Whether it’s patients suffering from mental illness in the ’90s or the current refugee crisis – the same social stigmas apply
Two stories from two different time periods, seemingly unrelated to each other, point to the timelessness of deep-rooted fears towards ‘the other’ which generate scapegoats and reflect people’s worst reactions and behaviors.
February 1991. Thanassis, 62, Kostas, 53, and two other fellow residents from Evia, all formerly incarcerated in what was called a “national disgrace,” − the Leros State Medical Center (formerly known as the Leros Psychiatric Facility) − arrive in Avlida, a small coastal town a few kilometers away from Halkida. There, in Avlida, where the legendary sacrifice of Iphigenia by her father Agamemnon took place, a new framework for psychosocial and community service is inaugurated. A home for the rehabilitation of psychiatric patients, part of the implementation of the reintegration/rehabilitation program, which had been launched a few years prior with the contribution of the then European Community. The infamous “deinstitutionalization” or post-discharge care of psychiatric patients.
January 2020. Hundreds of refugees and immigrants are transferred to a camp in Ritsona in an effort to reduce the overcrowding at the reception centers on the Aegean Islands. Since March 2016, more than 1,800 people have been at Ritsona, an industrial area ten kilometers from the nearest town, Halkida, and only five kilometers from Avlida. The same place, where, 30 years ago Kostas had imagined would be the place which would grant him his own freedom.
What can the story of 82-year-old Kostas, (Thanasis has passed away) have in common with the story of refugees and immigrants in Ritsona − two events that are almost three decades apart? How does the Leros State Medical Center and the rehabilitation home in Avlida (operated by The Association for Regional Development and Mental Health – EPAPSY) connect to the Moria Reception Center on Lesvos and the Ritsona Reception Center?
What is the commonality between the violence present in mainstream psychiatry, as expressed on the southeastern Aegean island, the struggle to empower former psychiatric patients and the refugee crisis? Research on the historical background, documents, photographs, news reports and testimonies point to what we probably already know: the social stigma.
A few days before Christmas 2019, organizations and residents of the Avlida community planned a rally on the bridge of Halkida to protest the resettlement of another 1,200 refugees at the Ritsona Reception Center.
The organizers of the rally strongly argued that there is no racist motive behind their mobilization. Halkida’s mayor and city councilors were present at the rally, along with a few dozen citizens, as well as officials from Golden Dawn (neo-Nazi political party). As reported on Golden Dawn’s official website the issue is about “the resettlement of illegal immigrants and an operation that aims to replace the local population with Islamist foreigners”.
In addition, the local newspaper in Evia with the largest circulation, the Evian Opinion, should be reviewed for its racist and xenophobic tone. In a news report published on January 10, it uses the phrase “cheerful invasion” to describe the resettlement of refugees.
Months earlier, a modern-day witch hunt had already begun. At a city council meeting of the city of Halkida, the deputy mayor of Avlida, spoke about the refugee issue, demanding “a fence of suitable height and durability around the facility, surrounded by a ring road, which will be lit and monitored 24 hours a day, either by private security or by the police.” A city councilor, noticeably annoyed, replied ironically to the deputy mayor adding, “and add some ovens too, like Auschwitz had.”
Going back further still, 30 years ago, Kostas, Thanasis and the other residents of the rehabilitation home faced similar reactions. Outraged people in the community, with the support of two city council members, organized rallies, referring to the home as “being built under the cover of night” and claimed “we are not racists, the area is inappropriate for these facilities”.
At the time, Mr Stylianidis the president of EPAPSY and a psychiatrist, had spoken of “displays of social racism and the exclusion of our fellow citizens, which stigmatize the region and its residents, the majority of which view the efforts favorably and with compassion.”
A typical example which illustrates the climate of the time is an article which was published on April 16, 1991 in the national newspaper Eleftherotypia, entitled “They should be saved, but elsewhere”. In addition, the front page of the local newspaper Panevoiko Vima, aroused fear of clashes between two opposing sides. Those who “view the issue of mental illness with empathy” and those who believe “that their beautiful village with bright prospects for tourism development will most likely deteriorate in the future.”
As for the bright future in tourism development, which never came, the home for psychiatric patients was considered the main culprit by the locals who opposed it. Likewise, according to locals who participated in the recent mobilizations, the refugees and immigrants residing in Ritsona today are responsible for burglaries in the fields and stables, the problem of garbage disposal, the alleged increase in crime and the overall deterioration of the area.
The story of the rehabilitation home in 1991
In preparation for the operation of the rehabilitation home on the beach in Avlida in 1991, a team of mental health professionals working on Leros was established. Another team, assisted by the scarce staff of the Mental Health Center of Halkida General Hospital, was working on finding an appropriate building, equipment, and informing the community.
Nikos Gionakis, a clinical psychologist, was a member of the first team. Currently he is the director of the Babel Day Center, a mental health unit for refugees and immigrants. He recounts: “On February 19, 1991, we left Leros, escorting four people from Evia, who had been confined for a long period of time at the Leros State Medical Center. We escorted them to a new living space, a rehabilitation home. Its total capacity could not exceed ten people. Of course, things never go as planned. This is what happened in our case. So we reached the point where the team working on the island could accompany the first people to the home, but the appropriate building hadn’t been found yet. They had looked for a place and owners had been contacted but as soon as they were told of its use, they refused − despite the fact that the rent which was offered was much higher than the average for the area.”
According to Mr. Gionakis, finally, and with the help of a member of the team working in Halkida, they found a contractor who was willing to lease two buildings that he owned along Avlida Beach. The great thing was that he didn’t care about the reactions and he seemed to be more interested in rent being paid on time. Mr. Gionakis states, “We arrived at the home with the first four people, all men, averaging about 65 years old. After we settled in, the community president was informed of our presence. We had bad luck on our side, because right next to our home, there was a summer house owned by a family and they reacted to anything that happened. So they roused the entire area. What followed would take hours to describe. It was a many-sided issue, however, and can be approached from many different angles: political, social, psychological, anthropological.”
The similarities to today’s situation
The similarities between the two stories are described by Panagiotis Hondros, president of the Board of Directors of EPAPSY and director of the rehabilitation home where Kostas (now free of psychotic symptoms), currently lives along with ten other residents. “I would point out that at the old psychiatric hospital of Leros – currently refugees are living in tents there and once again it has provided ‘shelter’ to boatloads of marginalized people. Again, ‘the other’, who may not resemble us, scares us.”
He commented that in interventions that take place from time to time in the Local Government and Regional Health Authority, he has sometimes been confronted with alarming reasoning which uses carefully crafted phrases and myths as narration, such as: “We want to take care of all of them, regardless of their race, but among them there are jihadists and we must protect our children. There are millions of them, they consume the country’s resources, they have no needs, it is their choice, etc.”
It is their goal to turn, what is fundamentally a political issue into something else, concludes Mr Hondros. What makes an impression, as Mr. Gionakis adds, is the fact that it’s the experts, the investigators who are most biased: “We’ve see so many doctors, nurses, psychologists, professionals in the field ranting against the ‘crazy people’ – saying ‘we know them, we’re the ones who work with them’.”
The history of the Psychiatric Facility of Leros
In 1965, the Psychiatric Facility of Leros, a symbol of institutional psychiatry, which opened in 1958 with a 650 bed-capacity, was renamed the Psychiatric Hospital of Leros and its capacity increased to 2,650 beds.
A key criterion for a patient to be transferred to Leros was whether or not they had a relationship with their families. A patient was never asked if he wanted to leave or not. Those who had not received a visit from a family member in at least a year were categorized as “the unwanted” and were the first candidates for transportation.
“Most patients faced their journey to the unknown with a passive reaction. They were loaded into military vehicles, and from Skaramanga (a deserted location) they boarded ferries to Leros,” says Theodoros Megaloikonomou in his book Leros, a living contestment to classical psychiatry. For many of them, their identification numbers were lost during the journey and when they arrived on Leros, they became people with no information, no past and no future.
There, social isolation and chronic illness lead to institutionalization, the complete breakdown of social skills, the obliteration of self and needs. Reduced to a state of severe mental illness, defenseless, weak, unresponsive – they roamed, some of them naked, in miserable living conditions, incarcerated. The state and society had already ensured their social death – they only thing left for them to do was await their physical death.
Local residents of Leros hired as nursing and auxiliary staff used hoses to bathe the patients, who, without the existence of a real framework for medical treatment suitable for their needs, were categorized as cases with “no capacity for improvement”.
Kostas survived in this environment from 1965 to 1991, until he found “refuge” at EPAPSY’s rehabilitation home in Avlida. At first, as documented reports from the staff at the home reveal, he had difficulty adjusting. Today Kostas can and does travel to the nearby town of Halkida, to go to a cafe, have a social life and participate in various group activities outside the home.
Going back to the early 1980’s, the level of barbarism which existed at the time, caused strong condemnations in Greece and abroad. “This led to the 1982 ban on transfers to Leros. In the mid-1980s Greece was forced by the European Community and by Funding Regulation 815/84 to improve the conditions of care and change the system of psychiatric care.”
“It is worth pointing out that as early as 1988, there were systematic condemnations in the press regarding the conditions on Leros, which culminated with the publication of an article in the UK’s The Observer in 1989,” recalls Mr. Gionakis.
The story of the Ritsona camp
It is the night of March 14, 2016, when about 500 refugees are transferred from the port of Piraeus to an abandoned Air Force base in the industrial area of Ritsona. In complete isolation from the community, what some call a “hospitality center” was set up. The day before, bulldozers had deforested the area, haphazardly clearing pine trees and leveling the ground, rushing to “plant” tents that would house the refugees.
In the coming days and as more and more refugees arrived at the camp, which has no sewage system or a water supply, chaos unfolded. Hundreds of people, mostly families from Iraq and Syria, crowded in front of a container, used as a storeroom, to receive basic necessities: diapers, wash basins, biscuits, toiletries. An old building on the former base was transformed into a storeroom for clothing, while another was used as a mosque. Volunteers from Halkida and the surrounding areas, the only contact from the outside world, attempted to set up a city from scratch.
It was still winter, and the constant rain turned the camp into an endless mud puddle. Refugees kept themselves warm by burning wood in barrels and dense smog began to blanket the area.
A few months later, in November, the tents were replaced with prefabricated, container houses with a bathroom and kitchen, making conditions just barely tolerable. “Reception centers like this one, have allowed our country to maintain its own national dignity and to provide refugees and migrants with their own dignity to the extent that it can, given the serious financial crisis we are experiencing,” stated Yiannis Mouzalas, Minister of Migration Policy at the time.
Instead of an epilogue
In a country like Greece (where lawmakers treat immigration like a historical accident or a crime), since 2000 the Hellenic League for Human Rights has stressed that there is a growing number of voices which demand that boats arriving on the Greek islands from Turkey should be sunk.
Those who are trapped in our country as a result of fortress-like European policies are not only forced to live under conditions which violate human dignity, but they also must deal with social exclusion and being stigmatized. In 1991, people who suffered from mental illness were forced to experience the same exclusion.
We asked Mr. Gionakis to comment on the connection that may exist between these two stories, and he said:
From 1991 to 2019 we had many cases where citizens reacted against everything. Two incidents are typical examples: First, in 1996 when we decided to move the home and the residents to Halkida, I visited the mayor at that time, to let him know. The city already had a Mental Health Center which had been in operation since 1992. We had created a workplace integration unit, and we generally did a lot of things and we were well known and relatively accepted. Reactions against the home in Avlida had long subsided. But when I informed the mayor of our intention to go forward with our plans for the home, he said ‘are you serious? All hell will break loose! People even had negative reactions when I tried to put up a basketball net on an empty lot so kids would have a place to play!’
Secondly, at that time, there was an association which provided support to children with neoplastic diseases, and they decided to create a home for children with cancer (and their families) who traveled to Athens from the provinces for treatment and could not cover the cost of accommodation. They had found a building somewhere in Gyzi or in Goudi, I don’t remember now, and the neighborhood protested against the initiative.
Their arguments were interesting… ‘We’ll see those poor bald kids and get we’ll get depressed, they’ll add more cars to the neighborhood and occupy the few parking spaces available, they’ll use their air conditioners too much and this will change the microclimate in the area’ and other such imaginative comments.
Thus, the connection to current times can be found in a foundation characterized by people who react automatically, collectively and without reflection. It’s the fear of change, even if it is positive change, the lack of trust in institutions and professionals, the refusal to budge even one step and view something from a perspective that’s different than the one stuck in their heads, the inconsistency and discontinuity of those who promote these policies and promote mixed messages that drive people crazy. It is not ignorance, because anyone who wants to learn can, especially today when there are many and varied sources of information.
Currently, the same narrative is being reproduced as it always was, only the protagonists change: sometimes it’s the gypsies, other times it’s the crazy people, junkies, illegal immigrants, the Albanians, the spear-fishermen, or the environmentalists (who release snakes and wolves into the mountains), etc.
In conclusion, we asked Mr. Gionakis how this narrative is shaped. He replied:
Prime Minister Mitsotakis comes out and says, here, we’re not dealing with refugees (because “refugees”− who are injured, vulnerable, victims − equal “good”), instead we are dealing with “immigrants” (who mean something “bad” because they are after our jobs). Georgiadis (Minister of Development) comes out and proclaims that our identity is in danger (my, how fragile is our Greek identity, with its history that goes back many millennia?!) Voridis (Minister of Agricultural Development) says that we are under attack by illegals.
At the same time, then they say we should relieve the overcrowding on the islands, because those who are there are causing problems, not because the overcrowded conditions violate basic human rights. Let’s transfer them and distribute them across different regions in Greece. So, what’s the message here? Let’s multiply the problem, not solve it. Who wants a problem in their back yard?
In 1991 they said that because of the ‘four crazy people’ in the rehabilitation home, their physical safety is in jeopardy, they’re in danger of contracting various diseases, that junkies will break into the home to steal the drugs (which we’ll be prescribing by the handfuls), that their property value will go down significantly, that their children will also go crazy, etc.
I think they’re saying the same thing now. In his book, A Scarecrow’s Autobiography, the French psychiatrist and clinical ethologist Boris Cyrulnik writes that after a crisis, the easiest way for a person, a group, a society to regain a (lost) sense of integrity is to invent a scapegoat, onto which the causes of all suffering are projected.
That’s how we functioned then (1991), that’s how we still function now (2020), that’s how we’ve always functioned.