Mental Health Interest Forum / Pszichiátriai Érdekvédelmi Fórum
http://www.gombosg.fw.hu/Introduction
Gabor Gombos is monitoring and protecting the rights of psychiatric patients while reforming the Hungarian mental health system. He trains consumers, survivors, and former users of psychiatric case to be democratic agents for change. He also educates doctors on patient-centered care.
The New Idea
Gabor challenges and empowers patients to play an active role in transforming social and health care for themselves and other psychiatric patients. He founded the Psychiatric Interest Forum, a three hundred-member organization designed to incubate and network consumer organizations, patient councils, and patient support groups. The Forum is building consumer (people receiving psychiatric care) organizations throughout Hungary, which mobilize patients to become active social change agents. These consumer-run groups conduct site visits at different social care facilities, document human rights violations, and publicly share their findings. Patient councils, governance bodies for social care facilities, are growing as well. There councils give patients a voice in the design, planning, and implementation of social care facilities and programs. In addition to giving a voice to people receiving psychiatric care, Gabor works to improve the lives of mentally disabled people either living in psychiatric institutions or at home. Gabor has designed the support groups to help and encourage people to live more active lives, to know and understand their civil rights, and to become involved in their communities. The support groups focus on specific problems and issues such as unemployment and preparing for family life.
The Problem
While the incidence of psychiatric illness in Hungary is high, the quality of care is low. There are approximately one hundred thousand people living with schizophrenia and another one hundred thousand battling depression. Over seven thousand of these people live in the country's fifty-three psychiatric institutions. Primarily located in small, secluded towns, these care facilities were originally created to hide the problem of psychiatric illness and have continued to go unmonitored. Therefore, patient rights have been denied in many different ways. There are reporting incidences of nonviolent patient requests gone unheard, and of the dramatic lack of psychiatric and medical staff available for patients.
The Strategy
Since 1993, Gabor has been setting up support groups for psychiatric patients to focus on specific problems and help with issues such as employment and preparation for family life. By 1999, he had established twenty groups throughout the country involving three hundred patients. Additionally, he organized the Psychiatric Interest Defense Forum, a three hundred-member organization that has gained the respect of policy-makers, secured representation in the National Healthcare Council, and is currently setting up additional centers. Through these centers, Gabor hopes to reach another thousand patients. The centers provide training programs and distribute informational materials for establishing "patient governments" in institutions. Gambor anticipates that in five years, there will be one hundred clubs in Hungary, each with approximately four hundred members. Trainers from the groups established early on will support and advise the newer clubs. Gabor will insure information exchange between clubs, through the Internet and through organized meetings and training programs.Gabor and his team introduced a training curriculum for doctors, nurses, and social workers relating to the treatment of psychiatric patients. He organized training programs for workers of institutions in the homes of patients. He has now handed over this program to volunteer patients who lead the process.
Additionally, Gabor has developed a training curriculum for institutional workers designed to raise empathy towards and understanding of psychiatric patients. To date, sixteen institutions and one hundred forty workers have participated in his training. In the next few years, he estimates that he will run his training programs for institution workers in each of the fifty-three institutions.Gabor is approaching the problem of patient rights from a policy level as well.
In 1995 Erik Rosenthal from the Washington University researched the topic of mental disability rights in Hungary. Gabor advised him to visit not only hospitals but also institutions. After Rosenthal's research was completed, Gabor organized a discussion to emphasize the importance of collaboration. Gabor thinks that psychiatric institutes should be closed down in the future, following the example of institutes for the physically disabled. But before patients would be put out in the streets or homes, well-designed preparatory programs must be outlined in advance. Gabor participated in a study trip to see American advances in psychiatric care that led to the closing down of institutes in the United States in the sixties and seventies. He began to look for partners in Hungary and abroad to create far-reaching impact. He convened Hungarian experts, organizations from Romania, and a lawyer from Poland to participate in an international movement called the Movement of Users, Ex-Users and Survivors of Psychiatric Methods.
In 1997, he was the representative of post-Communist countries in the movement and today he is the head of this organization. By 1998, with several Hungarian and foreign partners (including patients) from Slovakia, Romania, Poland, Slovenia, Czech Republic, and the United States, he organized an effort to influence state policy by building a common strategy. Gabor has already succeeded in changing certain paragraphs in the Hungarian Social Law about guardianship. Recently, the Ministry of Justice contacted Gabor to ask for his suggestions about guardianship. Gabor has invited a specialist in disability rights, who is a lawyer from the United States, to help him.
The Person
Brought up by a mother who battled severe depression, Gabor had several revealing glimpses into the Hungarian social care system at an early age. By the time he was a teenager, he had seen how electroshock therapy was stealing his mother's memory and personality. Years later, after a serious suicide attempt, his mother was put under the care of the National Institute of Psychiatry. During this time, Gabor witnessed how his mother was stigmatized, robbed of any rights, and treated inhumanely. After her death, Gabor discovered significant evidence that her passing was due to negligence of the part of the mental care system. It is this injustice that fuels Gabor's dedication to protecting the rights of psychiatric patients.