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How many dangerous patients are treated in psychiatric hospitals – The security gaps and the lack of staff

The issues highlighted by yesterday's murder of a 44-year-old woman by another patient at "Dafni" – Why cases are not separated – What can be done to ensure the safety of both patients and staff

Newsroom February 20 09:09

The issue of securing patients who are potentially dangerous and hospitalized in psychiatric hospitals, as well as the severe lack of nursing staff in public hospitals, is brought to light by yesterday’s murder of a 44-year-old woman by another patient at the Psychiatric Hospital of Attica “Dafni.” These two problems are longstanding, and once again, the discussion is brought back to what can be done to ensure the safety of all (patients and staff) inside psychiatric hospitals and clinics.

Yesterday morning, a 47-year-old patient hospitalized in a clinic at “Dafni” under the provisions of Article 69 of the Penal Code broke the bathroom mirror and attacked a 44-year-old woman, who was hospitalized in the adjacent room and had been admitted to the psychiatric hospital just the previous day. It is worth noting that patients under Article 69 of the Penal Code are individuals who have committed criminal acts but, due to mental disorders, are exempted from criminal responsibility and placed under therapeutic measures, such as hospitalization in a psychiatric hospital.

The medical and nursing staff made every possible effort to revive the victim, who unfortunately passed away. The 47-year-old fled after the incident and was arrested yesterday afternoon. Meanwhile, an Internal Administrative Inquiry is underway at the hospital to determine the circumstances under which the incident occurred.

As reported, the 47-year-old, who has a history of another murder in the psychiatric clinic of Corfu Hospital, and was previously held in Korydallos prison before being admitted to “Dafni,” was hospitalized in a room with two other patients. The rooms at “Dafni” are triple rooms, and there is no special security for patients not only under Article 69 of the Penal Code but also for those with addictions, hyperstimulation, or severe mental illnesses who may become dangerous. Additionally, in the specific department of the Psychiatric Hospital of Attica, there were two nurses on shift for 31 patients on the night of the tragic incident.

Given these facts, it is easy to understand why patients in psychiatric hospitals are not separated based on their illness, why individuals who could become dangerous to others are not isolated, and why adequate security is not in place.

Yesterday’s incident is not the only one recorded in psychiatric hospitals. In just the past ten years, the staff at “Dafni” still remember two other tragic events. In 2015, a 30-year-old patient set a fire that cost the lives of three patients who died from asphyxiation. This patient is now hospitalized in a special room alone, but this is the exception. A few months before this incident, there was the murder of a patient by another patient, using a… spoon as the weapon.

As reported, 41 patients at “Dafni” are hospitalized under the provisions of Article 69 of the Penal Code, 16 of whom are in shelters outside the hospital. According to data from the Panhellenic Federation of Employees of Public Hospitals (POEDIN), approximately 200 patients are being treated in psychiatric hospitals and psychiatric departments of general hospitals across the country under the same provision. However, employees explain that it is not just some of these specific patients who are dangerous, but also others with various psychiatric problems as well as substance users.

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In addition to the lack of separation between wards – only the Psychiatric Hospital in Thessaloniki has a special department for patients who could become dangerous – there is a need for specialized security personnel, according to employees of psychiatric hospitals. At “Dafni,” there is security at the entrance, meaning that in the wards and corridors, only the medical and nursing staff of the hospital are present. In foreign countries, the treatment of mentally ill patients is much more advanced, with even special buttons for emergency situations.

The relevant law regarding the hospitalization of individuals who have committed criminal acts stipulates that their special department of hospitalization should be part of a public psychiatric or general hospital, “with a small number of beds and appropriate infrastructure and equipment to meet the needs of the individuals being treated. It provides specialized services with increased care and security, for which a numerically increased and clinically specially trained staff is required.”

A major problem in psychiatric hospitals and clinics, where the heterogeneity of cases is vast, is the lack of nursing staff. Based on international standards, one nurse is required for every five patients. In Greek psychiatric hospitals and psychiatric clinics, one or two nurses are responsible for 30 or even 40 patients, unable to provide adequate care. It is emphasized that the recent law on Psychiatric Reform does not truly address any of these problems, as its provisions mainly concern administrative changes.

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