In Eastern Europe, Lives Languish in Mental Facilities

PRAVDA, Bulgaria — The name of this isolated spot in the lush Danube plains means justice or, in Russian, truth.

But little of either seems to have penetrated the home for men with mental disabilities and illnesses here, a bleak establishment reached most easily by a bone-jarring, six-hour ride from Sofia, the capital.

In the Communist era, this is where authorities hid the mentally ill from public view. Today, the Pravda Social Care Home for Men with Mental Disorders, a small complex of scrappy, two-story buildings, is still a favored destination for city folk to send away relatives with a mental illness or disability — and not worry about hearing from them again, employees and residents here say.

Across Central and Eastern Europe, many people with mental illnesses or disabilities are sequestered without rights or recourse under Communist-era rules that put their fates in the hands of legal guardians, often regardless of the severity of their disabilities, according to human rights groups.

In the tumult of the two decades since free markets and imperfect democracy took hold in Eastern Europe, the laws governing guardianship have largely remained intact, stripping hundreds of thousands of people of the authority to make the most basic decisions about their lives, even when they may be capable of looking after themselves, advocates say.

A study of guardianship in eight former Communist countries completed last year by the Mental Disability Advocacy Center in Budapest found jaillike regimens for patients with a wide range of mental disabilities, with one million adults in the region subject to “significant, arbitrary and automatic” violations of their human rights.

Throughout Eastern Europe, legally appointed guardians decide where their wards live, how to spend their money, how to use their property and sometimes even whom they can befriend or be intimate with. Often, guardians use their powers to send their wards to large state institutions forever.

Beyond that, the laws here in Bulgaria and across the region often fail to ensure any oversight of guardians who assume control of their wards’ property or bank accounts, the center found.

“We call it civil death,” said Victoria Lee, a lawyer at the advocacy center. “Once you are under guardianship, that’s it. You basically become a nonperson. These guardianship systems have no safeguards.”

Since the law assumes that guardians act in the best interest of their wards, there are no legal mechanisms to prevent guardians from neglecting their responsibilities or seeking financial gain. While the directors of social care institutions are required by Bulgarian law to submit yearly audits of their wards’ finances, the fine for failing to do so is about 14 cents.

Scattered legislation that sometimes contravenes international law, unclear standards for when guardians are warranted and a lack of due process in some countries in Eastern Europe mean that it is fairly easy for a relative to convince a judge that someone with a mental illness or disability should be placed under guardianship — simply because he or she wants control over assets, advocates say.

“It’s not for riches,” said Aneta Genova, a lawyer from the Bulgarian Helsinki Committee, an international human rights group representing several wards at Pravda. “It’s usually for little things, like using a room in an apartment, or renting or selling a property.”

Defenders of guardianship say the legal system is there to protect and care for people with mental disabilities, who may be helpless on their own.

But compared with the protections in most Western countries, guardianship systems in Central and Eastern Europe make few provisions for individual needs. Instead, they offer a black and white approach — full guardianship or nothing at all — to people along a wide spectrum of mental disabilities, advocates say.

Some countries are trying to change the system. In Hungary, Parliament is considering legislation to introduce so-called supporters, who would help mentally ill or disabled adults understand their situation and make their own decisions.

With guardianship, however, “it’s easy to get in, but almost impossible to get out,” said Oliver Lewis, executive director of the Mental Disability Advocacy Center.

Legal appeals to remove guardianship and restore legal capacity can lead to “Kafka-like” situations, Mr. Lewis said, because in many countries in Eastern Europe the procedures require the consent of the guardian. “Often the guardians don’t want the people to appeal, because it is in their financial interest to have the person remain under their guardianship,” Mr. Lewis said.

The director of the Pravda home, Beyti Hussein, testifies to the abandonment and helplessness of the residents.

Mr. Hussein said a typical story was one about identical twin brothers, Kiril and Metodi Mitsev, 46, who have schizophrenia and came to Pravda in 2000. Their brother Julian, appointed their guardian by a court, has never visited. And because his permission is required for the twins to travel, they are not allowed to leave the area except on field trips led by the home.

According to documents kept by the home, the brothers own shares in two buildings and land in Kyustendil, southwest of Sofia, as well as an apartment in Sofia. Yet their only income is about $30 per year from their elderly father’s pension.

“I can’t say why he doesn’t come,” Metodi Mitsev said of Julian. The twins do not even have his phone number.

“These people are resigned to their fate,” said Stoyanka Dimitrova, a social worker at the home. “There is no one to protect them and no one to show them how to claim what is rightfully theirs.”

Metodi Mitsev does the talking for the brothers. His gregariousness balances Kiril’s introversion. “If we were closer to Sofia it would be easier to visit our father, and we could find a lawyer,” Metodi Mitsev said. Their father is too old to make the long trip to Pravda, he said. Changing homes would require the consent of their guardian.

“A lot of years have gone by,” he said, staring off into the plains surrounding the home. “We are far away from the city and miss civilization. We have no girlfriends here. I miss taking getaways.”

http://www.nytimes.com/imagepages/2009/01/05/world/05bulgaria01.ready.html