Side effect: Crisis in Greece hits mental health

by Isabel Malsang

Greece is not feeling well. One in four men, and one in three women, has endured recent bouts of depression. As the grinding economic crisis continues to batter people's nerves, suicides and psychosomatic illness are both on the increase.

In April, a 77-year-old retiree, explaining in a note that he could no longer scrape by, went to a public square in the middle of Athens and put a bullet into his brain, a shot that echoed throughout the country.

While politicians and economists argue about how to pull Greece out of the quagmire of debt that has kneecapped its economy, there can be no doubt that the crisis -- once again threatening to eject the country from the eurozone towards an unknown fate -- is taking a devastating toil on the of its people.

Compounding the emerging health care emergency is the fact that the state's ability to cope with it has been deeply eroded by the austerity measures and slashed budgets prescribed to cure the patient.

If you're going to have a nervous breakdown, in other words, Greece is not the best place to be.

"My patients are clearly much more on edge and stressed," said Dimitri, an osteopath in Athens with a varied clientele. "Their incomes are dropping. Their day-to-day relationships are fraying at the edges. Those who do have work are afraid of losing it, and show telltales signs of musculoskeletal tension."

Before the crisis really took hold, he added, half of his patients came for fine-tuning sessions, or for a minor realignment. "Now many arrive in a state of acute crisis. Their backs are blocked, or they can't even walk."

For Dimitri, there can be no doubt as to the culprit: the no-end-in-sight that has plunged Greece deep into recession, ravaged its employment statistics and gutted social services.

The human body, he says, absorbs all these shocks like a spring.

"Often my patients don't know why they are in pain or unable to move, and tell me that they didn't lift anything heavy," he said. "Then, as we chat during the session, I find out that they're afraid of losing their jobs, or that a son's or daughter's salary has been cut in half, or that they can't pay the rent."

-- No way to keep a shred of dignity --

As officials vet new austerity measures and try to stave off further downgrades by credit agencies, the measureable impact of the crisis is getting inside the heads of Greeks.

Even if new elections later this month, called after a legislative vote on May 6 failed to produce a government, reverse course and reject the EU's austerity package, Greece is surely headed for more misery before things get any easier.

The numbers over the last year are sobering.

In the first half of 2011, more than a year after the economy began its dramatic slide, suicides in Greece shot up by 40 percent compared with the previous year. Almost daily, the media reports on someone who has put an end to it all because of financial burdens.

The old man who shot himself on April 4 in the middle of Syntagma Square -- site of many impassioned demonstrations against austerity measures -- clearly blamed his plight on the crisis.

"I can't see any other way to keep a shred of dignity and end my life without rummaging through garbage bins," the man wrote in a suicide note. Sick with cancer and living alone, he accused the state of depriving him of treatment after pensions were slashed, and compared the government in power to the one installed in 1941 by Nazi occupiers.

The man's fate seemed all the more shocking in a culture in which it is widely assumed that families can and will pick up the slack when the state falls short.

However, some of these numbers need to be put into perspective. Greece, like most other southern European countries, has a significantly lower suicide rate that northern nations. In 2009, before the crisis, the rate was three people for every 100,000 inhabitants, a third lower than the European average.

But there's no denying that Greece is in the doldrums.

According to health ministry statistics, a quarter of men and a third of women are depressed, double the European average for men, and nearly double for women. Calls to mental health hotlines also increased twofold in the first six months of 2011 compared with a year earlier.

"I don't sleep anymore," said 'Petros', who -- clearly embarrassed by his situation -- asked that his name be changed.

An importer/exporter of furniture with several stores in Athens, Petros said that over the last months he had been obliged to fire many staff, a first for his family-run enterprise. "And I'm going to have to cut the salaries of the ones that are left," he said, his voice brimming with emotion.

"I really wonder how people are going to get by after this summer, when most companies will have done the same," he added with creased brow.

-- State of war --

The crisis is not only making Greeks sick, it is making it harder for them to get treatment. Austerity measures have cut the national health budget by a devastating 25 percent since 2009.

"It's a state of war," said Yorgos Kalliabetsos, head of the pathology clinic at Volos Hospital in central Greece.

Doctors' salaries have been slashed by a quarter. Security staff are no longer paid at all. Nurses have become scarce, and shortages of medical supplies frequent. "My service has to take on 45 patients with 35 beds," Kalliabetsos lamented.

Since the uninsured have been left to their own devices, many now resort to desperate strategies.

"We have more and more patients who are inventing emergencies so they can be examined because they don't have any money for a regular consultation," explained Meropi Manteou, a lung specialist at Athens' enormous Sotiria Hospital. "We somehow manage to help the poorest patients that slip through the safety net, but for how much longer?"

An increase in poverty has brought in its wake an increase in diseases of the poor, notably tuberculosis.

The mental health picture is no less catastrophic. Several major psychiatric facilities have simply been shuttered. A third of the programmes to help addicts have also been shut down, which has led to a new wave of HIV infections.

Alexis, a 46-year-old journalist, has been treated since 2006 by Okana, an association that depends on the health ministry for street drug substitutes. He waited four years to get in the programme and feels lucky. "Most people who apply are dead by the time Okana calls them," he said.

The crisis has also encouraged the spread of a new street scourge called "sisa". Made from methamphetamines, the drug is ten times cheaper than heroin, but its effects are worse: blackened skin, sores all over the body, ultra-violent behaviour.

"One user stabbed another of my patients," recalled Emilios Katsoulakos, a psychiatrist. "There's no substitute we can prescribe for sisa."

Oddly, the economic downturn does seem to have had one salubrious impact: a decline in alcoholism. But that's probably only because new taxes on liquor -- another consequence of austerity -- make drowning one's sorrows too expensive.

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