The Situation of Patients' Rights in Lithuanian Psychiatric Hospitals
(A View From Users Perspective)

Monika Nemanyte
Club 13&Co.

   My name is Monika. I represent the Club 13&Co.
My own experience with psychiatry began 1996. This year I have graduated from Vilnius Pedagogical University and got a French-English teacher qualification. After my first psychotic episode I was still capable to work as translator and interpreter during three years. But a second psychosis has almost ruined my life. I have lost my job and ability to continue my studies for master's degree.
I was diagnosed as suffering from schizoaffective disorder. I wasn't satisfied with a way I was treated in outpatient clinic. My psychiatrist almost didn't talk to me and never asked about my daily life. Later I understood that my psychiatrist belongs to the category of "barman-psychiatrist" (proposed by famous community and social psychiatrist Bernadetto Saraceno). He sees a passing parade of patients coming in and out of his office, listens for some minutes before prescribing from a list of drugs, without explaining anything or saying only superficial phrases, like a barman.
However, I must be thankful to my destiny for lucky circumstances, that I joined a patients' organization and got a mental illness not in Soviet times but in time of essential mental health reforms.
The first time I heard about the Club 13&Co. was a small announcement in the premises of the Writher's Union. The Club 13&Co. had organized there an art exhibition and presentation of the first poetry book of mental patients.
Since the year 2000, I became a member and a volunteer of the Club 13&Co. My organisation became an invaluable guide and supporter towards my recovery. It helped me very much to regain my confidence and offered many opportunities to satisfy my intellectual, spiritual, cultural and social needs.
Since I joined the Club, I engaged myself in different activities. I started to participate at several learning courses, training seminars, workshops, conferences, forums, campaigns, fairs, excursions, rehabilitation camps, art exhibitions in Lithuania and abroad. I can say I made a certain career in my organization: a year later I was elected as an editorial board member in "The Club 13&Co. News". In 2002 I was elected into the Board. I can say I was struggling, growing and developing together with my organization.
I have started as an ordinary member and working on a voluntary basis, now I am a paid employee as a Board secretary and advocacy project assistant. I could tell almost the same story about other active and motivated members of our Club.
The only beginning of the Club was the creation of the group where people after the hospital could find friendship, support and the same will to escape from the illness. In the first stage, the organization was established to meet only the needs of its members and directed mostly against "turning doors" phenomenon. Now, after 13 years of activities our main goal is the advocacy of all mental patients in whole Lithuania.
The results of our activities are presented in the following tables.

Table 1.
History of the Advocacy in Club 13&Co.:
* Autumn, 2002 - Advocacy workgroup established and announced in the Club's magazine The Club 13&Co. News.
* 2003 - the project Advocacy for Mental Patients started.
* 2003 - the column for advocacy issues presented in The Club 13&Co. News
* 2003 - leaflet about the activities of the Advocacy group published and spread.
* June, 2004 - unprecedented investigation on violation of patients' rights in Lithuanian mental health institutions, performed by the patients themselves, started.
* 2004 - information about the investigation announced in the mass-media and internet.
* 2005-2006 - investigation is continued.

In 2004 Club 13&Co. started an unprecedented investigation on violation of patients' rights in Lithuanian mental health institutions (psychiatric hospitals and mental care homes), performed by the patients themselves. The questionnaire consisted of 21 questions. The questionnaires were prepared by the coordinator of the project, a professional lawyer and the user of mental services. The members of the workgroup introduce themselves to be the same psychiatric patients having been hospitalized, but being of the better condition at the moment. During the investigation more than 500 adult mental patients were questioned. The primary survey has shown that mentally disabled people are more open to the surveying patients (members of the Advocacy group) than they may be to other people.

Table 2.
Patients questionned in:

The administratiopn of two psychiatric hospitals in Kaunas district refused of our investigations.

Table 3.

The results of the investigation implemented in the Republican Vilnius Psychiatric hospital (RVPH) were presented in the 9th Conference of HPH held in RVPH and in all hospitals in 10th Conference of HPH held in Palanga, Lithuania.
The outcomes of the investigation were reported to the administration of all the hospitals and published in the magazines Psychiatry News and Club 13 & Co. News.
We continue the further investigations of violation of patients' rights in mental care homes and have already investigated two of them.

Conclusions
* Patients' situation in Lithuanian psychiatric hospitals is not bad, but still not satisfactory.
* Research on violation of patients' rights in hospitals, performed by the patients themselves, enhances to evaluate the situation in the most impartial way.
* Patients' activities may improve quality of services provided by medical institutions.
* It may be presumed, these institutions which patients advocacy group was not let in, may hide some patients' rights violations.
* It is worth to involve patients in the administration (or treatment) boards of hospitals.
* It is necessary to put more efforts in human rights education of junior staff.
* To turn attention of professionals to pay more human attention to patients, especially informing them.

The presentation was read on the 2nd November, 2006, at 9th GAMIAN-Europe Annual Convention in Blankenberge, Belgium