Policing and planning: Deinstitutionalization of mentally ill in Georgia

Abstract

ABSTRACT: Worldwide, 12% of total disability adjusted life years lost (DALYs) are caused by mental and behavioral disorders, which exceeds the global burden caused by cardiovascular conditions (9.7%) and malignant tumors (5.1%) (WHO, 2001). Despite the fact that mental disorders have considerable negative effects on the quality of life, low- and middle-income countries spend less than 2% of total national health care budget and large share of spending is diverted towards institutional psychiatric care. Georgia is a middle income country, where drastic reforms in the national mental health policy started from 2014. One of the key directions of those reforms was to transform post-soviet style institutional-based care into more community-based services. This paper looks at policy development process around mental health in Georgia and documents and analyses its key directions. One of the key aims of mental health reforms in Georgia was to support deinstitutionalization process. The key objectives of the strategy and policy development work to drive these reforms were to:  construct integrated chain of needs-based services  improve quality of life of mentally ill people  reduce stigma and protect human rights of mentally ill people This study concluded that the mental health policy and strategy development process in Georgia has been grounded on the best international practice and evidence. The strategic document that has been developed ensures the implementation of the deinstitutionalization process and future re-arrangement of the mental health system into a universal, flexible, equitable accessible, and sustainable model. The new model also respects the right to participate in decision-making, human dignity, nondiscrimination, transparency and accountability, and aims at promoting high standards of care and treatment and fair distribution of financial burden.