ECESR Files Lawsuit to Suspend Decision Raising the Costs of Care and Treatment at Psychiatric Hospitals

The Egyptian Center for Economic and Social Rights (ECESR), through its legal team, has filed lawsuit No. 86235/79 Judicial Year before the Administrative Court in Cairo. The case was brought on behalf of a group of affected parties, including guardians and custodians of patients as well as professionals and stakeholders in the field of psychiatry, against: the Minister of Health in his official capacity, the Secretary-General of the General Secretariat for Mental Health and Addiction Treatment in his official capacity, the Chairperson of the National Council for Mental Health in his official capacity, and the Director of Abbasiya Mental Health and Addiction Hospital in his official capacity. The action challenges the ministerial decision raising the costs of care and treatment in psychiatric hospitals.

In its petition, ECESR—acting on behalf of the plaintiffs, including Dr. Ahmed Hussein, former Assistant Secretary-General of the Doctors’ Syndicate and a psychiatrist at Abbasiya Hospital—sought an order suspending and annulling Ministerial Decree No. 220 of 2025 insofar as it introduced new pricing lists. The plaintiffs requested restoration of the previous pricing regime that applied prior to the decision, and a prohibition against imposing excessive financial burdens on the treatment, care, and accommodation of psychiatric patients and their guardians in hospitals operating under the General Secretariat for Mental Health and Addiction Treatment.

The lawsuit detailed the direct harm suffered by the plaintiffs. The first plaintiff, a 64-year-old day laborer (a carpenter), is the sole caregiver of his 40-year-old son diagnosed with schizophrenia. His son had previously been admitted to Abbasiya Hospital for approximately 18 months, during which the father paid EGP 1,800 per month. Following discharge for outpatient care, the son’s condition worsened and he attempted to throw his father from the sixth floor. Consequently, he was re-admitted more than six weeks ago. The hospital has since demanded EGP 5,400 per month for his son’s accommodation—an amount well beyond his financial means—given that the new pricing ranges from a minimum of EGP 1,800 to as high as EGP 11,000 per month.

The second plaintiff is the legal guardian of her brother, who has been hospitalized at Abbasiya for over two and a half years. She already bears the financial burden of covering his daily needs through hospital canteen payments and paying EGP 1,800 per month for accommodation. She was shocked to be required to pay EGP 5,400 per month for accommodation alone, excluding food and treatment costs, which exceeds her financial capacity.

ECESR underscored that mental health care is as vital as physical health care, constituting an integral part of comprehensive health. Psychiatric treatment addresses anxiety, phobias, obsessive-compulsive disorder, and mood disorders such as depression and schizophrenia. It enables patients to understand their emotions, adapt healthily to their circumstances, and improve their quality of life and relationships. Psychosis, in which patients lose the ability to distinguish reality from delusion and experience hallucinations and false beliefs, poses serious risks to both patients and those around them. Research shows that schizophrenia affects approximately 1% of the global population, meaning that Egypt has more than one million people living with schizophrenia, in addition to patients with other psychiatric disorders and addiction. Ensuring access to care, ECESR argued, is therefore an urgent national obligation.

The petition further noted that the history of psychiatric treatment in Egypt extends back to ancient times, as evidenced by references in papyri such as the Ebers Papyrus, which linked psychological states to the mind and heart and described remedies ranging from physical treatments to incantations. Temples served as centers of healing for mental conditions. During the Islamic era, Muslim scholars studied, diagnosed, and treated mental illness, translating Greek medical texts into Arabic and establishing dedicated psychiatric hospitals such as the Qalawun Hospital, which integrated spiritual, physical, and psychological therapies. In modern times, Egypt established Abbasiya Hospital in 1883 as the first psychiatric hospital, followed by Behman Hospital in 1940, and in 1997 created the General Secretariat for Mental Health and Addiction Treatment, which now oversees a network of specialized facilities.

On 14 July 2025, the Minister of Health and Population issued Decree No. 220/2025, introducing a new financial and administrative regulation for the Service Improvement Fund, including new pricing lists for treatment services. Previously, outpatient consultations and medication were provided for “one pound,” and at least 60% of beds were designated for free care pursuant to existing regulations. The new decree increased accommodation fees by up to 330%, with average monthly charges at Abbasiya ranging between EGP 4,500 and 11,500. Costs of therapeutic sessions and routine treatments also rose substantially, with electroconvulsive therapy sessions priced at EGP 400 per session, outpatient tests such as IQ assessments at EGP 150, and online psychiatric consultations—previously EGP 50—also affected.

ECESR warned that the likely consequences of enforcing the decision are severe: patients may be abandoned without care, endangering themselves and others; families may be forced to relinquish responsibility due to financial pressures; suicide rates and crime could rise; emergency departments could face additional strain; law enforcement could be burdened with further responsibilities; and the number of untreated patients in the streets could increase. Families would suffer devastating financial losses, while psychiatric treatment would become a luxury beyond the reach of most citizens.

ECESR emphasized that the Egyptian Constitution guarantees the right to health care as a fundamental right, obliging the State to provide integrated health services of acceptable quality, protect and support public health facilities, and allocate no less than 3% of GDP to health expenditure, with progressive increases toward international standards. International covenants, particularly the International Covenant on Economic, Social and Cultural Rights, also affirm that every individual has the right to the highest attainable standard of physical and mental health, with psychiatric care being inseparable from public health.

The petition further cited a 2020 judgment of the Supreme Administrative Court affirming that psychiatric patients enjoy fundamental rights, including confidentiality of their medical records. The Court stressed that the purpose of psychiatric treatment is to reintegrate patients into society as productive individuals, noting that Egypt was among the first countries to legislate on mental health care in 1944. Egypt has also committed to implementing the UN Principles for the Protection of Persons with Mental Illness, shifting from institutional isolation to open care and social reintegration, with penalties imposed on those who violate psychiatric patients’ rights.

In conclusion, ECESR argued that the challenged decision is not a mere financial adjustment but a direct infringement of constitutional and international rights and a threat to social peace. The Center urged the judiciary to suspend and annul the decision in order to safeguard psychiatric patients’ right to health care, protect affected families, and preserve societal security.