Do not board the Ship of Fools

"Insufficient care for people suffering from mental illness and society's ignorance about the problems of mental abnormality still result in the stigmatisation of the mentally ill."

IN HIS book Madness and Civilisation the French intellectual Michel Foucault describes the shocking way that people in the 14th century dealt with their mentally ill.

The "fools," as the Renaissance men called the unfortunate souls, were boarded on ships and entrusted to the care of the mariners on an endless sea voyage.

The "Ship of Fools" sailed the seas and canals of Europe providing entertainment in the harbours where it docked.

Many of the inmates on this floating asylum died as complete outcasts, far from the rest of their families.

True, society no longer confines the mentally ill to ships, but pressing issues of mental health in the post-communist countries have often been ignored. The psychological impact of economic and political upheaval on individuals has also been greatly overlooked or underestimated.

Insufficient care for people suffering from mental illness and society's ignorance about the problems of mental abnormality still result in the stigmatisation of the mentally ill.

Reforms and changes, no matter how successful and praiseworthy they may be, will always hurt a number of citizens who find it difficult to cope with the psychological burden of drastic change.

Massive redundancies from companies that the Mečiar-era privatisers were unable to sustain, left many Slovak people in dire circumstances. Suddenly they were jobless and marginalised, though few sought much-needed psychological help.

It was welcome news when Slovakia embraced World Mental Health Day on October 10, calling it "the day of forget-me-nots."

Thirty Slovak towns joined the initiative to draw attention to the rising number of people suffering from psychiatric problems.

World Mental Health Day was observed for the first time on 10 October 1992. It was started by the World Federation for Mental Health as an annual event to promote mental health advocacy and to educate the public on issues of mental health, human rights, ageing, mental health-related labour issues, trauma and violence in society.

Despite showing its support for the event, Slovakia has greatly fallen behind in the field of mental healthcare.

In 2001, Slovakia registered approximately 200,000 people with mental health problems. In 2002, the number of mentally ill had considerably increased.

According to data included in the Health Ministry's National Programme of Mental Health, in 1992 there were 58,119 new cases of mental illness registered, while in 2000 the number of new cases rose to 66,346; and in 2002, as many as 76,915 new cases were registered. Of this number, 70 percent of the people were of productive age, between 18 and 65.

The League for Mental Health warns that people suffering from mental illness often have suicidal tendencies and by turning the problem into a taboo often exacerbates the situation.

Although the country's economic record receives international accolades, a Eurostat survey shows Slovaks to be among the most pessimistic and gloomiest of Europeans, which makes the nation more vulnerable to suicidal tendencies.

Many Slovaks still fear prejudices and fail to seek medical help when there is an urgent need. Families often suffer too because whenever a family member refuses treatment, conditions of severe depression and schizophrenia become chronic and impact upon the entire household.

According to research carried out last year by the head of the school of psychology in Leipzig, Matthias Angermeyer, schizophrenia remains a taboo for most Slovaks.

Peter Breier of the League of Mental Health told the daily SME, that more than 76 percent of Bratislavans did not consider schizophrenia a mental illness, but a physical one.

Moreover, 15 percent of those polled thought that schizophrenia was the result of God's will.

Mental problems are the third most frequent reason behind physical disability, and five diseases of the mind are among the 10 illnesses that most burden society.

Slovakia's suicide rate is also increasing. Last year, 753 people committed suicide, which is two cases per day. However, the rising number of suicides is a growing trend in all post-communist countries. Slovakia still lies behind Hungary, which is traditionally known for its high suicide rate.

The European Committee for the Prevention of Torture and Inhuman and Degrading Treatment warned in 2000 of the serious violations of human rights in nursing homes for patients with psychiciatric problems.

The Slovak government has made an effort to remedy some of the problems.

The Slovak cabinet on October 6 approved a national plan on mental healthcare, aimed at instituting a better system to treat the mentally ill. It all appears to be a Herculean task.

The state needs to create proper conditions to expand more professional care for those mentally fragile citizens who are in desperate need of appropriate medical help. And not to view their problems as mere passing mood swings, symptomatic of an ever-changing society.

By Beata Balogová

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