Author: Enejda Groshi, Jurgen Bame
Albania is facing an increase in the number of people suffering from mental illnesses. In the last 5 years (2014-2018), there have been over 21 hospitalizations in mental health Services with beds, which have been handled by only 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 the 4 hospitals (Tirana, Vlorë, Elbasan and Shkodër), which offer mental health Services.
The causes of this "boom"?
"The causes are biological; patients who have it genetically inherited. Social causes are not left behind, such as unemployment, population migration, conflicts, parents' divorces, the impossibility of a normal life, such as housing," says the doctor. psychiatrist, Arjana Rreli.
Mental illnesses affect men more than women. From the data provided by MShMS (Ministry of Health and Social Protection), in 2018 the ratio of admissions for men to women is 2 to 1.
Another factor in this report, according to psychologist Adela Lamçja, is the use of narcotic substances or alcohol, which in Albanian culture is more widespread among men than among women. Also, women have the nature to share their problems with others and in this form it becomes easier to highlight mental problems and consequently receive health care at the right time.
"Men are more closed in nature. As a result, emotional and psychological burdens accumulate and burden the individual more, and their consequences become more severe. The closure itself makes it more difficult to identify the disease early and 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 to talk more openly about this disease.
"We need wider awareness of mental illness and its treatment, not isolation and hiding from the community... "
The age groups most affected by these diseases are those between 25-35 years old and 35-50 years old. Doctor Rreli says that in this age group the individual is more exposed to disappointments and has more family responsibilities. Also, a 20-year-old is more prone to substance abuse.
In the mental health Services with beds, the people admitted mostly come from rural areas.
According to psychologist Lamçja, social conditions are more difficult in rural areas, but health culture is also lower and receiving medical help is later than in urban areas.
"In rural areas there is a higher patriarchy. The symptoms of the disease combine and feed on the leading and ruling spirit over the family, and as a result it becomes more difficult to manage and sensitize them in time, and for this reason they receive treatment in the hospital in the most severe stage of the disease."
Treatment in the hospital or outside it....
The Ministry of Health aims for the service to be as close to the community as possible and comprehensive. Hospitalization beyond the necessary time has a negative effect, as it increases social distancing and decreases interest in engaging in various activities.
Government policies aim to reduce the number of beds in residential, psychiatric hospitals.
Ogerta Manastirliu: "All those people who have problems, who are treated for mental health problems, should not be treated in hospitals, but have the opportunity to be treated near their families and be followed by community, day mental health centers with the network of doctors."
But how functional has this initiative turned out to be?
From the table of data that the Ministry of Health sent for the capacity of beds, it appears that these hospitals have only 635 beds, while in the period 2014-2018 there were over 3000 beds per year.
According to Law No. 44 on Mental Health, the provision of health care for people with mental health disorders must be done in an environment that is as less restrictive as possible, mainly at the community level, to avoid displacement from the family environment as much as possible and to facilitate social integration and rehabilitation.
According to psychologist Adela Lamçja, deinstitutionalization is a process widely tested as a useful process for the functioning of an individual with full rights in a community with others beyond mental illness. Once mental status stabilization is achieved with inpatient therapy, each individual should continue treatment in the community (in their own home).
But, on the other hand, there are no shortage of cases where family members of people suffering from mental health problems due to the inability to take care of them find the easiest solution, abandoning their relatives in these hospitals for a long time, often up to end of their lives. This causes the capacities to be filled and the hospitals are unable to accommodate other individuals.
Albanian Committee of Helsinki (KShH) (during the monitoring carried out in the period March-June 2018) noticed a worrying increase in the population with mental health disorders. In the rooms of the psychiatric hospital, "Sadik Dinçi", in Elbasan, there was an extremely high number of chronic patients, up to 12 people with severe mental health diseases in a room with an area of 45 m2. But essential violations were found in other institutions as well.
In general, KShH thinks that the institutions do not have the appropriate capacities, both in terms of infrastructure, medications, but also in terms of human resources, which are faced with an insufficient number of specialists or the need to increase their professional knowledge as it belongs to the diagnosis and treatment according to the best standards of these patients.
The lack of adequate treatment in psychiatric hospitals in the country, overcrowding, their poor staff, infrastructure degradation and lack of multi-year investment have long been some of the recommendations of the Institution of 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 who remain at the mercy of the street, the Ombudsman asks the institutions to increase capacities and improve conditions in hospitals psychiatry in the country.
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The reduction of beds has not been so efficient, when we see that these people with mental health problems wander the streets and often in a serious condition.
*Feature photo at beginning of article taken from ABCNews
