Czech Republic criticized for poor quality of care for mental patients

Mentally ill waitress, photo: CTK

An international inspection team has ascertained that conditions in Czech institutions for mentally ill patients leave a lot to be desired. On the grounds of these findings the Mental Disability Advocacy Centre, an international non-governmental organization which monitors the situation in EU candidate countries, has issued a detailed report criticizing poor legislation, cases of human rights abuse and inadequate medical care. Daniela Lazarova has the story:

Mentally ill waitress, Zlin - café U vcely, photo: CTK
The Mental Disability Advocacy Centre claims that the Czech Republic is approximately 15 years behind Western Europe in the quality of care afforded to mentally ill patients. In a system inherited from the communist era, the authorities are accused of putting too much emphasis on institutionalized care, without considering alternative means. Dr. Zdena Vyhnankova is head of department in Bohnice, the largest Prague institution for mentally ill patients:

"Alternative therapy basically means various private or state clinics providing day care. We do have such institutions in Prague but not enough by far. In the regions the situation is even worse. Such a network was not established during the communist years -in fact in the past the authorities expected us to care for patients who did not -strictly speaking -belong here. Mentally disabled people or people with senility should have been in old people's homes or other institutions - but if there was no room they were simply placed here. We also treat alcoholics and drug addicts and since their number has risen sharply in the past years this is proving to be an additional burden. This is not to say we resent having them here -but sometimes there are eight mentally ill patients to a room, and the doctors and nurses naturally have less time for each individual because they are treating more patients."

Mentally ill patients, photo CTK
Aside from overcrowded institutions, mentally ill patients complain that they are rarely informed about their treatment, their daily regime or their prospects for the future.

In some cases even patients' relatives are not consulted about what is happening to their family member. Dr. Vyhnankova says that this is a practice that the Bohnice clinic is trying to root out.

" This is certainly a problem. I personally supervise a team of young doctors and I try to set a good example. Speaking for my department I can say that we do our best to explain things to our patients and respond to their concerns. Having said that the tendency to ignore a patient's need to talk is common to the whole medical sphere. There are plenty of reasons for that - the communist health system did not require it , and today doctors are overworked and underpaid. They gain the experience and then leave for a more lucrative practice. So we ourselves are struggling with a lot of problems at present."

Asked what would help them most to meet Western standards in care for the mentally ill, Czech doctors claim that the answer is money. Money to build larger hospitals, alternative care sanatoriums, employ more qualified personnel and allow them shorter work shifts. But currently there is no sign of additional funds from public sources.