Mental Health

Mental health
Facts listed below were revealed during the work of the Human Rights Center on the project “Legal Aid for the mentally disabled persons in Georgia.” This project, financed by Abilis Foundation, Finland lasted for 8 months and at the moment is on its final stage. In the frame of the project, the Human Rights Center provided people with mental health problems and their relatives with free legal aid. Over 90 consultations were provided; a number of cases were discussed at court. The Human Rights Center worked in close collaboration with mental health service users and organizations which involve service users. During the project a monitoring of the closed psychiatric institutions was conducted as well as visits to the Day Rehabilitation Centers.

Experience gained during the project implementation gives an opportunity to the Human Rights Center to stress out to those breached rights which occur in the system of psychiatric care.

Right for Medical Treatment

People with mental health problems must not be placed in general prisons, because it violates their right to receive proper medical treatment.

Precedent- the case of Ukrainian citizen, Aleksander Ch., who serves term in the general prison of Rustavi though he was diagnosed by schizophrenia and according to the conclusion of the medical commission, he is mentally incompetent.

The Human Rights Center studied this case and in May 2010 submitted it to the European Court, which accepted the case and requested the Georgian government to provide them with the information about living conditions of Aleksander Ch before June 24 and whether he receives proper medical treatment.

Right of freedom and personal life

People with mental disabilities are placed in closed psychiatric institutions even when they do not require treatment at hospital. One of the reasons is lack of accommodation or shelters for these people.

During the monitoring of psychiatric hospitals in Georgia it revealed that most patients of the chronic wards do not require treatment in hospital. These people stay in hospital because they have nowhere to go.

Damana S. spent 14 years in the Asatiani mental hospital in Tbilisi. She is an IDP from Abkhazia and has to live in the psychiatric hospital because there are no shelters.

One more example is Sergo M. who spent many years in psychiatric hospitals and can’t return home in Tsinandali, because he does not have relatives and his house is almost destroyed. Representative of the Human Rights Center went to Tsinandali, and saw that the house does not have roof, the concrete partition between floors is destroyed and living in this house is impossible even for a healthy man.

People who don’t have any place to go and have to stay in psychiatric institutions are tormented by the restriction of their freedom and absence of private life. They do not have an opportunity to live in society. At the same time those people who require hospital treatment cannot receive it because of the absence of places.

ID cards

Patients of psychiatric hospitals often do not have ID cards. As we cleared up, it is often impossible to restore ID cards, because many patients stay in hospitals for years and do not have contact with relatives. They do not have birth certificates, do not remember their address and never had ID cards before. Such people automatically lose almost all their rights, they cannot receive disability pension, and they are not included in any state programs of social assistance and stay without any source of living.
Unfortunately such cases are quite common.

Property Rights

Relatives of the people with mental health problems often take advantage of their relatives’ conditions and seize their property.

Nadia and Nana K., mother and daughter live in Asatiani mental hospital, because their legal guardians sold their flat with permission of the Social Service Agency, department of Guardianship and Care. Both guardians received pensions of the two women and nothing of this money was spent on the patients. Nadia and Nana K. should be liberated from guardianship, for this purpose they need medical expertise. For the expertise both women need to pay 500 GEL even if the results are negative. And the return of the sold property is not even discussed.

The Human Rights Center is ready to pay for Nana K.’s expertise, after which the Center will appeal to the court and request abolishment of her guardianship. But this is not enough for justice.

Right to Have a Guardian

People with mental health problems often require guardians, but do not have them.
According to the Georgian Law about Psychiatric Help, hospitals themselves should apply to the court if they have doubt about patient’s legal capacity. But hospitals do not do it, because there is no coordination between different institutions. Hospital’s administration and often lawyers do not have information about methods of solving problems they face, and about relevant agencies who are responsible for such types of problems. For example, we do not know a single case when director or lawyer of psychiatric hospital appealed to the court concerning adjudication of incapacity.

According to the hospital’s administration this should be done by the patient himself/herself or by the interested person, but Georgian Law on Psychiatric Help mentions that hospitals are responsible for this function. Another reason why hospitals do not apply to the court is that the hospital cannot pay legal expenses.

The Human Rights Center works on 5 cases on appointing guardians. All these cases are free from legal expenses and even expertise will be free if it is appointed by the court. The fact that lawyers of hospitals do not appeal to the court leads to failure of the guardianship system envisaged in the law. Only a very small percent of people who require guardianship have guardians. The rest of them stay without care, unprotected, which leads to the loss of property, worsening of their health conditions and necessity to stay in hospitals for good, because no one is legally responsible for them.

Right for recovery and reintegration into society

There are not enough rehabilitation services in Georgia. Rehabilitation Centers do exist, but there are only 120 places in them while the total number of registered beneficiaries with mental health problems is more than 80, 000. Besides, there is no system to support employment in Georgia, where disabled people could acquire new skills or restore old ones; it could support their integration into society. Without employment disabled people stay isolated from the society, and therefore the final goal of rehabilitation remains unachieved.

Right for information

In order to make informed decision, to prevent mental health problems and realize necessity of medical treatment, people have right to get information. Unfortunately prevention of mental health problems does not function in Georgia; society is not informed by mass-media sources, there are no special courses at school or in University. People do not know what kind of risk they face when they work in unregulated regime, under constant stress, they do not know how to recognize first symptoms of mental disorder. Consequently, people who need help of psychiatrists do not go to the specialists and do not receive their help in time. That is why mental health problems often progress without proper treatment.

Quite often, people with mental health problems, who already get mental health assistance, and sometimes their relatives, do not receive comprehensive information about patient’s diagnosis, symptoms of illness, ways of treatment, and side effects of medical treatment. As a result, patients and their relatives are not involved in the process of treatment.

The disease remains mystery both for society and for patients with their relatives, and because every mystery can scare, stigma and discrimination arise, which affect not only patients, but their family members as well.

Olga Kalina, Head of the Project

6 Jul. '10