Abstract
Mental illness affects one in four people at some point in their lives, and the incidence is increasing. Yet institutions are still responsible for preventing mentally ill people from having integrated lives in the community. Existing planning legislation might contribute to this. A potential mechanism is the requirement for non-residential use of land for mental health accommodation and the consequent characterisation of accommodation as ‘special buildings’. However, change in mental health accommodation planning and licensing legislation could be more enabling for people’s social integration. This paper explores the planning legislation of Greece, a country with an extensive network of community-based mental health facilities, the consequences of planning legislation for the actual integration of its mentally ill people and how alterations to the change of use legislation for accommodation for mental health affected the national integration outcome. The research was top-down, led by the European Commission and the Ministry of Health. The sample comprised 112 out of 116 community-based facilities. The research highlighted those elements in the existing planning legislation that favoured segregated institutions. The uses of land framework promoted the development of mental health accommodation in buildings designed for other purposes (industrial, logistics or offices) or in segregated areas. The research identified planning legislation as a key disabler of social inclusion. Then, alternatives were tested, including the redefinition of uses – a change that initially generated functional complications. The condition of altering uses alone proved inadequate, so new design guidelines were introduced to act as quality control mechanisms – a set of fit-for-purpose guidelines incorporated into national legislation.
Highlights
According to the WHO, in Europe almost 20 per cent of the burden of disease relates to mental illness, which affects one in four people at some point in their lives
This paper explores the planning legislation of Greece, a country with an extensive network of community-based mental health facilities, the consequences of planning legislation for the actual integration of its mentally ill people and how alterations to the change of use legislation for accommodation for mental health affected the national integration outcome
The fact that mental illness is treated in closed spaces, even if they are small in scale, often segregated from urban grid institutions, is contradictory to advances in social psychiatry
Summary
According to the WHO, in Europe almost 20 per cent of the burden of disease relates to mental illness, which affects one in four people at some point in their lives. The fact that mental illness is treated in closed spaces, even if they are small in scale, often segregated from urban grid institutions, is contradictory to advances in social psychiatry. These started to happen as early as 1932, with the establishment of what are called day hospitals.[4] Soon after the war, the Foyer Elan Retrouve was developed in Paris by Sivadon, and in the US the Movement for Mental Health in the Community was formed, laying the ground for deinstitutionalisation.[5] Since the WHO6 has directed that mentally ill people should primarily be treated as close to their home as possible, with hospital admission being the last resort
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