'We call it civil death. Once you are under guardianship, that's it

Throughout the communist era, this is where the authorities hid the mentally ill from public view. Today, the Pravda Social Care Home for Men with Mental Disorders, a small complex of scrappy, two-storey buildings, is still a favoured destination for city folk to send away relatives with a mental illness or disability – and not worry about hearing from them again.

Across the former eastern bloc, many people with learning disabilities or mental illness are sequestered without rights or recourse under communist-era rules that put their fates in the hands of legal guardians. Very often the degree to which they are suffering is not taken into account, meaning that simple depression will be treated the same as paranoid schizophrenia or psychosis.

In the tumult of the two decades since free markets and imperfect democracy arrived here, the laws governing guardianship have remained largely intact, stripping hundreds of thousands of people of the authority to make the most basic decisions about their lives – even when they may be perfectly capable of looking after themselves.

This difficult situation is not helped by Bulgaria's precarious economic situation. The transition to democracy has not been easy and the government has struggled to boost low standards of living. Among EU members, only Romania has a lower GDP. Painful market reforms have crippled the health and social-care system, and years of underfunding have led to a sharp decline in the quality of care in homes for people with mental disabilities. In the village of Goren Chiflik, close to the Black Sea, for example, the local institution for women with mental-health problems is in a dangerously dilapidated condition. With few facilities for recreation or rehabilitation, the patients spend long hours in the crumbling, draughty canteen. They feel the rest of the world has given up on them.

A report by Amnesty International in October 2008 found that many women in Bulgaria's mental institutions face a life worse than imprisonment. "The dreadful stench was the first thing that hit me," says Theresa Freese-Treeck, Amnesty's campaigner on Bulgaria after her visit to the Razdol home for mentally disabled women.

"As I began to adjust – both to the smells and to the darkness – breathing deliberately, trying to maintain my composure and preparing for what lay ahead, I recognised groups of women huddled together in filthy conditions, forming an assembly line. One group stood in front of a trough frantically rubbing their hands under jets of water streaming out of the taps. There was no soap to assist them. Puddles already on the cement floor were now turning into a pool. One woman stood dipping a loaf of bread into the water, making it soft. Then, the women moved into an adjacent room – small, dank, mouldy and already three inches deep in water. They waited, crammed into this tight area in darkness, until they were moved on.

"I was appalled," says Freese-Treeck. "As I surveyed the scene and listened to the screaming, watched women rocking idly in front of their plates, eating soup with their hands, or sitting isolated in a corner, starting in fear whenever anyone approached, I began to comprehend the horror of living in such an institution."

A study of guardianship completed last year by the Mental Disability Advocacy Centre in Budapest found jail-like regimens in eight former communist countries. This affected patients with a wide range of mental disabilities, with a million adults in the region subject to "significant, arbitrary and automatic" violations of their human rights.

Throughout Eastern Europe, legally appointed guardians control where their wards live, how their money is spent and how their property is used, and sometimes even decide whom they can befriend or be intimate with. Often, guardians use their powers to send their wards to large state institutions forever.

To compound the situation, the laws in Bulgaria and across the region often fail to ensure any oversight of guardians who assume control of their wards' property or bank accounts.

"We call it civil death," said Victoria Lee, a lawyer at the advocacy centre. "Once you are under guardianship, that's it. You basically become a non-person. These guardianship systems have no safeguards."

Since the law assumes that guardians act in the best interest of their wards, there are no legal mechanisms to prevent guardians from seeking financial gain or neglecting their responsibilities. While the directors of social care institutions are required by Bulgarian law to submit yearly audits of their wards' finances, the fine for failing to do so amounts to only a few pennies.

Scattered legislation that sometimes contravenes international law and a lack of due process in some countries in Eastern Europe mean that it is a simple matter for someone to convince a judge that a relative with a mental illness or disability should be placed under guardianship – simply because he or she wants control over their assets.

"Often it's not for riches," said Aneta Genova, a lawyer from the Bulgarian Helsinki Committee, an international human-rights group representing several wards at Pravda. "It's usually for little things, like using a room in an apartment, or renting or selling a property."

Defenders of guardianship say the legal system is there to protect and care for people with mental disabilities, who may be helpless on their own. But compared with the protections in place in the rest of Europe, guardianship systems in the former communist bloc make few provisions for individual needs. Instead, they offer a black and white approach – full guardianship or nothing at all – to people along a wide spectrum of mental disabilities.

Some of Bulgaria's neighbours are trying to change the system. In Hungary, for example, parliament is considering legislation to introduce so-called supporters, who would help mentally ill or disabled adults understand their situation and make their own decisions.

But in Bulgaria, guardianship is well established. And once you're in the system, says Oliver Lewis, executive director of the Mental Disability Advocacy Centre, "It's almost impossible to get out." Legal appeals to remove guardianship and restore legal capacity can lead to "Kafka-like" situations, he says, because such procedures require the consent of the guardian. "And the guardians often don't want the patient to appeal, because it is in their financial interest for that person to remain under their guardianship."

Beyti Hussein, the director of the Pravda care home, testifies to the abandonment and helplessness of the residents. He says a typical story concerns 46-year-old identical twin brothers Kiril and Metodi Mitsev. Both have schizophrenia and came to Pravda in 2000. Their brother Julian, appointed their guardian by a court, has never visited. And because his permission is required for the twins to travel, they are not allowed to leave the area.

According to documents seen by Hussein, the brothers own shares in two buildings and land in Kyustendil, south-west of Sofia, as well as an apartment in the capital. Yet their only income is about 20 per year, from their elderly father's pension.

"I can't say why Julian doesn't come," says Metodi Mitsev. The twins did not even have their brother's telephone number.

"These people are resigned to their fate," said Stoyanka Dimitrova, a social worker at the home. "There is no one to protect them and no one to show them how to claim what is rightfully theirs."

Metodi does the talking for both brothers. His gregariousness balances Kiril's introversion. "If we were closer to Sofia it would be easier to visit our father, and we could find a lawyer," he says. Their father is too old to make the long trip to Pravda, and moving to a home closer to the city would require the consent of their guardian.

"A lot of years have gone by," says Metodi, staring out at the flat, empty countryside that surrounds Pravda. "We are far away from the city. We have no girlfriends here and we miss civilisation."

It's hard to say whether Medodi holds out any real hope of seeing his father or his home again. But, at least, for once, the voice of one of Pravda's 'hidden' residents has been heard. Hopefully, the voices of those who are speaking up for the rights of the residents will eventually be translated into action that will bring true justice for these forgotten men and women.

'We call it civil death. Once you are under guardianship, that's it – you basically become a non-person'