The development of social mental health care and community services. Greece as a case study

Throughout the history of mental illness and its treatment in Europe, remarkable progress has been achieved, especially over the past 100 years with the evolution of medical services, diagnostics, social policies, and social attitudes. The process of deinstitutionalisation of mental health care progressed together with the acknowledgment of social and relational aspects of the mental illnesses. Consideration of the environment as an important factor of one’s mental wellbeing came to replace the earlier view of mental issues residing solely in the individual and their biological features. Over the last 60 years, the social status, economic and other factors, have all been increasingly acknowledged as having an important role in therapy. When such conditions are unfavourable, they tend to aggravate the existing condition, as has been evident world-widely in the majority of mental health institutions before the necessary reforms took place. Greece is no exception, as will be shown in this article; from alienation, isolation and stigmatisation of the mentally ill, a number of initiatives and psychiatric reforms facilitated the process of deinstitutionalisation and rehabilitation, and have helped society move away from stigmatisation towards integration of the persons with mental issues and learning difficulties into the society and family life. The process is however, far from complete, and much remains to be done. The article begins with a brief history of the development of psychiatric practices in Europe from 17th to 20th century. It then examines modern Greece as the case study, where the major psychiatric reform came rather late in comparison to other European states, particularly between 1970s-1990s. Three psychiatric reforms will be examined (Leros I and II, and Psychargos reform) as well as the subsequent collaborative efforts between Greece and EU services. The progress, as evidenced, has been slow and inhibited by numerous obstacles; nonetheless the outcomes are significant and continuously evolving.