Author: Enejda Groshi, Jurgen Bame
Albania is facing an increase of people suffering from mental illness. In the last 5 years (2014-2018) in mental health institutions with beds there have been over 21 thousand hospitalizations which have been managed only by 635 beds in the four hospitals that the country has.
Official data show that the peak was reached in 2018 with about 5000 hospitalizations treated in 4 hospitals (Tirana, Vlora, Elbasan and Shkodra) that provide mental health services.
The causes of this “boom”….?
“The causes are biological, patients who have genetically inherited it. Social causes do not lag behind, which can be various problems such as unemployment, population migration, conflicts, parental divorces, inability to lead a normal life, as it may be housing “- says Psychiatrist, Arjana Rreli.
Mental illness affects more men than women. From the data provided by MHSP (Ministry of Health and Social Protection) in 2018, the ratio of hospitalizations for men versus women is 2 to 1.
Another factor in this report, according to psychologist Adela Lamcaj, is the use of narcotics or alcohol, which in Albanian culture is more prevalent among men than women. Also, women have the tendency to share problems with others and in this form it becomes easier to highlight mental problems and consequently receive healthcare at the right time.
“By nature, men are more closed in themselves. As a result, emotional and psychological burdens accumulate and affect the individual more, and the consequences become more severe. “Closing itself off makes it more difficult to identify the disease early and to intervene in time”, says Adela Lamçja.
Adela Lamçja, psychologist at the psychiatric hospital in Elbasan “Sadik Dinçi”, says that it is time for more awareness and to speak more openly about this disease.
“We need broader awareness of mental health illness and its treatment and not isolation and hiding from the community.”
The age groups most affected by these diseases are 25-35 and 35-50 years old. Dr. Rreli says that in this age group, the individual is more exposed to disappointments and has more family responsibilities. Furthermore, a 20-year-old is more prone to substance abuse.
In mental health services with beds, inpatients are mostly from rural areas.
According to psychologist Lamçja, in rural areas the social conditions are more difficult but also the health culture is lower. Getting medical help happens far more later than in urban areas.
“In rural areas, there is higher patriarchy. The symptoms of the disease are intertwined and nurtured in the spirit of leadership and dominance over the family and consequently become more difficult to manage and raise awareness in time, and therefore receive hospital treatment in the most severe phase of the disease.
Treatment in or out of hospital….
The Ministry of Health aims for the service to be as close as possible to the community and all inclusive. Hospital treatment beyond the necessary time has a negative effect as it increases social distancing and reduces the interest to engage in various activities.
Government policies aim to reduce the number of beds in residential psychiatric hospitals.
Ogerta Manastirliu: “All those people who have problems, are treated for mental health problems, should not be treated in hospitals but they should have the opportunity to be treated near their families and be followed by community daily mental health centers with a network of doctors. “
But how successful has been this initiative?
From the information that the Ministry of Health sent regarding the capacity of beds, it results that these hospitals have only 635 beds, while from 2014-2018 over 3000 hospitalizations were made per year.
According to Law No. 44 on Mental Health, the provision of health care for persons with mental health disorders should be done in a less restrictive environment, mainly at the community level, to avoid as much as possible displacement from the family environment and to facilitate integration and social rehabilitation.
According to psychologist Adela Lamçja, deinstitutionalization is a widely tested process as a useful process for the functioning of an individual with full rights in a community with others beyond mental illness. Once the stabilization of the mental state is achieved with the hospital therapy, each individual should continue the treatment in the communities (in his apartment).
But on the other hand, there are cases when the relatives of people suffering from mental health due to the inability to take care of them, find the easiest solution: the abandonment of relatives in these hospitals for a long time, often until the end of heir life. This causes capacities to be overburdened and hospitals not being able to accommodate other individuals.
The Albanian Helsinki Committee (AHC) (during the monitoring conducted in the period of March-June 2018) noticed a worrying increase in the population with mental health disorders. In the Psychiatric Hospital “Sadik Dinçi” in Elbasan there was a very high number of chronic patients in its rooms, which went up to 12 people with serious mental health disorders, in a room with an area of 45 m2. Essential violations have been found in other institutions.
In general, the AHC thinks that the institutions do not have the necessary capacities in terms of infrastructure, medicines, but also in terms of human resources, which face an insufficient number of specialists or the need to increase their professional knowledge in terms of diagnosis and treatment in accordance with the best standards of these citizens.
Lack of adequate treatment in psychiatric hospitals in the country, overcrowding, their poor staff, degradation of infrastructure and many years of non-investment, have long been some of the recommendations addressed by The People’s Advocate for these hospitals and the line ministry.
While the topic of the day in Albania is how our mental health institutions should treat citizens, who suffer from these problems but remain at the mercy and on the road, the People’s Advocate urges institutions to increase capacity and improve conditions in psychiatric hospitals in the country.
Bed reduction has not been so effective when we see that these people with mental health problems wander the streets and are often in aggravated condition.
*Feature photo: ABC News