Human Rights Center Presented Report on the Research on Psychiatric Institutions in Georgia

Tamta Tvalavadze, Salome Chkheidze

On August 6, Human Rights Center presented its report “Research on Psychiatric Institutions in Georgia – Problems, Needs, Recommendations”. Executive Director of Human Rights Center Aleko Tskitishvili said the research revealed many urgent problems in psychiatric institutions of Georgia.

“Human Rights Center carried out research in psychiatric institutions of Georgia in April and May of 2013. Our representatives held warrants of Public Defender during the research that allowed them to pay sudden visits to the institutions and make more unbiased analysis of the real situation there,” he noted.

One author of the report, Olga Kalina spoke about the problems observed in psychiatric institutions and recommendations to relevant agencies. She said tender system negatively impacts on the psychiatric system because very often psychiatric institutions purchase low-quality medicines because of cheap price that is inadmissible approach in the healthcare field.

“Very often, beneficiaries of psychiatric institutions have not only psychiatric problems but different somatic diseases. They need particular medical treatment. Another problem is uninformed patients. They do not have information about their diagnosis, medical treatment details and very often they do not know the name of their doctor. This approach is inadmissible. There is also a problem of rehabilitation; this field is not developed in Georgia. Only one percent of funding is spent on the rehabilitation services; this service is almost unavailable inside the hospital. During our research, the only psycho-social rehabilitation center in Tbilisi was on the edge of close up because they did not have space for functioning. This problem really need respond. The state shall also develop quality control system. There is no joint standard in our country – in some institutions beneficiaries get high-standard service while it is very poor in others. Patients have right to get adequate treatment, good quality and honorable living conditions,” Olga Kalina said.

Another author of the report Simon Mamulashvili spoke about stigma in society and noted that people call “mad” to people with psychic problems that is inadmissible:

“During the research, director of Surami hospital noted with us that often people on excursion in

Summer come to the gate of the hospital and request “to show them crazy people” as if these people were aliens. Of course, it demonstrates social stigma that finally results into many problems.”

Research of psychiatric institutions in Georgia was carried out by Human Rights Center in the frame of the project (“Strengthening the advocacy & institutional capacity of HRIDC“) with financial support of Pro Victims Foundation (Geneva, Switzerland).

The members of the research group were lawyers of Human Rights Center Nino Andriashvili and Eka Kobesashvili; they provided people with psychic problems with free legal consultations. In the frame of the project two-part documentary film “The Rejected” was prepared, which is available at the video-portal of Human Rights Center. 

According to official data, in 2011, 67 736 people were registered in Georgia with mental or behavioral disorders. But in reality this number is a lot bigger. 12 083 people are registered in Georgia with the diagnosis of schizophrenia.

The report reads: “For years, mental hospitals were visited only by poor and homeless people or people with the most severe forms of illnesses. They were treated in the hospitals and stayed there for years as the medical treatment outside of hospital was not developed. Sometimes, people with mental problems receive medical treatment abroad. Sometimes, they refuse to receive treatment; they do not register and receive medical treatment at home.”

As of today, six mental hospitals provide mental help programs in Georgia. The revealed problems are: relevant reimbursement of medical personnel’s labor; insufficient number of psychologists and social workers. 

Another issue is ill-treatment towards patients. The report states that significant positive changes were observed in this direction: “If the practice of ill-treatment from the side of medical staff was widespread practice in the past and nobody was held responsible for these kinds of actions except for few exceptions, nowadays this problem is mostly eradicated in mental hospitals.” 

As for the method of restrictive physical intervention, it is widespread medical manipulation in mental hospitals in Georgia. The goal of the research group was to examine the compliance of this procedure to the law. . According to relevant legal regulations, restrictive physical intervention can be used in the instances when the patient represents a danger for himself/herself or for other persons. Unlike regions, in new hospitals in Tbilisi the beds are equipped with the special metal loops for restrictive physical intervention. In some cases, presumable the restrictive intervention is used for the punishment of patients, sometimes the notice journal is not filled in that is necessary in similar cases.

In accordance to the 2004 recommendation of the Committee of Ministers of the Council of Europe, persons treated or placed in relation to mental disorder should be individually informed of their rights as patients. Law of Georgia on Psychiatric Care states the same. Majority of interviewed patients did not know their diagnoses and details about their treatment.  According to the report, patients do not have information about their rights. It mostly refers to the patients taking “voluntary treatment”, who in fact want to leave hospital but are not sure they have right to.

The research showed that for the recent years, one of the most significant achievements in the sphere of mental health has been improvement of housing conditions in new hospitals. However, conditions vary with different hospitals. State of infrastructure in the hospitals represents a general problem.

Particularly, patient wards where they spend most of the time are in unsatisfying state. Due to lack of ventilation systems, there is strongly unpleasant smell in the hospitals; the lightning is insufficient; the heating conditions are unsatisfying. Particularly urgent situation is in Kutiri and Surami old mental hospitals.

At the end, the report presents results of public survey about people with psychic problems. The results showed that big part of society does not have sufficient information regarding this problem. The stereotypes which stigmatize mentally ill people and impose risk of discrimination dominate in society.