Interview with Radu Teodorescu
Radu Teodorescu Psychiatrist, trainer of cognitive behaviour therapy and rehabilitation, vice-president of the Romanian League of Mental Health.
Dr Radu Teodorescu of the Obregia Psychiatric Hospital in Bucharest is one of the twenty psychiatrists who after the transformation went to France to take extra training. The other 19 staid in France, he came back after five years.
´It has never become clear to me why the others staid in France, or why I should have staid. I have never regretted my choice to go back to Romania. Because of bad luck, of having nothing, I could start a lot of things here in Bucharest. It is very rewarding to work with young people, to see how they develop an ethical way of thinking about mental health. Ethics didn’t exist before 1990. Patients were like objects, you were the guard’.
That was the situation when he finished his studies as a psychiatrist in 1986. ´Luckily I have not had to work under that system for longer than three years’, he says. ´We were completely isolated. We didn’t know what happened in the West, we didn’t realise we were on another planet in ethical thinking. We were able to get technical information because one of the psychiatrists in the hospital in Bucharest had a brother in the United States. He sent him a DSM. We copied it 20 times; there were 20 psychiatrists in Obregia’.
´When the first psychiatrists from abroad came to Bucharest in 1990, they were surprised we were able to communicate about the biological and technical part of the profession. We shared the same ideas about medication and diagnosis. The gap was that we didn’t have any training in psychotherapy and psychosocial rehabilitation. There was no idea about community psychiatry. This still marks the difference between our world and yours’.
Psychotherapy was forbidden until 1990. ´The system considered itself as having materialistic roots,’ Teodorescu explains. Psychotherapy was seen as idealistic, so it was forbidden. Only Marx was accepted, every other philosopher was banned’.
Professor Teodorescu was one of the founding members of the Romanian League of Mental Health and has founded the Romanian association for Community Psychiatry. ´The lack of community psychiatry is still there,’ he says. ´In Bucharest, a city with 2,5 million inhabitants, we have 12 sheltered homes, supported by NGOs. In every normal country mental health care is an obligation of the state. Here we succeeded in making some sheltered homes only thanks to NGOs’.
How to realise the ideals? ´We have to put pressure on the government. The professional organisations, but also the patients and their families. There is no government in the world that easily gives money to psychiatry. Pressure is necessary. In Romania we have to start with the basics. For a patient who has no house, no income, no proper drugs, psychiatry is not sufficient. Most of the chronic patients have to live with their families. When both parents are on a retirement pension, they don’t have enough income to provide for their child’.
Do patients expect the state will pay for them? ´Yes and no. They are so used to not getting what they need. ´Maybe’, they say, ´but not in our lifetime’.
established where 40 to 50 chronic patients come every day. ´Since we spend so much time together we understand what their problems are. 20 or 25 of them come because they do not get bread anywhere else.’ Teodorescu collects clothes for his patients among his friends. ´We have to spend a lot of time on things outside our profession’.