Psychiatry in Greece

1
Psychiatry in Greece

• George Christodoulou
• President, Hellenic Psychiatric Association

2
Hellenic Republic
3
Hellenic Republic

• Population 10.631.000 (2002)
• Natural population growth - 0.3 (1999)

4
similar trend

• Slovenia
• Italy
• Sweden
• Germany
• Moldova
• Chechia
• Romania
• Croatia

• Lithuania
• Hungary
• Estonia
• Belarus
• Bulgaria
• Latvia
• Russia
• Ukraine (-7.6)

5
Hellenic Republic

• Old population (gt65 yrs) 17.1
• Third in Europe after
• Italy 17.8
• Sweden 17.3

6
Hellenic Republic

• Deaths from suicide 3.3/100.000 pop.
• Lowest in Europe, after
• Albania
• Georgia
• Armenia
• 
  (1.8/100.000)

7
Hellenic Republic

• Deaths from motor vehicle
• Traffic accidents 19.30 / 100.000 pop.
• Highest in Europe, after
• Latvia
• Lithuania
• Russia

8
Hellenic Republic

• Diabetes 0.2 of population
• Lowest in Europe
• Smoking 38 of adults
• Highest in Europe,
  after
• Poland
• Albania
• Hungary
• Serbia
• Bosnia (48)

9
Hellenic Republic

• Physicians 438 / 100.000 pop
• Third in Europe after
• Belarus
• Italy (567/100.000)
• Nurses 257/100.000 pop (1992)
• Lowest in Europe after
  
• Turkey (244/100.000)
  

10
Hellenic Republic

• Hospital beds 488/100.000 pop (1998)
• 
  (middle)
• Psychiatric beds 92.1/100.000 pop (1999)
• (high)

11
Hellenic Republic

• Member state EE 1981
• Urban population 60

12
Psychiatric care

• 1980s Nine public mental hospitals
• Inadequate staff
• Inadequate community services
• No units in General Hospitals
• Inadequate undergraduate and
• postgraduate psychiatric
  training
• 1983 Provision for de-centralization
• of psychiatric services
• (Law 1397/83)

13
Psychiatric care

• 1984 EEC Regulation 815/84
• Financial support for
• decentralization
• deinstitutionalization
• improvement of conditions in
• public mental hospitals
• dealing with the Leros problem
  

14
Psychiatric care

• 1989 Contribution of the Hellenic
• Psychiatric Association
• 1990 Implementation of Leros
• deinstitutionalization program
  

15
Psychiatric care

• 1998 Program Psychargos
• For the completion of
  psychiatric
• reform.
• Deinstitutionalization of the
  
• remaining 3000 long-stay
  patients.
• Development of 616 mental
  health
• care services, residential
  alternatives and
• rehabilitation units

16
Psychiatric care

• Between 1984 and 2004
• Decrease of number of chronic patients by
  66.5
• (from 7.487 to 2.542)
• Small decrease in number of beds of private
• mental hospitals
• (from 4.817 to 4.000)

17
Psychiatric care Development of community
services

• Outpatients Departments 70 (20)
• (General hospitals)
• Day hospitals places 1000 change
• Psychosocial rehabilitation
• services 1500
  change
• Residential alternatives 2500 change

18
Psychiatric care

• Regional distribution Partial success
• Increase in mental
• health personnel Inadequate
• Psychiatric education Improvement at
• 
  undergraduate
• 
  postgraduate level

19
Psychiatric care Non-resolved issues

• Primary care
• Prevention and Mental Health Promotion
• Incomplete occupational rehabilitation
• (high unemployment)
• Integration of psychiatric and medical
• services
• Quality assurance of services
• Quality of life of patients