Mental health centers proving very effective but struggling with lack of funds

In the wake of worrying reports regarding the quality of care for patients in Czech mental hospitals there is a push to expand the existing network of mental health centers, which help people to avert the onset of serious problems requiring hospitalization.  

Photo: Anna Košlerová,  Czech Radio

Reports of inhumane practices in mental hospitals, including overuse of mechanical restraint, tranquilizers and isolation, have resulted in experts on mental health ringing alarm bells regarding the need for reform. While that goal may take years to implement there is a faster solution at hand – expanding the network of mental health centers around the country, which would serve as an important first tier and prevent many patents from reaching a stage where hospitalization is inevitable. It would also help overburdened mental hospitals who are struggling with a shortage of staff.

The mental health centers in different parts of the country were established several years ago as a pilot project aimed at addressing the lack of psychiatrists in Czechia which resulted in patients having to wait long months for an appointment.

Mental health centers provide help much faster but also work in an environment that builds trust and offers all-round support in dignified conditions. They speak of “clients” instead of “patients”, and meet with them in surroundings they consider safe – their home, a café or workplace. Clients are given counselling by multidisciplinary teams including a psychiatrist, a psychologist, a social worker  and a peer counselor.

Mental health center | Photo: Ludmila Křesťanová,  Czech Radio

In the case of people who suffer from depression or anxiety because of social or work problems that can be resolved, the staff try to help them root out the cause of the problem. In the event of mental illnesses, they provide regular care, respond to urgent needs and make it possible for clients to remain in their own home environment even with a mental illness.

According to one scientific study as many as seventy percent of patients either partially or completely skip medication during certain periods. This often dramatically worsens their condition and lands them in hospital. Mental health center staff talk to them and explain the importance of taking the medicine.

If hospitalization is inevitable, the team at the center remains in touch with the client and takes over once they are discharged. In the year and a half of its pilot operation, the network of mental health centers has helped over 9,000 people with serious mental illness. This appears to be a good groundwork for the future reform of the mental health system but there is one hitch – a lack of funds at a time when economizing has become the operative word at the ministries of health and social affairs which co-finance the centers.

Photo: René Volfík,  iROZHLAS.cz

Pavel Novak, who coordinates the network, says he would like to see more financial support from the regions as well. He argues that the money would be well invested in view of the results achieved.

“Surveys have shown that the centers are very effective when it comes to preventing hospitalizations or shortening their period. This holds for 65 to 70 percent of cases.”

At present there are 30 mental health centers operating around the country. Another nine teams specifically support children, the elderly or addicts. The plan is to set up 70 more centers by 2030. However, the process is slow and laborious, with only two to three new centers expected to open next year.

Authors: Daniela Lazarová , Petr Král
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