Policy context and impetus for the reform
Based on the 10-year National Action Plan for Mental Health (2021–2030) introduced in March 2023 by the Ministry of Health containing policies and interventions for the promotion, protection and enhancement of mental health for the population, Law 5129/2024 for the “Completion of the psychiatric reform” was passed in July 2024. The aim of the new law is to reform the structure and governance of Greece’s mental health institutions, therapy centres and drug and alcohol rehabilitation programmes.
Content of the reform
The three main changes introduced are:
a) The establishment of a legal entity of private law under the name “National Network of Mental Health Services”, which attempts to unify into a single network all the mental health units of the National Health System (NHS) and private psychiatric clinics, together with NGOs.
The National Network of Mental Health Services is structured into Regional Networks of Mental Health Services, operating in the Directorates of Health Regions. These Regional Networks are managed by the Deputy Governor of the relevant Health Region, which is responsible for mental health issues.
(b) The establishment of a legal entity of private law under the name “National Organization for the Prevention and Treatment of Addictions”, to which all the organizations, units and addiction programmes in the country will belong. The National Organization will have its headquarters in Athens.
(c) The establishment of a Register of Mental Health Units of legal entities under private law.
Reactions to the reform
The legislation has caused controversy and protests from unions and people working in public health services. One of the main objections is that the measures contained in the Law do not directly address the chronic underfunding and understaffing of public mental health and psychiatric services delivered by the NHS. The other concern is over potential moves towards privatization.
Media reports highlight that according to the Pan-Hellenic Federation of Professionals in Public Hospitals the reform “will serve to further dismantle the already crippled public mental health care system by abolishing and centralizing existing local units, which will lead to the privatization of services” and to non-profit organizations undertaking some service in an ineffective way (Tovima, 2024; The National Herald, 2024).
The Federation’s response reflects strong objections to putting all NHS mental health units under the jurisdiction of the relevant Regional Health Authority, under a single Directorate covering medical, nursing and mental health services. In theory, this kind of centralization would allow the Deputy Governors of the Health Regions (who are appointed by the Minister of Health) to close public units in order to give space to private providers. A further concern is that the intention of the new law is to give more space to NGOs and private clinics by channelling funding from the EU Recovery and Resilience Fund to them (Health Daily, 2024).