Assessment of forensic psychiatry in Ukraine
On March 18, 2016, the final report on the assessment visit to forensic psychiatric hospitals in Ukraine was presented at the Office of the Ombudsman for Human Rights of the Verkhovna Rada. The report is a joint publication of the Ombudsman for Human Rights and Human Rights in Mental Health-FGIP.
The English version of the report van be downloaded here
The Ukrainian version of the report van be downloaded here
The followinf is the short statement of FGIP Chief Executive Robert van Voren during the presentation of the report:
Ladies and Gentlemen,
I do not want to take much of your time. What we encountered during our fact-finding mission to forensic psychiatric institutions in Ukraine has been described in detail in our report, and our conclusions and recommendations are clear and detailed.
What I would like to add are a few personal impressions. Having worked in Ukrainian psychiatry for the past 25 years, I did not really expect anything better than we encountered. My first impressions of Ukrainian psychiatry date back to the summer of 1991, when I for the first time entered the psychogeriatric department of the Pavlov psychiatric hospital here in Kyiv, and these impressions remain with me for the rest of my life. Since, I have been involved in literally hundreds of projects and initiatives, large and small. I have shared both hopes and disappointments, saw optimism gradually reduce to feelings of hopelessness and despair, saw many people start with enthusiasm and along the way give up. There were times when I gave up too, unable to maintain the drive to fight a Soviet psychiatric monster with too many members of the nomenklatura being interested to maintain the old and to prevent reform.
After the popular uprising of 2013-2014 we started again, with new hopes and new determination. One of the happiest moments was the agreement that formed the basis of today’s report: the decision to join forces with the Office of the Ombudsman of the Verkhovna Rada and the willingness of Valeriya Lutkovska to provide all possible technical, logistically and above all institutional support.
The second happy moment came when in early December we discussed the first conclusions after our visit and found, I have to admit to our surprise, Deputy Minister of Health Viktor Shafransky open to collaboration. Since, significant steps have been made in the right direction and our optimism and determination has remained unaffected. This, I think, is a major feat for which I am immensely grateful.
Yet this is not the time to sit back and relax. First of all, we suggested to pilot a modern forensic psychiatric facility in Ukraine in order to develop a model that can be repeated elsewhere in the country. This suggestion was welcomed, and since we are in the process of laying the grounds for this complex and important initiative.
We understand this is a project that will take a lot of effort and cannot be completed within a short period of time. It will require a long-lasting involvement and a lot of energy and resources. We are ready: after 25 years of involvement we are ready to add another 5, 10 or even 15 years.
However, it also requires that the donor community responds favorably, and I would like to call upon this community here and now to understand the importance of this initiative and to provide its support. This is not a project that affects only the several thousand forensic psychiatric patients and their families. It is a project that deals with one of the most resistant vestiges of Soviet psychiatry, and if successfully changed it will fundamentally affect the profession as a whole. It is also an area that is crucial in protecting the safety of the Ukrainian population. Well-treated and rehabilitated forensic psychiatric patients will return home without being a threat to their environment, and good resocialization programs will help them to become productive and law-abiding citizens again.
And last but not least, forensic psychiatry is an area where massive human rights violations occur on a daily basis. Allowing these to continue to take place is a serious threat to a society that is based on the rule of law and where human rights are respected, and seriously tarnishes the image of Ukraine as a whole. They simply cannot be allowed to continue to happen.
This brings me to my final point: the forensic patients themselves. Like in 1991, when I had my first direct encounter with Soviet psychiatry in the basements of the Pavlivka, I will never forget the patients that we met and spoke with, in person. I remember the sadness in their eyes, the fear of knowing that they later might be punished with extra dosages of aminazine, but also the amazing strength of enduring life under very dire circumstances, often knowing that they still had many years of incarceration ahead. Incarceration, mind you, that had no relation to their mental health but to the crime they committed while being mentally ill.
For me what is vital is that we are able to improve their lives immediately. They cannot wait till our pilot projects are up and running and prove to be successful. They need to feel the results now. There is no reason to withhold them the right to telephone their relatives when they want; there is no reason to lock them up most of the day, prevent them from going outside, doing sports, recreate or work in a vegetable garden or doing other things that help them to rehabilitate. These people are on the inside because they are suffering from a mental illness; so then keep them in a therapeutic environment and not inside a prison. There is no way people can be rehabilitated and resocialized when such restrictions remain.
I would like to call upon the relevant authorities to take immediate measures to improve the lives of these unfortunate persons, to approach them with humanity and compassion, and to introduce all necessary measures and regulations to end the human rights abuses that happen there, right now.
And let me assure them once again: we are their partners. And we are loyal partners if we remain convinced we share the same values and expectations.
35 years of FGIP: 35 years of commitment to mental health
Anniversary project: support the work of Nest (Sri Lanka)
In December 2015 it is 35 years ago that the Foundation Human Rights in Mental Health-FGIP was founded in Paris. Originally called “The International Association against the Political Use of Psychiatry”, it was intended to be a temporary confederation of national organizations involved in the fight against the political abuse of psychiatry in the USSR. The organization successfully lobbied national and international medical associations, human rights groups and governmental agencies and by the end of the decade the political abuse of psychiatry had indeed come to an end. However, with the USSR opening up to the outside world, a new challenge appeared on the horizon: the struggle for a humane, ethical and consumer-oriented mental health care system. The subsequent 25 years the organization, now called GIP (Geneva – and later Global – Initiative on Psychiatry) worked tirelessly to improve the lives of persons with mental illness in Central & Eastern Europe, the former USSR, and later also in Africa, Sri Lanka, Indochina and the Caribbean. Hundreds of projects were implemented, ranging van small grassroots initiatives to large-scale reform projects, and the organization received international acclaim for its efficacy and commitment.
Now that the organization exists 35 years, our work is far from over. Through its central office of the Federation Global Initiative on Psychiatry (FGIP), its member organizations in Bulgaria, Georgia and Lithuania, and its many partners all over the world the organization continues its struggle for a humane and ethical mental health care system worldwide.
One of our partner organizations in based in Sri Lanka. Set up more than 25 years ago by Sally Hullugalle, the organization has developed a wide range of activities for persons with mental health problems who need support and care. Tirelessly, the volunteers of Nest work in both hospitals and the community, and through their work they have helped hundreds of people restore their lives and become active members of society again. Nest embodies all the values that FGIP stands for: commitment and dedication, determination, putting the consumers central and helping them to become or remain part of the community and have full-bodied lives.
One of the projects focuses at the Mulleriyawa mental hospital for women, where originally more than seven hundred women were locked up for the rest of their lives and lived under horrific conditions. Thanks to Nest, more than half of the women have been reintegrated into society and the remainder is living under far better circumstances both on the hospital grounds and in houses nearby. In order to continue their work, Nest needs financial support to meet the basic needs of the women, as well as to purchase a trishaw to transport women to the market for shopping or for outings into the community. Having a trishaw would greatly enhance the efficacy of Nest and give the women of Mulleriyawa a much greater sense of mobility and independence. The total cost for a trishaw is 4,000 euro, while the annual budget for Nest operations at Mulleriyawa is approximately 6,000 euro.
Instead of presents: support to Nest
When people have a birthday, they often receive presents. And so in the case of GIP's 35th anniversary, people have asked us whether we have special wishes. GIP was founded to help people in difficult circumstances. Then our target groups were people who were incarcerated in psychiatric hospitals for non-medical reasons because of their political or religious beliefs, now they are persons with mental illness who do not get adequate treatment or are stigmatised within their society. We feel it is not GIP that deserves a present, but rather our target population. For that reason we would like to ask your financial contribution to this special anniversary project.
Help us to continue our work in the coming years – and help Nest to continue their invaluable work.
ING Bank, Amsterdam, The Netherlands
BIC code: INGBNL2A
Bank account number: NL46 INGB 0006 0707 13
att.: Human Rights in Mental Health-FGIP, Postbus 1956, 1200 BZ Hilversum (NL)
Donations from the US that are made by check should be made out to “GIP-USA” and send to our address in The Netherlands, as they will be cashed in the United States by one of our members to avoid excessive bank costs.
Jim Birley Scholarships 2016: call for Applications
In November 2013, the Board of the Federation Global Initiative on Psychiatry decided to honor its late Past Chairman Dr. Jim Birley by instituting a scholarship focusing on issues that Dr. Birley was especially committed to: issues of human rights in mental health, and stimulating young mental health professionals and other stakeholders to pay special attention to the rights of persons with mental illness.
The Jim Birley Scholarship will be provided once a year during a high visibility event to a young mental health professional or another stakeholder (user, family-member or carer) who has shown exemplary commitment to the issue of human rights in mental health.
In 2016 one scholarships of 5,000 euro will be awarded (in case of equal points the scholarship might be divided between two winners). The scholarship is to be used for a cause to be proposed by the winner and should contribute to the strengthening of human rights in the field of mental health.
A committee consisting of four members, including a member of the Birley family, will select the winners from the submitted applications.
How to apply?
Candidates for the Jim Birley Scholarship should write to Human Rights in Mental Health-FGIP and in a letter explain:
- Why they should be eligible,
- Provide details about their background and what they have done to further human rights in mental health, and
- What they intend to do with the scholarship.
Two letters of recommendation should be added.
Applications should be submitted before May 8, 2016.
The Selection Committee will then select the winners of that year.
The winners of the award will be announced in late June 2016.