Planned psychiatry reforms promise more tailored approach to mental health

The Health Ministry has released the first comprehensive plan for new reforms in psychiatry. The ministry is planning to decentralize psychiatric care and individualize the approach of mental health professionals. Critics, though, are worried that the planned changes will result in more patients falling through the cracks.

Psychiatric Institution Bohnice, photo: Filip Jandourek

Psychiatry in the Czech Republic has long been under-financed and undervalued, receiving only 3.5 percent of the health ministry’s budget, with average spending on this sector among EU countries being eight percent. The demand for psychiatric care is growing fairly quickly, particularly in the case of out-patient care, according to the director of Prague’s Psychiatric Institution Bohnice Martin Hollý:

“The number of people seeking psychiatric help has grown by 50 percent in the past ten or 11 years. The main increase is in the number of patients with anxiety or depression-related disorders, which are related to lifestyle choices and most often result from stress.”

Martin Hollý, photo: Alžběta Švarcová

The first awaited step of the planned mental health reform is seemingly superficial – almost all of the 13 Psychiatric Institutions, or léčebny, in the country will change their name to Psychiatric Hospitals. Many practitioners claim that this will help improve the status and break the stereotypes often associated with psychiatric care. The main focus of the reform, according to its proponents, will be to offer a more holistic approach to mental health – offering not only medical treatment, but also helping patients lead balanced everyday lives.

There is currently a lack of facilities and specialists at hospitals to help patients with mental health disorders who do need to remain in an institution. The Health Ministry is hoping to improve psychiatric care facilities for outpatients, creating so-called local community centers that would address various needs of patients in their immediate surroundings around the clock. According to Dr. Hollý, who is a strong supporter of the reforms, the ministry plans to open one such center per approximately 100,000 inhabitants.

“We plan to decentralize a large part of psychiatric care, making it available in the place and at the time that a patient may need it, at 24-hour local centers. And the specialized facilities will stay open for those patients requiring more intense or long-term care.”

Hospitals and the ministry have also led successful negotiations with insurance providers, who should in the future cover at least some psychiatric treatment for outpatients.

Psychiatric Institution Bohnice, photo: Filip Jandourek

Critics of the reforms, many of whom are leading experts in the field, say that the anticipated changes will happen too quickly, leaving critical and long-term patients without sufficient care. Some have voiced their fears that the existing long-term care facilities will be closed down or will have to drastically limit the number of patients before alternative facilities can be secured.

Another point of contention is the expected cost of the reform, which is currently estimated to be at least six billion crowns. The ministry plans to draw this amount from EU funds over seven years, starting next year, if the reform is approved in the next few months. The details, though, will be decided on by the government and later the parliament.