We are requesting the closure of psychiatric hospitals because they don’t cure people but rather prolong their suffering through isolation. If someone is different this doesn’t necessarily make him or her dangerous, and it’s up to all of us to contribute to overcoming these stereotypes. It’s been a long time since the World Health Organization recommended deinstitutionalization in regards to mental health treatment. It’s now just a question of whether we want to follow world trends or not – Lepa Mladjenovic, psychologist and activist from Belgrade, told Radio Kotor during an interview. Last Friday Mladjenovic held a lecture at the Special Psychiatric Hospital in Kotor on the anti-psychiatry movement and deinstitutionalization.

She noted that there’s no reason for these hospitals to exist. “Patients are people who are suffering, they don’t need beds or to be locked up because this will most certainly not lead to their cure. Hospitals are not a place where people are cured but rather places of discrimination, they are institutions of violence – because it is violent to lock someone up. Therefore, the “white coats” aren’t here to cure people but to discriminate them. Democratic psychiatry is founded on the belief that patients are people just like us. We should treat them with respect and dignity as anyone else. People who are in psychiatric hospitals stop being subjects of their own lives, and their life simply stops when they’re locked up behind bars. There is no time in a psychiatric hospital, it just stops and every day is the same. All hospitals of this type should be closed immediately”, Mladjenovic noted. You can listen to her interview on Radio Kotor’s show “Medikament” on Friday, December 2nd at 5:15 pm.

The last time there was a public discussion on anti-psychiatry in Kotor was last year when the Dobrota hospital hosted a visit from doctors from Trieste – one of Italy’s anti-psychiatry centers where Franco Basaglia did much of his work. He is one of the biggest names in what is now a world wide movement. A psychiatrist from Trieste, Stana Stanic, on that occasion said if it were up to her she’d immediately close the psychiatric hospital in Kotor and all others in Yugoslav countries. Psychiatry circles have however been rejecting this approach. How long will vulnerable people with mental difficulties and illnesses play hostage to our indecisiveness and incompetence  to advance social support services – doctor Stanic asked, while Mladjenovic agreed. “We want a democratic society and democratic psychiatry. In a democratic society all citizens must be provided equal conditions in life. People with diagnosis of mental illness are suffering first of all. This isn’t a state brought upon them by genes, or hereditary means, or something endogenous. During the last twenty years we have learned that this suffering stems from the fact that these people had emotionally difficult situations in relation to their parents or their environment, they didn’t have strong survival mechanisms to handle said situations, and therefore they “froze”, as we refer to it. They became different from most people. People like this used to be sent to ships where all other crazy people would be, and today we send them to insane asylums. This will certainly change. Psychiatric hospitals will not exist in a 100 or 200 years”, Mladjenovic added.

She thinks that people everywhere must be made aware of this issue. “People with mental illness are no more dangerous than any one else.  In Serbia, a woman is murdered every seven days by a current or former partner – shouldn’t those people be in prison? I hear that in Kotor you have different clans, and this is a threat everyone’s security. We do not understand the mentally ill, we don’t understand their suffering and that’s why they seem dangerous to us – which they aren’t really. We need to bust this myth on how the mentally ill are dangerous. We need to re-educate psychiatrists so that they unlearn everything they read in old textbooks, and they will come to understand that these hospitals don’t offer a cure. A patient may feel better just the same as he would feel better someplace else”, noted Mladjenovic, who has for years advocated deinstitutionalization. In this regard not much has been done here. “What the World Health Organization and the European Commission recommend (based on experiences from Italy and other countries) is that we should move toward deinstitutionalization in treatment of mental illness. This is not my personal opinion but that of the leading authorities on the issue, and this isn’t something really new either – it’s been widely discussed world round. Western Europe has been working on deinstitutionalization for years now. Italian hospitals have been closed, as have Spanish. A lot of work has already been done in Belgium, the Netherlands, Scandinavian countries, but we don’t know much about this since there isn’t much talk about it”, Mladjenovic noted.

She reminded that Basaglia’s Law was adopted in Italy in 1978. In it’s first Article this law defines what it means to be a danger to oneself and to others, and it continues to treat people with mental illness as not being a danger to the community. Mladjenovic recounted her experiences in Italy where they closed psychiatric hospitals 40 years ago. “When you lock a person up you don’t really have to deal with him any more and it simplifies things. When we start opening up those doors and let these long suffering people out they will have to be greeted by people willing to talk to them, and have access to full social and medical support. I remember what I saw in this regard when I was in Trieste. They organized beach days, movie and theater outings, walks for patients. Italian people were also more accustomed to seeing different people in their communities and were more willing to help. I remember one situation when one of those different people wanted to bring a huge window into public transport. I was on the bus already and noticed that other passengers were also more than willing to step outside and help him. People were already sensitive to this issue, and those 5 minutes they spent helping him weren’t lost to them but rather time they invested in helping someone who needed help. They were accepting of the fact that these people who are emotionally different were a part of their city and none of them thought of saying “he’s a madman, throw him out, we’re late, he’s dangerous”, or any such thing. On another occasion one of them told me that he’s not comfortable with Italian and that he’d rather we speak in English. So that’s what we did. We also had activities where we’d prepare them for carnival and help them dress up as they wished, and then we’d all go to parties. These people are different, but even so that doesn’t mean they’re dangerous”, Mladjenovic explains.

When asked about what we may do individually to help things improve, Mladjenovic said that first of all everyone can take steps and confront their own prejudice. “Every one of us can do something so that a mentally ill person would feel better in their community. We can take them out, to a café, to a theater show, we can write about it. However, key decisions must be made by politicians of course. We can contribute individually to making the world a better place and overcoming prejudice. For instance, I always stop and talk to those who are different, I stop and talk to Roma women rummaging through waste bins on the street, and those who are discriminated. I talk to them, ask them how they’re doing, if they’re cold – I also do this so that others who are watching could see that even though these people are vulnerable they are still a part of our community”, Mladjenovic, a Belgrade psychologist, told us. She also added that in Serbia people in this situation are still bound and tied and treated with electric shock therapy. “When it comes to human rights violations, the situation is horrendous. We need enthusiasts both here and there – people like the Italian Basaglia who would treat people with respect and love. We need people with a vision of society where everyone would have equal rights and be treated with dignity and respect. Everyone – us, Roma women, lesbians, and people with mental illness – we all have a right to a dignified life and to community life. There are psychiatrists who are convinced in the validity of this idea and they stand for a better and more equal society, but seeing as they’re the minority they can’t steer their work as they’d want to, and so they blend into the community. Just here in Kotor several young women psychiatrists were fully supportive of what I’m doing, which is encouraging”, Mladjenovic concluded. 

The lecture on anti-psychiatry and deinstitutionalization held by Lepa Mladjenovic is part of the “Out of Isolation – Realization of Rights of Mentally Ill Patients”, conducted by the Center for Women’s and Peace Studies – ANIMA from Kotor, Action for Human Rights from Podgorica and the international organization Mental Disability Advocacy Center MDAC, with support from the European Union and Kotor Municipality.

Article published at Lepa Mlađenović: Zatvorimo bolnice koje ne liječe već ponižavaju