At some point in her room Child Psychiatry Clinic in Zanejo they needed paint. The chief physicians several times appealed to the hospital management, but its satisfaction was delayed.

Then they bought paints at their own expense, bought brushes and ceiling brushes, and got to work. The incident may be considered off topic for this text, but sometimes it is the most unexpected details that provide the most important information. In this regard, for its residents, the Zaneios Children’s Psychiatric Clinic is their home, and the patients are their children.

In this light, perhaps the Administration of the 2nd Medical Region of Piraeus and the Aegean (2nd Medical Region) should have expected that its decision (02.03.2023) to transfer the Department of Child Psychiatry of Canea to the General Directorate of Western Attica “Agia Varvara will provoke a violent reaction. Who leaves a home built unscathed? And, above all, how to “freeze” your work at a time when the community needs you more than ever?

“Since the pandemic, the number of incoming cases has increased, while they have more serious needs than in the past, more complex needs,” says “K” Director of the Clinic and child psychiatrist Dimitra Kottorowwho has been there since the first day of operation of the department, in 2010. Although, as always, most cases involve anxiety and depressive disorders, doctors also treat adolescents with self-harm, suicidal thoughts, eating disorders, and psychosis, he said.

“Problems are more complex, with more comorbidity and familial dysfunction.” During the pandemic and until today, cases of child abuse have also increased. In these cases, the doctors and social workers of the Child Psychiatry Clinic cooperate with the Cani Children’s Clinic.

In 2022, the polyclinic treated 1380 cases on an outpatient basis, while 40 children were hospitalized (average hospitalization 53-55 days). The news about the transfer of the “Agia Varvara” structure came with four children standing in line for admission and hospitalization. “We always look for a bed in another apartment in Athens and almost never find one,” says Ms Kottorow. “Therefore, we keep the children under observation on an outpatient basis in cooperation with the prosecutor’s office, the family, the school and with medicines, if they need it, until an inpatient bed becomes available.”

The Clinic for Child Psychiatry in Tsanio covers the so-called southern arc, that is, all areas from Nicaea and Perama to Neo Faliro, the Argosaronic Islands and the islands of the Aegean Sea. “The department was designed on the basis of the 1999 asylum law, in the logic of unloading Athens and creating a clinic that will provide comprehensive care within the framework of a general hospital. The goal of this reform was for these clinics to operate within the framework of general hospitals, next to children’s clinics.”

Today, children’s psychiatric clinics operate in “Agia Sophia” with 10 beds, in “Aglaya Kyriakou” with 5 beds, in Pedon Pentelis with 5 beds and in Tsanio with 5 beds. These departments accept children from 0 to 14 years old and children under 16 years old for hospitalization. Adolescents aged 16-18 are currently under the exclusive care of the Sismanoglio Child and Adolescent Psychiatry Unit, which has 10 beds. Already from the planning of 2010, care for adolescents will be supplemented by two new clinics in Agia Varvara (formerly Loymodon) and Asklepio Voula, which until now have not had the possibility of hospitalization due to the lack of a building. infrastructure. According to the information, the new Department of Child and Adolescent Psychiatry in Asklepio is being completed, and in “Agia Varvara” a new psychiatric clinic for adolescents was opened in the summer in a building bequeathed to the “Antonios and Ioannis Angelikoukosi” Foundation without being staffed. (There will be an announcement for psychiatrists next week.)

The Southern Duga will remain without secondary psychiatric care for children – After the pandemic, the number of cases has increased.

teen block

It is clear that the transfer of the Tsanei clinic with all its organizational positions, medical and nursing staff to “Agia Varvara” essentially means its abolition. There are many questions, such as whether it will retain its child psychiatric nature or become a unit exclusively for teenagers. As the commander of the 2nd DYPE Piraeus and Aegean, Christos Roylos, told K, the new unit will be intended for teenagers from 12 years of age and older. “In any case, they are essentially teenagers, most cases (s.s. accepted) belong to this age group (s.s. indeed, most cases are 11-15 years old).” According to him, the children who are already being monitored in Janeyo will not go unnoticed. “The idea is to have outpatient appointments 2-3 times a week in Janeio to make life easier for parents. If they need hospitalization, they will be taken either to Asklepion if they are younger or to Agia Varvara if they are teenagers.”

But what was the reason for this step? According to Mr. Roylos, the equipment of the clinic in Zaneio does not meet modern standards. “According to the WHO, a child psychiatric hospital cannot be located on the 5th floor,” he says. “In addition, the department is adjacent to the pathoanatomical clinics, which is also incompatible with the modern interpretation of these incidents.”

Critical interface

Ms. Cottorow paints a very different picture. “Apparently, all safety measures are observed in the department, and the directive (for the floor) is not even included in the National Mental Health Action Plan (for public comment until tomorrow February 23). The facilities are very good and we will take care of them.” In addition, according to her, proximity to pathology clinics provides a critical relationship. “When, for example, a child who has made an attempt comes to pediatricians, they call us, and we immediately see both the child and the family. He wants these services to go hand in hand. In “Agia Varvara” there is neither a children’s clinic nor a pathology department. The hospital is open until noon, off call. This step removes the principle of segmentation, accessibility. Piraeus will be left without primary psychiatric care for children. We were told it was none of our business. This may not bother us, but as mental health workers trained in community psychiatry, we do. That’s the difference.”