the shortest possible time to contribute to deinstitutionalising the process and developing communitybased, family-type services in mental healthcare to contribute to the integration of the beneficiaries.
It is necessary to elaborate a plan for setting up shelters based on the estimated number of potential
beneficiaries. Determining the number of persons to be discharged and referred to community-based
services will enable determining the required financial resources.235
5.9.
PSYCHOSOCIAL REHABILITATION
The monitoring conducted in psychiatric facilities showed that the volume of psychosocial
rehabilitation236 is still extremely limited and the existing interventions are fragmented and are not
tailored to needs. Conversations with patients indicate the formal nature of these interventions; family
members are not involved in the process of the resocialisation of patients.
Against the background of staff shortage237 and under-qualified238 personnel, which is further
aggravated by hard working conditions and low remuneration, the management of mental disorders in
the facilities is still based on pharmacotherapy exclusively; the bio-psycho-social approach is not
implemented. There are no multi-disciplinary teams in psychiatric establishments (for instance, in the
Surami Psychiatric Clinic and the Bediani Psychiatric Clinic of LTD Mental Health Centre of Eastern
Georgia and the Senaki Inter-District Psycho-Neurological Clinic) that would assess the individual needs
of beneficiaries, elaborate individual plans and ensure their implementation. According to patients, they
are not occupied with any worthwhile activities during the day.239
It is problematic how inpatient support persons are appointed in psychiatric clinics and how their social
packages are managed. For instance, the head of the clinic is the support person for 9 patients placed
235
It should be borne in mind that when those long-term patients are discharged, the financial resources allocated
for their long-term inpatient treatment will be released and it will be possible to use these resources as patient’s
social benefits. In its turn, this can facilitate the families to assume the role of a social supporter and, whenever
families fail to do so, the existing financial resources can be spent on providing a shelter (it is the assessment of
the Public Defender that the shelter component should be considered as a community service).
236
Mainly occupational therapy and art therapy.
237 During the visit to the Bediani Psychiatric Clinic on 26-28 September 2018, the position of a social worker was
vacant. During the visit to the Academician B. Naneishvili National Centre for Mental Health on 6-7 March 2018,
the position of a psychologist was also vacant.
238 For instance, during the visit to the Bediani Psychiatric Clinic on 26-28 September 2018, it was established
that the professional qualification of a social worker employed in the Bediani Psychiatric Clinic did not comply
with the requirements of Article 42.1.c) of the Law of Georgia on Social Work. In particular, the employed social
worker did not have a bachelor’s degree, master’s degree/equivalent of master’s degree or doctorate in the field
of social work or a certificate of a social worker as stipulated by law.
239 No sport competitions or recreational activities are organised and psychical activity is not encouraged. Cultural
activities are rare and only organised during important holidays. Only some patients participate in these events.
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