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Pandemic in Greece seems effectively manageable in comparison with our neighbors, Spanish and Italians. The particularity of the Greek situation is relating to the fact that the current health crisis has coincided with the symbolic end of a long term crisis starting in 2010 and lasting more than in any other European country. In fact we are coping with a crisis within a
crisis as well as with a number of “new” inequalities on the top of other previously witnessed.
I would like to share with you some narratives of mental health service users amidst crisis, some observations of sociological perspective in relation to the responses towards restrictive measures and finally, lacks of the public healthcare system that are dramatically emphasized during Covid-19 times.
Narratives:
20 year old, mental health service user:
“Doctor, I feel like we are in a huge psychiatric hospital all together. When I was first admitted I knew about when I will get out. Now I know nothing about when we will all get out”.
40 year old mental health service user with a history of hypochondriasis:
“I get my temperature about 70 to 80 times per day and because of the spastic cough I have, because of my anxiety that I will be infected, I also observed some blood in the sputum. Immediately I thought I had lung cancer and that I will die during the pandemic without my relatives close”.
40 year old mental health service user with chronic dysthymic disorder:
“I think I am better than ever. Everyone is locked in their homes so I do not feel like I miss something from my life as I had been experiencing during the whole previous time. I am a bit ashamed to share it with you but I would like what we experience to last more”.
42 year old doctor, intensive care specialist, in the first line of the ICU:
“In the past I had been discussing during psychotherapy about death anxiety as a matter of existential nature. What I am experiencing now is that I might die any moment, without anyone close to me in my last hours, just like a patient of mine passed away two days again suffering from agonizing dyspnea. I administered morphine to better facilitate his passing away”.
These exerpts delineate in many levels how this health crisis impacts our mental state: We are hanging on the lips of infectious disease specialists and on the same time we are all co-experiencing two major ethical dilemmas:
– The anxiety of triage of patients if at some point the ICU beds are insufficient.
– The decision to lift the restriction measures with whatever consequences might come with it.
Such is disaster and war medicine without being in an actual war.
Observing our fellow citizens: The context of restrictions is common for each one of us. In a “sunbathed” country like Greece, how agonizing it can be to stay home and not enjoy spring, the sea and the colorful sunset. Nevertheless, social inequalities within quarantine are strongly evident. It’s not the same to be a refugee in a camp in Lesvos, an “illegal” migrant in Athens, a homeless person or with substance abuse seeking for her or his “fix”, a member of a large family living in 40 square meters in a downgraded place. It’s different to live in the expensive north suburbs or south suburbs of Athens, with a garden, a pool and trees around you or even the sea.
It might even sound appealing the motto that the virus does not discriminate against, while there are strong discriminations in diagnosis, care and isolation conditions. It looks like the needs of the people who have a chronic mental illness, the burden of their families are completely out of the picture, downplayed in terms of importance compared to the catalytic power of emergency, which during these times means dealing with the pandemic. I wonder, can support through web platforms and applications substitute a warm look, a touch, the caring that is expressed through the whole of our body?
We are all learning in this unfamiliar condition of negotiation with virtual reality. The “in” and “out” seems to be confused.
However, there are social behaviors that are emerging in our everyday life that are worth mentioning:
– In our everyday walk that takes place after getting permission for “physical exercise” we are experiencing kindness and “complicity” (a common experience of guilt). People greet each other and smile like the climbers when they meet fellow travellers sharing a hard path. We
understand each other within a common matrix. Like we are discovering our common and fundamental humanity, to be related with others.
– Cohabitants in the same block of flats, younger taking care of their elderly neighbors, shopping for them and gently knocking on their door to ask if they are in need of something.
– But also dark sides of this: situations of “ratting” on the other, when someone calls the authorities for an isolated swimmer or cyclist. Others are warning for “suspicious” gatherings beyond two people or for groups of youngsters meeting at square. The unconscious jealousy for the temporary joy of the other seems to legitimize “ratting” in the shape of upholding the
law.
– In some cases following the life of others becomes an obsession and is facilitated by public urge and motivation to protect public health.
Crisis of the public health care system: Pandemic makes us measure up as institutions and as society in a dramatic way, having an understanding of deficits and weaknesses of the national healthcare system but also to revise the neoliberal obsessions about lack of funding provision and shrinking such a system.
Lacks of diagnostic tests, staff and beds in the ICU, protective health equipment, effective organization and quality of services, destabilization of the primary health care which should have been functioning as an effective filter before hospital admissions are brought to the surface through solid complaints of hospital doctors. Giving them the award through the
ceremonial night applause on Sunday cannot substitute the long term structural weaknesses of the system, their cuts on wages, their professional burnout which can only be reduced through providing necessary means to cope with everyday clinical and therapeutic burden.
Public mental health services should have a triple role:
Α. To respond to urgent requests from patients and their families affected by the virus.
B. The continuity of care for people with chronic psychiatric needs.
C. The psychological support and empowerment of the first line healthcare staff.
After ten years of financial crisis it can be easily understood that we are far from such a necessary multiple level support. Pandemic does not only make us question our lives at an individual level, our social reality but it also radically puts into question the cohesion of the common European house itself. The continuity of inactivity, blaming our fate and being suspicious, the submission of leaderships to the interests of the financial elite can this time prove to be fatal.
Stelios Stylianidis
