclusion in the national plan were made, there were 88 persons released from punishment due to a mental or mental disorder and for this reason kept and living in state psychiatric hospitals and their structures.