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Mental Health Support: Policy and Strategy
Belgrade, May 5, 2014
HELSINKI FILES No.
33 - Mental Healthcare: Befitting Human Dignity >>>
The conference in Belgrade’s Aero Club convened under the title
“Mental Health Support: Policy and Strategy” was a part of the
project implemented with the support of the Royal Norwegian Embassy
in Belgrade. The project was realized in partnership with the
International Aid Network /IAN/ and in cooperation with the Ministry
of Healthcare of the Republic of Serbia, the Citizens’ Ombudsman and
the Provincial Ombudsperson of Vojvodina.
The conference was also the opportunity for the
Helsinki Committee to launch an outcome of the project, the brochure
“Mental Healthcare Befitting Human Dignity”.
Sonja Biserko, chairwoman of the Helsinki
Committee, Ljiljana Palibrk, project coordinator, His Excellency
Nils Ragnar Kamsvag, Ambassador of Norway, His Excellency Laurent
Louis Stokvis, Ambassador of the Netherlands, Dr. Slavica Đukić
Dejanović, MP and president of the Psychiatric Association of
Serbia, and Judith K Lepuschitz of the US Embassy in Belgrade,
welcomed the participants and opened the conference.
Referring to the process of deinstitutionalization
of persons with mental disorders in Serbia, Ms. Biserko underpinned
stigmatization of this vulnerable group of population as a most
pressing problem, noted as such also by representatives of
nongovernmental organizations, independent agencies and governmental
institutions assembled in the project’s work group. “The concept of
human rights has not been incorporated systemically in all domains
of social life, and this particularly affects marginalized and
vulnerable groups. I believe that only together we could trigger off
deinstitutionalization and put an end to inhuman treatment of these
persons,” she said.
Ambassador Laurent Louis Stokvis said that his
country had recognized the significance of deinstitutionalization
long ago, suggesting that Serbia considers the Dutch model and, if
possible, adjust it to its needs and potentials.
For his part, Ambassador Nils Ragnar Kamsvag
commended the initial steps Serbia has made in the mental health
reform. However, the challenges facing it in this domain are many
and complex, and the state is duty-bound to cope with them
efficiently, he said.
According to Judith K Lepuschitz, the rights of
persons with mental disabilities are inadequately protected in
Serbia. One of the reasons why is that the issue as such is treated
solely from the angle of medicine, rather than in the context of
human rights. “The situation of persons with mental disabilities
cannot improve unless this point of view changes,” she said.
Dr. Slavica Đukić Dejanović takes that the problem
of stigmatization continues to plague persons with mental
disabilities, while not a single segment of the society can solve
the problem on its own. “Since antiquity persons with mental
disorders have been treated with exorcisms and that has not
basically changed till this very day in our collective conscience,”
she said, adding that despite of all Serbia has already launched the
process of deinstitutionalization – as of lately release of
residential beneficiaries of psychiatric care has grown by ten
percent in four big medical centers in the country.
Panelists in the first session, moderated by
Jelena Mirkov Subić of the Helsinki Committee, were Miloš Janković,
deputy Ombudsman, Prof. Dr. Đorđe Alempijević, member of CPT, Žarko
Marković of the Belgrade Center for Human Rights and Nikola Grujić
of Lawyers’ Committee for Human Rights (YUCOM). According to Dr.
Alempijević, although cases of physical torture are nowadays rare in
psychiatric institutions, one should always keep in mind that
insalubrious living conditions equal inhuman and degrading
treatment. His also underlined the importance of individual
treatment programs in psychiatric institutions, which imply the
proper proportion between professional staff and patients – and that
is usually not the case in Serbia.
Miloš Janković spoke about the National Preventive
Mechanism /NPM/ within with the Citizens’ Ombudsman in tandem with
the Provincial Ombudsperson and non-governmental organizations has
been inspecting psychiatric hospitals. These teams have observed
many shortcomings – from understaffing to the practice of isolation
of agitated patients. Our legislation is also faulty, he said,
because the problem itself is systemic in nature. He takes that
Serbia must establish special and autonomous departments for mental
health protection under the jurisdiction of the Ministry of
Healthcare, with multidisciplinary teams – physicians, occupational
therapists and lawyers – taking care of patients’ well-being.
Representatives of YUCOM and the Belgrade Center shared his view
about the need to amend the legislature and court practice.
According to them, findings by court experts are often
unprofessional and based on outdated medical records.
Marina Bogdanović of IAN moderated the second
session addressed by Dr. Vladimir Jović, psychiatrist and member of
the NPM expert team, Dr. Paolo Serra, psychiatrist and consultant to
Caritas Italiana, Dr. Jovanka Petrović, director of Psychiatric
Hospital „Sveti Vrači“ in Novi Kneževac and Dr. Tatjana
Voskresenski, director of Psychiatric Hospital „Dr. Slavoljub
Bakalović” in Vršac. “Only deinstitutionalization secures humane
treatment. Patients who absolutely have to be placed in a
psychiatric hospital can be hospitalized as acute patients but not
kept in hospitals once their diseases are not longer acute – which
is usually what we are having here,” said Dr. Jović.
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