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The Leros PIKPA Asylum. Deinstitutionalisation and Rehabilitation Project

Published online by Cambridge University Press:  06 August 2018

J. Tsiantis ,
A. Perakis ,
P. Kordoutis ,
G. Kolaitis  and
V. Zacharias
J. Tsiantis*
Affiliation:
Medical School, University of Athens; Department of Psychological Paediatrics, “Aghia Sophia” Children's Hospital, Athens
A. Perakis
Affiliation:
Association for Child and Adolescent Psychosocial Health, Holargos
P. Kordoutis
Affiliation:
Department of Psychological Paediatrics, “Aghia Sophia” Children's Hospital, Athens
G. Kolaitis
Affiliation:
Department of Psychological Paediatrics, “Aghia Sophia” Children's Hospital, Athens
V. Zacharias
Affiliation:
Association for Child and Adolescent Psychosocial Health, Holargos, Greece
*
Professor John Tsiantis, Director, Department of Psychological Paediatrics, “Aghia Sophia” Children's Hospital, GR 11527 Athens, Greece
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Extract

A three-year deinstitutionalisation and rehabilitation pilot intervention project was implemented at Leros PIKPA for people with severe learning disabilities. Initial conditions at the asylum were appalling. Residents suffered severe deprivation, extreme institutionalisation, and violation of basic human rights. Intervention involved professionals from different disciplines, and involved residents, their families, care staff, the institution, and the local community. As a result, resident care and adaptive behaviour has started to improve. Communication between residents and families has increased. Owing to training and sensitisation, care staff's poor resident-management practices and negative attitudes toward disabled people have changed. Living and hygienic conditions have been upgraded and building renovation is under way. Asylum administration and the local community have been sensitised to residents' needs. Eleven residents have moved to the project's pilot community home in Athens; two others now live with foster families. The results suggest that deinstitutionalisation and rehabilitation can be successfully initiated even in residential institutions of the severest kind.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 167 , Issue S28: The Children of Leros PIKPA , July 1995 , pp. 10 - 45
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

Allen, D. (1989) The effects of deinstitutionalization on people with mental handicaps: a review. Mental Handicap Research, 2, 18–37.Google Scholar
Aman, M. G. (1987) Overview of pharmacotherapy: current status and future direction. Journal of Mental Deficiency Research, 31, 121–130.Google Scholar
Aman, M. G. & Singh, N. N. (1988) Patterns of drug use, methodological considerations, measurement techniques and future trends. In Psychopharmacology and the Developmental Disabilities (eds Aman, M. G. & Singh, N. N.), pp. 122–138. New York: Springer Verlag.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Antonak, R. F. & Livneh, H. (1991) The Measurement of Attitudes Toward People with Disabilities: Methods, Psychometrics and Scales. Springfield: Thomas.Google Scholar
Ballas, D. (1976) Relationship of institution size to quality of care: a review of literature. American Journal of Mental Deficiency, 81, 117–124.Google Scholar
Ballas, D. (ed.) (1991) Greek Psychiatric Reform. Brussels: Commission of the European Communities, Directorate General V, European Social Fund.Google Scholar
Bank-Mikkelsen, N. E. (1976) Residential services for the mentally retarded. In Changing Patterns in Residential Services for the Mentally Retarded (eds Ungel, R. & Shearer, A.), pp. 28–44. Washington, DC: DHEW.Google Scholar
Baroff, G. (1980) On “size” and the quality of residential care: a second look. Learning Disability, 80, 113–117.Google Scholar
Bassuk, E. L. & Gerson, S. (1978) Deinstitutionalization and mental health services. Scientific American, 238, 46–53.Google Scholar
Beardshaw, V. & Morgan, E. (eds) (1990) Community Care Work – Learning from the Torbay Experience . London: Mind Publications.Google Scholar
Booth, T., Booth, W. & Sinason, V. (1989) Clients and partners: the role of families in relocating people from mental handicap hospitals and hostels. British Journal of Mental Subnormality, 35, 40–49.Google Scholar
Bouras, N., Webb, Y., Clofford, P., et al (1992) A needs survey among residents in Leros asylum. British Journal of Psychiatry, 161, 75–79.Google Scholar
British Medical Journal (1993) Children's homes provide poor care. British Medical Journal, 307, 1300.Google Scholar
Browne, I., Liaropoulos, L., Lorenzen, D., et al (1984) Report of a Study into Mental Health Care in Greece. Brussels: Commission of the European Community.Google Scholar
Bullock, R. (1981) The grief relief process: coping with the life and death of physically and mentally disabled children. Orthopsychiatry and Clinical Psychiatry of North America, 12, 193–200.Google Scholar
Cooperation of European Firms, Employment Initiatives and Cooperatives for Physically Disabled (1988) Leros, Special Issue, October. Maastricht: CEFEC.Google Scholar
Clarke, A. M. & Clarke, A. D. B. (1976) Early Experience, Myth and Evidence. London: Open Books.Google Scholar
De Bruxelles, S. (1990) Island of the damned: UN is urged to intervene. Observer, 4 March.Google Scholar
Dohrenwend, B. P. (1980) Mental Illness in the United States. New York: Praeger.Google Scholar
Ekdawi, M. Y. (1987) Asylums of Leros. Psychiatric Bulletin, 11, 275.Google Scholar
Farmer, R. & Rohde, J. (1983) A register of mentally handicapped individuals using a microcomputer. Journal of Mental Deficiency Research, 27, 255–278.Google Scholar
Firth, M. & Firth, H. (1982) Mentally handicapped people with special needs. King's Fund Centre Reports, 82, 213–224.Google Scholar
Gath, A. (1992) A visit to Romania in October 1990 and to Leros in May 1991. Journal of Intellectual Disability Research, 36, 3–5.Google Scholar
Gath, A. (1994) The case of the vanishing boiler. Psychiatric Bulletin, 18, 427–428.Google Scholar
Goldberg, D. & Williams, P. (1988) A User's Guide to the General Health Questionnaire. Windsor: NFER-Nelson.Google Scholar
Greek Bank of Industrial Development, Prefecture of the Dodecanese Islands & Municipality of Leros (1989) Study on the Development of the Island of Leros, pp. 3–47 (in Greek). Athens: Greek Bank of Industrial Development.Google Scholar
Grossman, H. J. (ed.) (1983) Classification in Learning Disability. Washington, DC: American Association on Mental Deficiency.Google Scholar
Grove, R. (1991) Greece: a Greek tragedy revisited. Lancet, 338, 107–108.Google Scholar
Hallahan, D. & Kauffman, J. (1991) Exceptional children. Introduction to Special Education (5th edn). Englewood Cliffs: Prentice Hall.Google Scholar
Haughton, A. (1979) Mentally Disabled Handicapped Persons in Greece. USA Public Health Work Study. Athens: Institute of Child Health.Google Scholar
Hill, B. K., Balow, E. A. & Bruininks, R. H. (1983) A National Study of Prescribed Drugs in Institutions and Community Residential Facilities for Mentally Retarded People (Brief No. 20). Minneapolis: University of Minnesota, Department of Educational Psychology.Google Scholar
Hughes, P. S. (1977) Survey of medication in a subnormality hospital. British Journal of Mental Subnormality, 23, 88–94.Google Scholar
Intagliata, J. & Rinck, C. (1985) Psychoactive drug use in public and community residential facilities for mentally retarded persons. Psychopharmacology Bulletin, 21, 268–278.Google Scholar
International Commission of Jurists (1984) The mentally ill in Japan. International Commission of Jurists Review, 32, 15–20.Google Scholar
King, D. R., Raynes, V. N. & Tizard, J. (1971) Patterns of Residential Care. Sociological Studies in Institutions for Handicapped Children. London: Routledge and Kegan Paul.Google Scholar
Koluchova, J. (1972) Severe deprivation in twins: a case study. Journal of Child Psychology and Psychiatry, 13, 107–114.Google Scholar
Koluchova, J. (1976) The further development of twins after severe and prolonged deprivation: a second report. Journal of Child Psychology and Psychiatry, 17, 181–188.Google Scholar
Landesman, S. & Butterfield, E. C. (1987) Normalization and deinstitutionalization of mentally retarded individuals: controversy and facts. American Psychology, 42, 809–816.Google Scholar
Landesman-Dwyer, S. (1981) Living in the community. American Journal of Mental Deficiency, 86, 223–234.Google Scholar
Lax, R. (1972) Some aspects of the interaction between mother and the impaired child: mother's narcissistic trauma. International Journal of Psycho-analysis, 53, 339–344.Google Scholar
Lazerson, M. (1975) Educational institutions and mental subnormality: notes on writing a history. In The Mentally Retarded and Society: A Social Science Perspective (eds Begab, M.J. & Richardson, S. A.), pp. 33–52. Baltimore: University Park Press.Google Scholar
Liakos, A. (1990) Coordination, Management, Organisation, Education, Personnel. Regulation 815/EEC. Expert Committee Report to the Greek Ministry of Health and the EEC (in Greek). Athens: University of Ioannina.Google Scholar
Lipman, R. S. (1970) The use of psycho-pharmacological agents in residential facilities for the retarded. In Psychiatric Approaches to Mental Retardation (ed. Menolascino, F.), p. 387. New York: Basic Books.Google Scholar
MacKeith, R. (1973) The feelings and behaviour of parents of handicapped children. Developmental Medicine and Child Neurology, 15, 524–527.Google Scholar
Madianos, M. (1994) Psychiatric Reform: From Theory to Practice (in Greek). Athens: Ellinika Grammata.Google Scholar
Madianos, M. & Economou, M. (1990) Institutional care and rehabilitation in Greece: a general view and the case of Leros. In Psychiatry: A World Perspective, Vol. 4 (eds Stefanis, C. N. et al), pp. 629–634. Amsterdam: Elsevier Science.Google Scholar
Madianos, M., Yfantopoulos, J., Kaprinis, G. S., et al (1994) Decentralisation of mental health services in Greece, 1979–1982 and 1989–1992. In Topics in Preventive Psychiatry (eds Christodoulou, G. N. and Kontaxakis, V. P.), pp. 103–115. Basel: Karger.Google Scholar
Malliori, M. (1990) Organisation of mental health care delivery system: policy and planning. In Psychiatry: A World Perspective, Vol. 4 (eds Stefanis, C. N. et al), pp. 502–505. Amsterdam: Elsevier Science.Google Scholar
Manos, N. (1990) The evolution of the concept of the “community” mental health centre in Greece. In Psychiatry: A World Perspective, Vol. 4 (eds Stefanis, C. N. et al), pp. 512–515. Amsterdam: Elsevier Science.Google Scholar
Martin, J. P. (1984) Hospital in Trouble. Oxford: Blackwell.Google Scholar
Mavreas, V. G. (1987) Greece: the transition to community care. International Journal of Social Psychiatry, 33, 154–164.Google Scholar
Maynard, A. (1989) Misery of lost souls on holiday island. Health Service Journal, 99, 12–13.Google Scholar
Menolascino, F. (1990) Community issues. Current Opinion in Psychiatry, 3, 616–620.Google Scholar
Mental Health Foundation (1993) Learning Disabilities: The Fundamental Facts. London: Mental Health Foundation.Google Scholar
Merritt, J. (1989a) Europe's guilty secret. Observer, 10 September.Google Scholar
Merritt, J. (1989b) The naked and the damned. Observer, 10 September.Google Scholar
Moutzoukis, Ch, Adamopoulou, A., Garifalos, G., et al (1990) Manual of the General Health Questionnaire (in Greek). Thessaloniki: Psychiatric Hospital of Thessaloniki.Google Scholar
Munro, J. D. (1980) Epidemiology and the extent of learning disability. Psychiatric Clinics of North America, 9, 591–624.Google Scholar
Nunnally, J. & Bernstein, I. (1994) Psychometric Theory. New York: McGraw-Hill.Google Scholar
Open Mind (1987) A Greek tragedy. Open Mind 29 October, pp. 12–14.Google Scholar
Panopoulo-Maratos, O., Stangos, L., Georgas, J, et al (1988) Patterns of residential care for children in Greece. Functioning of the institution and effects on the mental health of the children. In Growing Up in an Institution (ed. Doxiades, S.), pp. 49–65. Athens: Hellenic Society of Mental Hygiene and Neuropsychiatry of the Child.Google Scholar
Quinton, D. & Rutter, M. (1983) Parenting behaviour of mothers raised in care. In Practical Lessons from Longitudinal Studies (5th edn) (ed. Nicol, A. R.), pp. 34–52. London: Wiley.Google Scholar
Ramsey, R. (1990) Banished to a Greek island. Psychiatric Bulletin, 14, 134–135.Google Scholar
Raynes, N. V. (1987) Adaptive behavior scales. In Assessment in Mental Handicap. A Guide to Assessment Practices, Tests and Checklists (eds Hogg, J. & Raynes, N. V.), pp. 81–106. London: Croom Helm.Google Scholar
Rohde, J., Farmer, R., Glover, J., et al (1989) A method of displaying assessment information about people with multiple handicaps as a disability profile. Journal of Mental Deficiency Research, 33, 45–98.Google Scholar
Rowitz, L. (1987) The American learning disability service system. Journal of Mental Deficiency Research, 31, 337–347.Google Scholar
Russell, O. (1985) Mental handicap. In Mental Handicap (eds Paykel, E. S. & Morgan, H.), pp. 112–126. Edinburgh: Churchill Livingstone.Google Scholar
Russell, O. & Menolascino, F. (1990) Learning disability. Editorial review. Current Opinion in Psychiatry, 3, 573–574.Google Scholar
Rutter, M., Quinton, D. & Liddle, C. (1983) Parenting in two generations: looking backwards and looking forwards. In Families At Risk (ed. Madge, N.), pp. 221–257. London: Heinemann Educational Books.Google Scholar
Safilios-Rothschild, C. (1970) The Sociology and Social Psychology of Disability and Rehabilitation. New York: Random House.Google Scholar
Schor, E. L., Smalky, K. A. & Neff, J. M. (1981) Primary care of previously institutionalised retarded children. Pediatrics, 67, 536–540.Google Scholar
Seligman, M. & Darling, R. (1989) Ordinary Families Special Children. A Systems Approach to Childhood Disabilities. London: Guilford Press.Google Scholar
Sinason, V. (1986) Secondary mental handicap and its relationship to trauma. Psychoanalytic Psychotherapy, 2, 131–154.Google Scholar
Sinason, V. (1992) Mental Handicap and the Human Condition. New Approaches from the Tavistock. London: Free Association Books.Google Scholar
Skuse, D. (1984a) Extreme deprivation in early childhood. I. Diverse outcomes for three siblings from an extraordinary family. Journal of Child Psychology and Psychiatry, 25, 523–541.Google Scholar
Skuse, D. (1984b) Extreme deprivation in early childhood. II. Theoretical issues and a comparative review. Journal of Child Psychology and Psychiatry, 25, 543–572.Google Scholar
Spitz, R. A. (1946) Anaclitic depression. Psychoanalytic Study of the Child, 2, 113–117.Google Scholar
Stefanis, C. N. & Madianos, M. G. (1981) Mental health care delivery system in Greece. A critical overview. Bibliotheca Psychiatrica, 160, 78–83.Google Scholar
Stefanis, C. N., Madianos, M. G., Gittelman, M. (1986) Recent developments in the care, treatment, and rehabilitation of the chronic mentally ill in Greece. Hospital and Community Psychiatry, 37, 1041–1044.Google Scholar
Stewart, J., Myers, W., Burret, R., et al (1990) A review of the pharmacotherapy of aggression in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 269–277.Google Scholar
Szymanski, L. & Crocker, A. (1989) Learning disability. In Comprehensive Textbook of Psychiatry (3rd edn) (eds Kaplan, H. I., Freedman, A. H. & Sadock, B. J.), pp. 1728–1771. Baltimore: Williams and Wilkins.Google Scholar
Totsuka, A. (1990) The history of Japanese psychiatry and the rights of mental residents. Psychiatric Bulletin, 14, 193–200.Google Scholar
Tsiantis, J. & Maratos, O. (1990) Institutional care and rehabilitation for children in Greece. In Psychiatry: A World Perspective, Vol. 4 (eds Stefanis, C. N. et al), pp. 643–649. Amsterdam: Elsevier.Google Scholar
United Nations General Assembly (1971) Declaration on the Rights of Mentally Retarded Persons, UN General Assembly Resolution 2865, XVII, 20 December. New York: UN.Google Scholar
United Nations General Assembly (1989) The Convention on the Rights of the Child, UN General Assembly Resolution XXII, 20 November. New York: UN.Google Scholar
Vorria, P. (1991) The stigmatizing effect of institutional care in Greece. Children and families with special needs: the right to hope. In ESSOP European Congress Proceedings (eds Petaridou, E. & Nakou, S.), pp. 341–346. Athens: European Society for Social Pediatrics.Google Scholar
Wolkind, S. N., Kruk, S. & Chaves, L. P. (1976) Childhood separation experiences and psychosocial status in primiparous women: preliminary findings. British Journal of Psychiatry, 128, 391–396.Google Scholar
World Health Organization (1977) Child Mental Health and Psychosocial Development. Technical Report, Series 613. Geneva: WHO.Google Scholar
Wold Health Organization, Division of Mental Health (1992) Assessment of People with Learning Disabilities. Geneva: WHO, Division of Mental Health.Google Scholar
Yfantopoulos, J. N. (1989) Social and economic policies in the mental health sector in Greece. In Costs and Effects of Managing Chronic Psychotic Patients (eds Schwefel, D., Zollner, H., Potthoff, P.). New York: Springer-Verlag.Google Scholar
Yfantopoulos, J. N. (1994) Mental health reforms in Greece. International Journal of Social Psychiatry, 44, 44–52.Google Scholar
Yuker, H. E. (1988) Attitudes Toward Persons with Disabilities. New York: Springer Verlag.Google Scholar
Zigler, E. (1973) The retarded child as a whole person. In The Experimental Psychology of Learning Disability (ed. Routh, D. K.), pp. 185–201. Chicago: Aldine.Google Scholar
Zimbardo, P., Ebbesen, E. & Maslach, C. (1977) Influencing Attitudes and Changing Behavior. Reading: Addison-Wesley.Google Scholar
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