Changes in mental health care since 1989

Following the fall of Communism, horrifying images hit western televisions screens of the squalid conditions of psychiatric institutions in Albania and Romania. In this week's Talking Point Ita Dungan will be looking at how mental health care in the Czech Republic has dealt with the transition from totalitarianism to democracy. An average of 2 to 3 percent of every nation's population suffers from serious mental illness - that means that in the Czech Republic, there are over 200,000 sufferers.

I asked Dr Jan Pfiffer of the Centre for Mental Health Care Development to explain how he saw the situation of mental health care in the Czech Republic. The Centre for Mental Health Care Development was founded six years ago as a non-profit, non-governmental organisation. Its aim was to facilitate and co-ordinate the providers of mental health care in the Czech Republic and to help in the transfer of services from institutions to community care. This was to follow the trends that already existed in developed democracies. An idea that was not very warmly received according to the organisation's director - Dr Pfiffer. Without any experience of community care - many large psychiatric hospitals see themselves as the basis of all mental health care. Although some hospitals have changed, attitudes and conditions in many hospitals remain unaffected by modern humanising trends. Dr Martin Jarolimek is one person who has succeeded in changing the system. The founder of Na Pul Cesty - a half- way house for schizophrenic and psychotic patients - also believes that despite obvious economic constraints, the adage of teaching an old dog new tricks rings true. Again, the will to change is sometimes lacking among psychiatric professionals, but many people outside the profession are more positive. Dr Jarolimek was a pioneer of non-institutionalised treatment for less severe psychotic patients in the Czech Republic. Having founded a day hospital as far back as 1986, he soon realised that there was a need for something to further integrate the mentally ill back into society. It was in 1997 that he established Na Pul Cesty and has since established three similar cafes in other parts of Prague. One of Dr Jarolimek's success stories is Silvie Vurcfeldova, a woman who has suffered from mental illness who has just opened an exhibition at the Na Pul Cesty café.

Author: Ita Dungan
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