State of mental health care in Georgia

In 2018, 389 suicides and 477 suicide attempts were reported in Georgia. During the first 6 months of 2019, 219 people attempted and 207 committed suicide.

October 10 is the World Mental Health day and this year the focus is on suicide prevention.

While the majority of the developed world has caught up to the importance of Mental health and the absolute necessity of working on the suicide preventing tools and practices Georgia seems to largely ignore the issue, at least on the political level.

The Conversations around mental health are slowly but surely becoming more normal. But the initiatives mostly come from regular citizens, who either still battle with or have previously experienced mental health issues. According to the official statement by the World Federation for Mental Health, the suicide rates have increased gradually in all parts of the world and, in the past few decades, reached alarming statistical levels.

The object of making suicide prevention the theme of World Mental Health Day in 2019 is to attract the attention of governments so that the issue might be given priority in public health agendas around the world.

The big part of the taboo, when it comes to openly discuss mental health in Georgia is seeing people who struggle with it as “abnormal”, when in reality considering the rhythm and the stress levels of today’s day to day life it seems more difficult to find a person who doesn’t struggle with mental health.

People who suffer from severe mental illnesses and substance abuse don’t have a lot of options for a safe place to go and until very recently gong to therapy was considered a shameful thing, only necessary for the people who were unable to be a functioning member of the society without it. Taboos regarding mental health also come from the fear of being judged, misunderstood or alienated by the community.

On the occasion of World Mental Health Day, the European Psychiatric Association and its member national psychiatric associations, including the Georgian Psychiatric Society, joined in on the main call of the World Suicide Prevention Day(September 10th ) to tackle suicide and the World Health Organization' s 40 Seconds to Action campaign, to help raise awareness of the adverse effects of suicide on public health and to provide information to the public on suicide prevention issues.

About 800,000 people commit suicide each year, meaning that one person dies every 40 seconds (hence the message “40 Seconds to Action). It is shown that there are 20 or more suicide attempts on one completed suicide. This statistic highlights the importance of having these preventative practices.

So when Georgia fails to provide people with any tools for suicide prevention, it sends a message that mental health and especially suicide prevention is not a priority. The State has failed to take any proactive measures to prevent suicides.

Public Defender’s Office held an event on this topic, where the Ombudsman, Nino Lomjaria, noted, that unfortunately, mental health issues are remembered only when certain cases end up very tragically, with bodily injury or more severe damages.

“In the field of mental health care, budgetary funding has increased to some extent in recent years, but mainly these funds are spent on infrastructure and rehabilitation. The situation has improved in some inpatient psychiatric institutions, although this is very minimal and insufficient for the challenges that exist in this area.”- said the Public Defender, Nino Lomjaria during the event.

Lomjaria continued to say that Georgia offers long-term care services where patients live their entire lives. They do not have enough skills to live independently, cannot leave these institutions, and their families refuse to accept them. In addition, it is very problematic to identify mental and health problems at an early stage and treat them.

“Only 37% of patients were involved in treatment after hospitalization last year. This is a field that receives less attention from the state”- said the Public Defender.

The Public Defender’s office also monitored specific mental health establishments and shared their observations with the public. When talking about the Acad. b. Naneishvili Mental Health National Center Ltd., Deputy Public Defender Giorgi Burjanadze said that from the mental health point of view, the protection of beneficiaries from ill-treatment is particularly challenging, especially when using physical and chemical restraints; as well as the patients' quality of care and treatment, which is exacerbated by a lack of staff and poor skills, the patient's informed consent, involvement of the service and the use of antipsychotic medication.

The main message of the Public Defender’s office towards the Georgian Government is the Deinstitutionalization of Mental Health treatments.

“We urge the State to take effective steps as soon as possible to support the process of deinstitutionalization and the development of community-based services. Including community-based small-town housing, providing all the necessary living conditions and facilitating the integration of beneficiaries into the community. But before we do that, we need to take some steps to ensure that those in large mental health facilities are in dignified condition,” said the Public Defender at a Mental Health Day event.