Changing Psychiatry or Changing Society? The Motion for the Rights of the “Mentally Ill” in Greece, 1980-1990

Abstract In 1980, the first formal association of mental patients, their relatives, and mental health professionals was founded in Athens, Greece. The Motion for the Rights of the “Mentally Ill” proposed a total restructuring of mental health care and a novel conceptualization of mental illness. On the one hand, it demanded that the mental health system be based on open services, psychotherapy, and on patients’ active participation in all decisions concerning their treatment and life. On the other hand, it conceptualized mental illness as a political issue that concerned all. Thus, the Motion viewed the promotion of the rights of the mentally ill as part of a broader project of cultivating conscious, active, and collective citizenship. This paper traces the Motion’s history during the 1980s, showing that it was shaped by both the socio-political conditions of Greece in the post-dictatorship period, a time of intense politicization, and by the legacy of mental patient activism in the Western world during the 1970s and 1980s. It argues that, although the Motion had a limited long-term impact, it represented the mental patient movement in Greece as it furthered the latter’s main features, most importantly its twofold endeavor to change not only the mental health system and the attitudes towards mental illness, but also society.

collective sentiment" or "social forms" (groups or collectivities) that voice grievances and demand or resist change, 1 and that have some degree of organization and continuity in space, time and activity, 2 and a "durable culture." 3 As this paper will argue, the Motion did not manage to have this kind of long-lasting impact since it was a small and relatively isolated organization, one of the just two mental patient organizations in 1980s Greece. However, it can be argued that in its unique way, the Motion represented the MPM in Greece, as it introduced to the country a new approach to mental health, viewing it as a political issue and asking for broader social change. Within this context, the history of the Motion highlights important aspects of the MPM in the Western world, contributing to our understanding of the latter's origins, ideas, activities, and legacy. 4 In order to place the Motion within the context of the MPM in the Western world, I start by proposing an outline of the MPM, based mostly on the more researched cases of northern America and Britain. This general account concentrates on how the movement emerged within and was shaped by the critiques and innovations in mental health after the Second World War, and the broader social and cultural changes of the time. In the second part of the paper I turn to Greece, and explore when, how, and why the MPM developed there. I consider the post-war mental health reforms and sociopolitical situation, paying special attention to the period after the fall of the dictatorship (1974) -a relatively new field in Greek historiography. 5 Finally, I focus on the Motion to analyze its discourses and practices, and explore how these fit in, and can further elucidate, the history of the MPM. I chose to study the first decade of the Motion's history primarily on the basis of the rich material provided by its magazine, Freedom Is Therapeutic, published from 1982 to 1993. The magazine, which "echoed the concerns, climate and activities of both the Motion and the surrounding atmosphere," 6 along with discussions and interviews with former members, provides the main sources of this section and an entry point to the views and experiences of the Motion's participants. 7 THE MENTAL PATIENT MOVEMENT: AN OUTLINE The MPM developed in the later part of the twentieth century, though earlier and with a greater intensity in some countries, such as the USA, the Netherlands and the UK, than in others, such as France, Spain and Greece. 8 It centered around the protection of patients' rights and most of all the right to have control over their treatment and lives. Although this paper concentrates on the first decades of the MPM, the 1970s and 1980s, it is important to note the mental health and social background that were crucial to its development, most notably the transformations of mental health care since the 1950s, and the counterculture and new social movements of the long 1960s. 9 After the Second World War, fascism's devastating realities reinforced the discourse of human rights, and brought isolation, separation, and torture under attack. Wellestablished psychiatric practices were now subjected to mounting criticism. In different 6  , 5-7. These initiatives, however, were isolated before the 1970s, when the MPM gained momentum. 9 The long 1960s cover the period from the late 1950s to the mid-1970s. Arthur Marwick, The Sixties: Cultural Revolution in Britain, France, Italy, and the United States, c.1958-c.1974 (Oxford: Oxford University Press, 1998). New social movements have been defined as those that center less on social class and the means and organization of production and more on a common identity, including personal and cultural aspects of life, which they turn to political and public issues. The term is usually used for the civil rights, women's liberation, and gay rights movements, but the distinction between old and new social movements has been contested. Alain Touraine, "An Introduction to the Study of Social Movements," Social Research Counterculture is also an ambiguous term, which, for the purposes of this research, is understood as "an ongoing project of self-conscious cultural producers who tried to build more autonomy into their lives and who did so with a sense that they were working not as lone practitioners. . ., but as part of a collective experiment in community building." David Farber, "Building the Counterculture, Creating Right Livelihoods: The Counterculture at Work," The Sixties 6 (2013): 1-24, 3.
countries, asylums, the main locus of psychiatry, were compared to concentration camps, and their violent and dehumanizing features were exposed, while nonpsychiatric theoretical analyses brought out the repressive and social control perspective of psychiatric institutions. 10 In some countries, non-patient advocates organized to give legal advice to patients and help them to secure their rights regarding hospital commitment and treatment. 11 These discourses and practices were reinforced within the zeitgeist of the long 1960s. The counterculture and the social movements, including the civil rights, student, feminist, and gay rights movements, that strove for social liberalization and helped in consciousness raising, facilitated patients in evoking their identity and rights as human beings and citizens, thus giving a strong push to the MPM, as to other patient movements. 12 Asylum-based psychiatric practice was also criticized by mental health professionals, who from the late 1940s to the 1970s developed a number of alternative theories and practices that played an important role in the rise of the MPM: the therapeutic community, institutional psychotherapy, democratic psychiatry, antipsychiatry, and radical therapy. 13 These models were applied in different geographical and temporal contexts and in diverse ways, and had a series of differences among them, with democratic psychiatry, antipsychiatry, and radical therapy being more radical and politicized, incorporating a critique of social institutions. However, they all conceptualized a new patient role that was more active and responsible, and a new type of patient-professional relationship that was more open and equal. 14 Certainly, the calls for a more humane and democratic psychiatric practice and the introduction of new treatments, such as group psychotherapies, did not abolish the authoritative character of psychiatry, but they helped render patient-staff relationships less rigid and hierarchical, and fostered in patients new expectations of their treatment and rights, mobilizing them to speak for themselves and demand changes. As out-patient services increased in many countries since the 1960s within the context of mental health care reforms, patients found new potential for freedom, association, and peer support. The latter proved much needed in the course of deinstitutionalization, as patients faced difficult conditions outside hospitals and struggled with stigma, poverty, and homelessness. 15 The MPM was part of the activism of the 1970s, and sometimes even used tactics of the social movements of the time, such as demonstrations and sit-ins. Even if many groups were not directly interested in social revolution, the early MPM was politicized, as it viewed mental patients as an oppressed minority, and placed freedom in the foreground. Influenced by radical psychiatric thinking, it understood madness not as an illness but rather as an alternative state of being or a result of social conditions and oppression, while psychiatry was a harmful, repressive institution. The MPM strove to empower patients and secure their freedom of choice and the right to refuse treatment; it challenged established social and professional attitudes towards mental illness and countered negative perceptions of the mentally ill in the media. It established alternative, patient-run services, and fought to abolish involuntary hospitalization and forced treatment, especially psychosurgery and electro-convulsive therapy. 16 Peer support and communication were important aims of the MPM, promoted not only by drop-in centers and self-help groups but also by magazines, most notably the Madness Network News in the USA, informal international contacts, and formal conferences, such as the National (later International) Conference on Human Rights and Psychiatric Oppression in the USA from 1973 to 1985. 17 Asylums: Franco Basaglia and the Revolution in Mental Health Care (London: Verso, 2015); Ois ın Wall, The British Anti-Psychiatrists: From Institutional Psychiatry to the Counter-Culture, 1960-1971 (London: Routledge, 2018); Dunst, "'All the Fits That's News to Print.'" The term antipsychiatry was introduced by David Cooper, one of the protagonists of the movement, but was refuted by others, most notably by R.D. Laing, while it is rejected by some scholars today. However, the term has been established to describe a series of radical critiques and alternative practices between the mid-1960s and mid-1970s. For a comparison of antipsychiatry with institutional therapy and democratic psychiatry see, Catherine While the early MPM can be seen as one of the emancipatory movements of the long 1960s, in the 1980s its calls for broader social change faded, and a more moderate version of it appeared, sometimes called the consumer or user movement. This development was connected to the decline of counterculture and activism, the ebb of radical psychiatry, and the return of biological psychiatry. The consumer movement also reflected changes in mental health systems, some of which had addressed a number of the key grievances of radical psychiatry and the early MPM movement concerning involuntary treatment and patients' rights and self-representation. The consumer version of the MPM was less critical towards the medical model of mental illness and biological psychiatry, seeing it as one of the patient-consumer's choices in treatment, and did not discuss the issues of power, hierarchy, and coercion. Since they were less radical, consumer organizations were more easily included in decision making in health care, could collaborate with mental health professionals, and received government funding. 18 The radical segment of the MPM, often called the survivor movement, persisted but became less prominent. It still focused on psychiatric abuse and repression, and interpreted consumers' cooperation with professionals and officials as co-optation. Despite the early involvement of mental health professionals -mainly radical ones -in the MPM, since the mid-1970s patients were hesitant or downright opposed to the involvement of non-patients, placing emphasis on self-determination and asserting that their experiences provided expertise. Although in the 1980s some survivor groups included professionals as allies or members, they did so to a lesser extent than consumer organizations, which argued that the cooperation with professionals was necessary for the improvement of the mental health system. Therefore, throughout its history, the MPM has been characterized by ambiguities and tensions regarding the involvement of professionals, which also translated to ambiguities and tensions regarding the meaning of patients' freedom and autonomy. If mental health care was a stable system, shaped and dominated by professionals, could patients really be free and responsible to choose how to live and be treated? Such ambiguities notwithstanding, the discourse of the MPM, both in its consumer and survivor versions, agreed on the incapacitating effects of institutionalization, and the value of choice, knowledge, self-determination, and selfadvocacy, with goals to offer peer support, establish self-help alternatives, and promote recovery. Most importantly, it endorsed a new conception of patients, from isolated individuals to empowered citizens, members of a collective, who shared an identity and articulated their demands. 19 stronger. http://enusp.org/who-we-are/; http://www.wnusp.net/index.php/history-of-the-world-network-of-users-and-survivors-of-psychiatry.html. A DIFFERENT STORY: THE MPM IN GREECE This outline of the MPM's course in the 1970s and 1980s is based on the cases of North America and Britain, which have been studied more extensively. In other countries, such as Greece, the MPM has been less researched, and it has been considered as slower to develop and less dynamic. 20 Certainly, the conditions that led to the development of the MPM in other countries, namely the critiques and reforms of psychiatry from both outside and inside the mental health field, and the counterculture and social movements, were almost non-existent in Greece before the mid-1970s.
Regarding mental health care reforms, most patients were confined in asylums under inhuman conditions until the 1980s. 21 A few islands of reform developed since the late 1940s and mainly in the 1960s and 1970s, when some mental hospitals and new extra-mural services introduced the therapeutic community, and initiated patients' clubs, meetings, and elections. 22 Staff members, usually younger psychiatrists, psychologists, and social workers, attempted through psychotherapy and social methods based on communication to mobilize patients and help them socialize and gain initiative and responsibility. These reforms were not radical or politicized; they did not challenge psychiatry in toto, or society. The reforms did not aim at patients' liberation from psychiatric power and social oppression, but rather focused on their adjustment to society. Nevertheless, the reforms followed a different path from the established and authoritative psychiatry, and in the long run, they had an effect on the patients' and professionals' mentalities and attitudes, paving the way for a more radical approach to the rights of patients at the end of the 1970s. 23  Rights of the "Mentally Ill" were patients and professionals of one of the new services established in the early 1970s, the day care unit of the Center for Mental Health and Research in Athens. They became frustrated by the "arbitrary interventions" of the administration to the relationships between therapists and patients, when in October 1979 the director of the unit was transferred to another city. 24 Despite the mobilization of patients and staff, the decision was not recalled and the director quit. The result was the foundation of the Motion, as well as of a new extra-mural service, the Open Psychotherapy Centre, which as we will see, was closely connected to the Motion. 25 The case of the Motion thus corroborates that patient mobilization was cultivated in new extra-mural services, where more democratic patients-staff relationships, and new forms of treatment such as group psychotherapy, increased the expectations of the patients and enabled them to organize themselves and voice new demands. At the end of the 1970s, the social and political conditions were ripe for such demands. In the previous decades, the post-civil-war (1946-1949) "sickly democracy" 26 and the following military dictatorship (1967-1974) did not leave much space for counterculture and new social movements. Although these had become known in the last years of the dictatorship, and demands for social liberalization were expressed, activism concentrated primarily on political rights and democratization. 27 Things changed after the establishment of democracy in 1974, which inaugurated a period of open expression and intense mass politicization, with strong demands for social emancipation and against discriminations and the violation of human rights. 28 The Communist Party was legalized, political dissidents returned from exile and prisons, and the new constitution in 1975 introduced safeguards for the human dignity and the free development of personality. 29 At the same time, in the early post-dictatorship years psychiatrist, Marios Markidis, who noted that Lyketsos was not an anti-psychiatrist, but similarly to them he had the ability to go out of the common cynical mind of the "down to earth," domineering psychiatrists. Georgios Lyketsos, demands for radical social change and liberation were strengthened, as grassroots political activity exploded and movements close to the new social movements -feminist, homosexual, ecological -developed. 30 The movements of people with physical disabilities became stronger and politicized, promoting a different concept of disability as active and empowered, and of social rehabilitation as a matter of rights and a result of struggle. 31 In 1981, the formation of government by the socialist party, PASOK, which defined itself as a social movement for the non-privileged, and the full accession of Greece to the European Economic Community gave impetus to the process of democratization and social change with a set of social and economic measures, including policies of income redistribution, the institution of the National Health System, the reform of family law, and the redefinition of the legal position of women. By the end of the 1980s, Greek society had changed. Higher education, national health insurance, and employment in the public sector became accessible to a larger part of the population, and the stigmatization and marginalization of the Left ended. The middle classes were enlarged and social coherence improved. 32 At this time of politicization, democratization, and concern about human rights, the inhumane and repressive character of psychiatric practice stood out. In this sense, the end of the dictatorship in Greece was an analogous historical moment to the end of the Second World War and the onset of the long 1960s in other countries: it triggered unprecedented criticism of psychiatry and induced mental health reforms. 33 34 The hideous conditions in the public mental hospitals, most of all of Leros, were exposed. Asylum scandals occasionally aroused the public and state's interest in mental health care, further radicalized professionals, and mobilized the system's reform as had happened in other countries. 35 With or without the support of the European Economic Community, new mental health programs and services were inaugurated, including in their aims the increase of citizens' participation in mental health care and patients' empowerment with group psychotherapy, therapeutic communities, patients' committees, and cooperatives. 36 Within this context, it was not unexpected that the first two patient organizations, the Motion and the Association against Prejudice towards Mental Disorder (Continuity), were closely connected with such new mental health initiatives, namely the Open Psychotherapy Center and the professional preparation programs of the university clinic in Athens, respectively. 37 Mental health critiques and reforms of the late 1970s and early 1980s had a radical and political dimension. 38 Their protagonists, usually young, left-wing professionals who had studied abroad, viewed psychiatry as a locus for social intervention, and drew a parallel between the exclusion of the mentally ill and that of the communists, which had stopped only recently. 39 They were influenced by radical psychiatric thinking, 40 mainly by democratic psychiatry, which since the 1980s seemed particularly attractive to progressive Greek mental health professionals, and provided a model for deinstitutionalization based on the effort to restore the subjectivity and freedom of patients. 41 The stress on the political, social, and ideological dimensions of psychiatry found a receptive audience among left-wing professionals, as well as the mentally ill and the politicized public of the post-dictatorship period. However, already by the early 1980s skepticism was expressed about the extreme appropriation of radical psychiatry. Even those who acknowledged the subjective nature of psychiatric diagnosis and treatment, the relationship of psychiatry with the state and the pharmaceutical industry, and the violations of patients' rights, disapproved of the "pseudo-intellectuals" with their "contestation verbalisms," 42 which ignored the patients' pain and need of treatment, and were therefore useless or harmful to them. 43 The eclectic adoption of a mildly radical psychiatry was criticized by more radical thinkers as a trick of mainstream psychiatry to increase its power. 44 However, it can be understood within the recession of radical psychiatry and activism in the 1980s in many countries, including Greece, where calls for social change were turning more moderate, and radical psychiatric critiques became less popular after the socialist party came to power in 1981. 45 Since the late 1980s, psychiatric reform lost its political character and the orientation to social change, and it became more preoccupied with the technical and administrative aspects of the mental health system than with challenging its authoritative philosophy. 46 Nevertheless, as the psychiatric reform progressed during the 1990s and 2000s, the issues of rights and selfrepresentation of the mentally ill came to the foreground, with more opportunities for patients to speak and be heard. The MPM in the country was strengthened, as new patient organizations were formed and created links with international networks. While patients' rights and participation were far from secured, by the 2000s it was recognized that progress had been made. 47 The Motion for the Rights of the "Mentally Ill" -Demanding a Different Mental Health System Back in the late 1970s and early 1980s, when mental patients' rights and selfadvocacy were just starting to be discussed, many professionals still considered that the condition of patients, especially of "chronic psychotics," did not allow them to form associations, promote their rights, or ask for the best treatment for them. 48 The Motion was founded, among other reasons, to react to this view and to the zero involvement of patients in the decisions and policies that concerned them. 49 Indicatively, in the early 1980s, during the discussions about the National Health System law, which included mental health, the Motion remonstrated that even the socialist government handed the issue to expert committees, 50 and asked, "those who are directly interested -namely the 'mentally ill' -who are eaten alive by the psychiatric system, should they not be asked finally and participate" in the reform of the law, instead of just psychiatrists, legal professionals and other scientists? 51 The right to participate in decision and policy making would guarantee the other rights of the mentally ill: to exist as equal citizens and independent personalities, live as they freely and consciously chose, have access to occupational rehabilitation and work, 46  and decide if they were ill and if and how they would be treated. 52 The Motion reported cases of rights violations, and tried to intervene by providing legal and medical advice to patients and by informing their relatives. While these efforts were not too frequent, and often not successful, the Motion demanded a complete dynamic transformation of the mental health system. It had to become less medical-centered, asylums had to close, and new legislation, not grounded on the notion of dangerousness, was needed. Further, the training of psychiatrists had to improve and the dominance of medication, which was used not for therapy but for repression, and served the profits of the pharmaceutical companies and psychiatrists, had to stop. Finally, involuntary treatment, any kind of confinement and restraint, and violent methods such as ECT had to be abolished. 53 The reforms implemented during the 1980s did not satisfy the Motion, who saw them as simple bed increases and building renovation, while institutionalization, confinement, and repression were perpetuated. It criticized the law of 1983 for introducing only minor changes to the psychiatric legislation of the dictatorship, and for discriminating against the mentally ill, not protecting their rights, and depriving them of the control over their treatment. 54

DISSEMINATING "ANOTHER TRUTH ON PSYCHIATRIC ISSUES"
For the Motion, the existing mental health system, with its involuntary and violent "treatments," but also the media, with their overstatements on the dangerousness of the mentally ill, criminalized mental illness and propagated ignorance and stigma. 55 The Motion aimed at changing professional and lay approaches to mental illness through dissemination and publicization activities, such as interviews in magazines and newspapers, radio broadcasts, presentations or interventions in professional conferences, and public events. Most notably, in 1984 and 1985 the Motion organized two public events in two neighborhoods of Athens, and in 1983 and 1984 participated in the festival Avgis-Thouriou, a yearly political and cultural event organized since 1975 by the Eurocommunist youth organization of Rigas Ferraios, which was affiliated with the Communist Party of Greece of the Interior. 56 Various organizations, including the gay rights movement organization AKOE, were taking part in the festival, a fact that brings out the openness of the Communist Party of Greece of the Interior toward social movements. The Motion's participation in the festival offers a hint of its political inclination to the Left and particularly to the New Left. This political orientation went hand in hand with the Motion's agenda on human rights and broader social change, with the emphasis, as we will see, on active citizenship and pluralism.
An important communication vehicle was the Motion's magazine, Freedom Is Therapeutic, with ten issues from 1982 to 1993. The magazine presented the Motion's views and activities, included information on different treatments and mental health systems, and published reviews of books, magazines and films, poems and prose, anonymous or eponymous, Greek and translated, humorous texts and caricatures. The magazine's foremost function was to further the Motion's aim to break the silence and make the voices of the mentally ill heard, which was a first step for their selfdetermination and inclusion in all decisions that concerned them. To this end, the Motion asked readers to write about their experiences and complaints. Still, especially in the first issues, many articles were anonymous, which can be interpreted as a sign of collective redaction, but also as an indication of the authors' reluctance to reveal their names because of the stigma and the "internalized censorship and repression." 57 In total, the Motion strove to show "another truth on psychiatric issues" as issues that concerned everyone, since mental illness was seen not a fixed or objective category. As the quotation marks in the phrase "Mentally Ill" in the title of the Motion implied, mental illness was viewed less as a disease and more as a label that the family, society, and state used for those who were different from the statistical norms, including homosexuals, drug addicts, anarchists, activists, the voluntarily unemployed, or simply those with an independent behavior. 58 The Motion located the root of the problem in society and its institutions. It argued, in an anti-psychiatric vain, that modern society exterminated joy, desire, imagination, and laziness, thus making people crazy, and along with 56  the family, turned its most vulnerable members into scapegoats. 59 "In a society that is ill, we are all possible 'patients,'" claimed the Motion, 60 similarly to patient organizations in other countries. 61 "Tomorrow, our brother or us" could be inmates of the psychiatric hospital of Leros, and thus it was necessary for everyone to stop being indifferent and fight, wrote a member of the Motion in 1983. 62 Psychiatry was regarded more as part of, rather than solution to, the problem. Along with the media, it assisted the family, society, and the state in safeguarding normality, excluding and humiliating those who did not fit in. Psychiatrists substituted for policemen, and mental hospitalsfrom public asylums to private clinics -served not the patients but their families, communities, and the state, and exterminated the inmates' individuality, personality, imagination, even physical existence. Moreover, mental health sciences were constantly expanding their control, in a process of "psychiatrization" of everyday life, which was part of the "everyday fascism" against those who were different. 63

COMBINING RADICAL AND MODERATE APPROACHES
The above discourse incorporated many elements of radical thinking about psychiatry, while the Motion's magazine featured texts of and about Thomas Szasz, R. D. Laing, Michel Foucault, F elix Guattari, the German Socialist Patients Collective, and democratic psychiatry. Some of these elements were being discussed in other alternative mental health agents, such as reformed services, but certainly not in the majority of mainstream mental health institutions. Thus the Motion was in the vanguard of radical thinking about mental health care in 1980s-Greece. In particular, though democratic psychiatry was not without shortcomings, its impressive results in the neighboring country exercised the strongest and most lasting influence on the Motion. 64 Indicatively, a catch phrase of the Motion and the title of its magazine came from the slogan of democratic psychiatry, "freedom is therapeutic." 65 The radical elements of the Motion were particularly potent in the early 1980s, a time of "night meetings, endless conversations, a feeling of revolution and contestation, punch to the eye of authority." 66 However, even at this time the Motion's radicalism was combined with a more moderate discourse, which became stronger in the later part of the 1980s, even though the Motion remained highly critical of the repressive social and political functions of psychiatry. Within the context of the national and international decline of radical psychiatric thinking during the 1980s, the Motion never negated the existence of mental illness, and it disapproved of "strange views," such as that were no mental problems but only organic brain disturbances, that mental illness was caused by capitalist society, or that it could/should not be treated. 67 On the contrary, it accepted mental health professional approaches, even medication, as long as they were applied in a humane and individualized way, based on social psychiatry and psychotherapy, and undertaken in extramural services with the individual's free will. 68 The interweaving of heterogenous influences and perceptions, which led to a rather eclectic and ambivalent outlook, was also reflected in the relationship between the Motion and mental health professionals. The latter were among the founding members of the Motion, and continued being members and presidents, playing an important part in representing it in public and writing in its magazine. Although they participated in equal numbers with non-professionals, they constituted a more stable segment of the Motion, and were the ones to encourage patients and relatives to join, even more so at times when the number of non-professionals decreased. 69 This involvement of professionals might seem as contradictory to the Motion's position against the "passivitization and submission" of the patients, and for their liberation "from the constant and exclusive guidance of experts," in order to take their fate into their hands. 70 The Motion was particularly critical towards psychiatrists in positions of authority, such as university professors and public hospitals directors, who were deemed 65 In addition, in the 1990s the Motion used "Freedom Is Therapeutic" as its name, as it was thought that the term "mentally ill" in the original appellation did not sound well. Natasa Karapostoli  accountable for the repressive and violent mental health system in Greece. 71 The Motion often reproached even professionals who initiated new types of community and social psychiatry services for not taking a stance against the violation of human rights and the use of psychiatry as a tool of discipline and control. 72 The Motion's ambivalent stance towards professionals was to a degree balanced out by the fact that its professionals were not part of the academic or public psychiatric establishment, but rather alternative professionals, usually young psychiatrists and in many cases psychologists, occupational therapists, psychotherapists, and social workers. Most of them were working in the Open Psychotherapy Center, where also most of the patient members were or had been under treatment. 73 Indeed, the Center can be seen as the major enlisting structure for the Motion. The two institutions, although distinct, were closely allied. They had, as noted above, a common beginning, and they also had common views regarding stigma, the rights of the mentally ill, and the restructuring of the patient organization to function without the support of a professional structure. 76 Cooperation with professionals seems to have been the only means to build a MPM in Greece, and the international context reinforced this tendency, as the MPM's radicalism and separatism (the exclusion of professionals from patient organizations) was receding.
The ambivalence towards professionals was, as already mentioned, a universal aspect of the MPM. In the case of the Motion, another point of ambiguity related to its contacts with foreign mental health organizations. By exchanging information and ideas with both radical and moderate foreign organizations, and drawing material from their publications, 77 the Motion was endeavoring to belong to and get support from an international network, regardless of its precise orientation. Probably sensing the unifying elements of the different segments of the MPM that I underlined in the first section of this paper, the Motion stressed the importance of the awareness that the problem of mental illness was common for all humans and that, all over the world, people thought and fought as the Motion did in Greece. 78 Eventually, as the Motion's moderate side became more prominent and as more opportunities for international networking were given within a moderate framework, the Motion participated in the First European Conference of Users of Mental Health in the Netherlands in 1991. The conference was sponsored by the European Economic Community, the World Federation of Mental Health, and the Dutch Ministry of Health, hosted organizations from nineteen countries, and led to the establishment of a European network, which in 1998 became the European Network for (ex)-Users and Survivors of Psychiatry. 79

BEING POLITICAL
Even if the Motion combined moderate with radical perceptions and demands, it approached mental illness and its handling in a radically new way: as political. 80 Inspired by democratic psychiatry and the idea that all psychiatric practices establish a 76 According to a retrospective of the other patient organization founded in the 1980s, the Association Against Prejudice on Mental Disorder (Continuity), this organization had been criticized for being less challenging and demanding because professionals supported it. However, this support was deemed essential for the continuation of the Association's work for twenty five years. Pqajsij e1 edt alxrg1 rsg joixij g pokisij g. political relationship between the patient and society, 81 the Motion presented itself as the first politicized activity of the mentally ill, 82 and as "a movement of social contestation." 83 Founded by patients, mental health professionals, and other people "interested in the social and political aspect of the issue mental health," it viewed the lack of concern about the constant violation of the rights of the mentally ill as a sign of weakened political consciousness. 84 It asserted, "To the extent to which we don't have full consciousness of the 'therapy' process that they impose on us, and we don't actively react against it, we are politically dead." 85 Moreover, since anyone was a potential victim of stigmatization and repression with the help of psychiatry, particularly as everyday life was becoming more "psychiatrized," the fight for self-determination had to be collective. In other words, a broader, politicized anti-asylum movement was necessary. It would be based on those subjected to the consequences of the asylum, namely patients and nurses, and it would be framed by wider social and political forces who wanted social change. 86 The specific situation in Greece in the 1980s -especially the early 1980s -was the necessary background that shaped and allowed to emerge this new understanding of mental illness and health care. The cultivation of conscious, active, and collective citizenship was important during the post-dictatorship period, if the rise of authoritarianism in the future was to be prevented. What was more, as was the case for several progressive and radical voices of the time, the Motion did not regard the end of the dictatorship as the end of political and social repression. 87 It denounced "the authority's violence against the autonomous development and self-determination of the personality" and called for the continuation of the struggle that students had begun in 1973, which it interpreted as a fight not only against political authoritarianism but also more generally for social liberation. 88 It denounced not only psychiatric but also police violence, extensive in the late 1970s and early 1980s, especially in Exarchia, the neighborhood of Athens where the Motion's office was located, and a key area for anarchist and autonomist groups. 89 Worrying that police violence could easily expand to more and more citizens, the Motion was solidary to all "minorities," from anarchists and prisoners to homosexuals and drug addicts, as they all fought for their rights and against their stigmatization, criminalization, humiliation, and persecution. 90 Within this context, the Motion published in every issue of Freedom Is Therapeutic an open call to all interested to attend its weekly meetings, and endeavored to establish a "broad collaboration" with "progressive individuals" and "social movements." It had contacts and cooperation, participating in common events and co-authoring texts, with various organizations and groups, including the Liberation Movement of Homosexuals of Greece (AKOE), the Group of Prisons, the Committee for the Right Information and Handling of Drugs, and the Alternative Ecological Motion. 91 The Motion did attract the interest of a non-patient and non-professional audience, especially young people who were drawn to the anarchist, feminist, gay and/or antipsychiatric discourses, frequented Exarchia, and read the magazine of the Motion, which was sold in the kiosks and the anarchist bookshop of the area. However, this audience was not prepared to become actively involved in the Motion's work. Their interest was less connected to the rights and problems of the mentally ill than to the meanings of madness in relation to the self and the revolt against the dominant social and political system and culture. In addition, they did not know exactly who partook in the Motion, and felt uneasy towards it; mental illness remained difficult to talk about or connect to and it was still surrounded by fear and stigma. On the contrary, other organizations of the time, for example feminist and gay, were more accessible as their members were more recognizable in the public sphere and their narratives appealed to broader audiences. 92 It is indicative that, although the Motion was optimistic about its participation in the festival Avgis-Thouriou and aspired in future collaborations with other parties and organizations, this practice did not seem to continue after 1984. 93 The lack of a wider interest in the issues of the mentally ill, at least in the way that the Motion understood them, was also evidenced by the fact that newspapers usually did not publish the denunciation texts that the Motion sent them. 94 The Motion faced difficulties in extending its reach not only beyond the mental health field, but also within it. It was a small organization, not only in quantitative terms of members and activities -which was a usual feature of the mental patient organizations in many countries -but also in terms of the momentum that would further the MPM in Greece. Moreover, in the late 1980s and the beginning of the 1990s, it lost many of its members, especially patients, and its activities weakened. Significantly, the last issue of the magazine was published in 1993, four years after the previous one. In addition, since the mid-1980s as the Motion became less radical, it also became less political and polemic. It turned to new goals, such as international collaborations and the collection of data about mental health institutions in Greece. 95 Its magazine published more varied material and fewer denunciations and political statements. 96 The loss of dynamism and political orientation was linked to the gradual weakening of collective activity and politicization in Greece since the midand late 1980s, but also to the shift of the psychiatric reform movement in the country in a less political and ideological direction. 97 Or, as the Motion lamented in 1988, psychiatric reform had failed in Greece before it had even started, as it had been deprived of its social and political dimensions and had been reduced to the object of a guild of mental health experts, predominantly psychiatrists. 98 Within this context, mental patient organizations in the 1990s were more orientated towards professional rehabilitation and artistic expression, and less concerned with larger social issues such as the psychiatrization of life and the "everyday fascism" against those deemed different. They were less politicized and did not aim at forming or participating in a broad social movement against authoritarianism and for social liberation, but centered more on the specific rights of mental patients, their inclusion in decision making, the fight against stigma, and self-help. The Motion seems to have followed this trend in the early 1990s, when it enlisted new members, mainly through the Open Psychotherapy Center, and managed to continue its meetings, organize some events, and initiate a new self-help group until it was officially terminated around 2007. 99

CONCLUSIONS
Mental health critiques and reforms in the Western world during the second part of the twentieth century together with the activism of the long 1960s paved the way to a more active patient role and a less hierarchical and more democratic types of relationships between patients and professionals. All this contributed to the emergence of the MPM, which had a varied course and impact in different countries. In Greece, the MPM appeared at a later time -the first formal association of mental patients was founded in 1980 -and its presence was less marked. However, it shared many of the key features of MPM organizations, which it can help further highlight.
An important common aspect of the Motion and the MPM was their double origin in psychiatric reforms and social activism, which corresponded to their double goal, to change not only the mental health system and the attitudes towards mental illness, but also society. This aspiration was shaped mainly by leftist-leaning ideologies, the social movements, and the radical psychiatric thinking of the long 1960s, and in Greece of the late 1970s and early 1980s. In this framework, mental illness and mental health were understood as social and political issues inextricably linked to the efforts to promote political consciousness, democracy, tolerance, and social liberation. The linking of mental health with socio-political demands was a novel and significant element of both the early MPM and the Motion. However, a broad mobilization around mental illness was hard to achieve even by developed examples of the MPM in other countries, especially as activism and politicization ebbed in the 1980s, and indifference and prejudice around mental illness persisted. So, it should not be surprising that "almost none of the positions and the goals of the [M]otion materialized in the mental health field." 100 The mission to establish mental illness and health as political issues that concerned everyone in the framework of a broader social movement, and to remove mental health care and reform from the sole authority of psychiatrists and administrators, proved unattainable.
Nevertheless, the Motion was not without accomplishments. It promoted a novel discourse on mental illness in Greece at a time when public narratives on the subject were centering on philanthropy, hospital scandals, and the dangerousness of the mentally ill. It disseminated information, exposed abuses, and furnished a network of communication and support, helping at least some of the mentally ill to counter the fear, stigma, and shame, and claim the title of the expert of their health and life. 101 Belonging to the Motion legitimized the members' experiences, and challenged established perceptions of mental illness and mental health care. Therefore, the Motion shared the MPM's major themes, aims, and activities: the establishment of contacts and communication; the spread of information; the breaking of isolation and silence, and the publicization of mental illness issues. All this was enabled by the Motion's (and the MPM's) tendency to blur the boundaries between mental illness and health, and perceive them as socio-political matters. In other words, the Motion shared and promoted two main aspects of the mental (and other) patients' movements: it strove to turn (mental) illness from a personal to a public issue, and to promote a new notion of citizenship, based not only on responsibilities and rights, but also on collective action and solidarity. 102 This was an important legacy that even small MPM organizations with limited impact such as the Motion managed to leave behind.