Accessebility to Psychiatric Services in Georgia

Abstract

Background: Heavy socio-economic condition and military conflicts negatively affected mental health condition of the population in recent years in Georgia. Eventually, prevalence of mental disorders has increased. Despite the fact that allocation of funds for state program on mental health has been annually increasing, it is still quite low and amounts only 2,11% of the total expenses on health care (2012). Scarcity of resources is also preconditioned by low development of relatively cost-effective, out-of-hospital, community-based mental health services in the country. The purpose of survey is to study accessibility to mental health services in Georgia, to identify gaps existing in mental health state program. Methodology: Within the qualitative study the in-depth interviews were conducted among the managers of medical institutions and medical personnel. Face-to-face interviews using specially designed questionnaire were conducted among mental health state program beneficiaries as part of the quantitative research. Findings and discussion: under-funding of the mental health programs negatively affects patients' health. A large number of patients, who do not require inpatient psychiatric care, remain in psychiatric institutions due to lack of development of out-patient, community based mental health services; while many of those discharged from hospitals often return there because of re-hospitalization needs. The problem is further aggravated by the lack of professional personnel, unequal distribution of services throughout the country's territory, fewer outpatient psychiatric services development, and difficulties in ensuring the proper material-technical capacity, equipment and finances. Conclusion: For the development of mental health sphere it is necessary to elaborate effective funding mechanism, which will be tailored to the needs of patients; to enhance knowledge and skills of specialists in the field and their appropriate level of compensation; to facilitate the development of psychosocial rehabilitation centers, shelters and other services in the country; to expand the state programs over a non-psychiatric diagnosis and treatment; to change the public attitude towards the patients and to reduce stigma.