This article originally appeared on VICE Serbia
It's 9 AM and we are sitting in a spacious, well-lit living room in one of the oldest psychiatric hospitals in the Balkans. A smell of fresh coffee and a cloud of smoke take over the room, pushing away that typical hospital smell. This room, with its large windows blocked by metal bars, is the only place where smoking is allowed in the state-run Laza Lazarevic in Belgrade
"Taking cigarettes away from a psychiatric patient would burden them with additional pressure," says chief nurse Sandra Radulovic as a patient named Blondie rolls me a cigarette. He is about my age and before being admitted, he worked as a business consultant. The nickname, which has nothing to do with his real name or the way he looks, was given to him here.
The hospital was founded by Serbian duke Mihailo Obrenovic in 1861, as a " Home for Those Who Lost Their Mind." About 15 epilepsy patients were admitted that year. Nowadays, more than 33,000 people are admitted on a yearly basis. The clinic's emergency ward treats up to 7,000 patients per year, and on average 3,000 of them are hospitalized for a certain period of time.
"People usually don't know that only 1 percent of our patients are chronically ill. The remaining 99 percent come when the crisis erupts," Radulovic says.
Blondie was one of the 10 percent of patients brought in by the police. "I forgot what reality felt like," he explains and offers me black coffee in a plastic red cup. He starts rolling another cigarette. "I don't remember my first three days in here," he says, smiling. "I feel better now."
Nurse Radulovic explains that in the case of great psychomotor agitation, the patient immediately receives pharmaceutical treatment. "It's very rarely—only when it's established that the drugs don't help—that a patient will be chained to a bed. And that is not allowed to happen for longer than two hours," he goes on.
Straitjackets have not been used in this hospital since the middle of the 20th century but the stigma of mental illness has remained as strong: In the small town I grew up in, 200 miles from the capital Belgrade, anyone having spent time in "Laza" was to be avoided. There are even football chants concerning fans who've "escaped from Laza."
"Everyone in Serbia knows what Laza is about," project manager Dr. Gorica Djokic tells me. Meanwhile the clinic's manager D r. Slavica Djukic Dejanovic adds that "our collective subconscious is characterized by a fear of insanity. And we are right to be afraid, in a way—every human being can become mentally ill," she explains.
Shame or fear of discrimination is what most often leads to a majority of mental patients not getting treated in time, while experts insist that the sooner one seeks help, the more likely it is for the healing process to be successful. In Laza, patients are sent from other medical or social care institutions, or they come voluntarily when they feel the need for help.
One of the patients, Jimmy, tells me that he "always felt rather tense" before coming in. He moved to Belgrade with his wife a couple of years ago. She is in Laza for treatment, too.
"It's like you two are on your honeymoon," Blondie jokes, in a constant bid to charm everyone. Only certain tiny details make it obvious that I am talking to mental patients; wide pupils or restless hands, for example. Blondie manages to calm his hands by playing with his cigarette.
A while later, he shows me to the ward's library and I ask him what he's reading at the moment.
"Something called Love Delusions," he says.
"What's the biggest delusion," I ask.
"I would say it's being in love, isn't it?"
As we leave the ward, we pass a row of big, neat rooms taken over by rows of beds. At times, my eyes meet those peeking below the blankets and I involuntarily avert my gaze, feeling embarrassed. However, it's not before the doors of the ward lock behind us and I see the big "Lock Twice" sign on them that I remember where I am.
With an average monthly salary of £254 [$384] and the unemployment rate hitting just over 20 percent, Serbia is one of the poorest European countries. Recent studies have shown that about 45 percent of the younger population is unemployed, while the majority of 20-somethings still live with their parents.
"Because of the social tensions that we experienced in the past decades, late adolescence in Serbia has now been prolonged. We have 30-year-olds facing problems that would normally stress a 20-something. Most of the patients of that age mention unemployment and a dependence on their parents as their focal sources of stress," Dimitrijevic says.
And that is the reality that most Serbians—just like Blondie—often forget.
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