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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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