До питання готовності вітчизняних лікувально-профілактичних закладів до захисту психічного здоров’я населення України, що постраждало внаслідок воєнних дій

Abstract

Objective: The article carried out a predictive hygienic assessment of the state of mental health of the Ukrainian population, analyzed the incidence of mental disorders in the pre-war period of 2018-2020, determined the level of readiness of domestic medical institutions to protect the mental health of the Ukrainian population, suffered as a result of hostilities, and provision of medical personnel. A retrospective analysis of the stay conditions of patients and the state of intrahospital comfort in stationary premises in the pre-war period was carried out and the experience of European countries on this issue was studied. The purpose of the work: on the basis of a retrospective analysis of the incidence rates of the Ukrainian population with mental disorders, to make a forecast of the readiness of domestic medical institutions’ (DMI) state to organize mass psychiatric and psychological assistance to the population that suffered as a result of hostilities. Methods: In the course of the analysis, statistical materials of the Ministry of Health of Ukraine for the period 2018-2020 were used regarding the incidence of mental and behavioral disorders and the provision of medical institutions with medical personnel, data from Form № 18 of the Ministry of Health of Ukraine «Report on the work on monitoring environmental factors affecting the health of the population» for the period 2014-2021. Results: It was found that men for the period 2018-2020 more sought help and were treated in psychiatric hospitals over the years from 67.2% to 65.3%, and were also treated in psychiatric day hospitals 57.3% to 59.4%. At the same time, women during the same period were treated on an outpatient basis from 78.9 to 81.0%, respectively, while less were treated in psychiatric hospitals - 32.8 to 34.7%. Non-compliance with the regulatory requirements of state sanitary rules № 173-96, state building norms V.2.5.-28: 2018 «Natural and artificial lighting» was determined, where the largest share was in 2017 - 11.8% and in 2019 - 10.7% , and the lowest non-compliance rates were noted in 2015 - 3.4% and in 2018 - 3.78%. The largest share of microclimate inconsistency in healthcare facilities was 11.3% in 2015 and 12.9% in 2016, and 3.2% in 2014, 4.4% in 2020, 2021 - 4.2%. The non-compliance with the regulatory requirements of state sanitary rules №. 173-96, state building norms V.2.5.-28:2018 "Natural and artificial lighting" was determined, where the largest share was in 2017 11.8%, in 2019 - 10, 7%, and the lowest non-compliance rates were noted in 2015 3.4%, in 2018 - 3.78%. The largest share of microclimate inconsistency in healthcare facilities was 11.3% in 2015 and 12.9% in 2016, and 3.2% in 2014, 4.4% in 2020 and 2021 - 4.2%. Conclusions: In connection with the ongoing large-scale armed aggression of the Russian Federation and the introduction of martial law in Ukraine, according to the conclusions of the Ministry of Health of Ukraine, a large-scale increase in the incidence of mental disorders among the country’s population can be expected, which will lead to an increase in the burden on psychiatric treatment and preventive institutions, which are only partially ready for a qualitative solution of problems. To ensure the readiness of domestic medical institutions to protect the mental health of the population of Ukraine, it is recommended to create a network of Centers for socio-psychological assistance / counseling, which will be staffed by psychologists, social workers and open psychiatric departments, day hospitals, outpatient clinics based on general hospitals.