ANALYSIS OF THE STATE OF PSYCHIATRIC CARE IN UKRAINE

Abstract

The aim of the study. To analyze the current state of psychiatric care in Ukraine against the background of its reform; to investigate the dynamics of individual indicators of mental health and the activity of institutions providing psychiatric care for the period 2008-2021. Material and methods. The materials of the study were official statistical data from the reports of the State Statistics Service of Ukraine, the Center for Medical Statistics of the Central Health Service of the Ministry of Health of Ukraine for 2008–2021, and the Institute of Health Indicators and Evaluation (IHME, USA) on the global burden of diseases. Bibliographic, epidemiological, medical-statistical, analytical methods were used in the research. The results. The relevance of studying the current state of the organization of psychiatric care in Ukraine is primarily determined by the growing need of the population in connection with the negative impact of the consequences of the war on mental health. It was established that the prevalence of mental disorders in Ukraine in the period from 2008 to 2017 decreased by 17.8% and amounted to 3944.8; primary morbidity decreased by 38.7% and amounted to 300.9 cases per 100,000 population in 2017. Mortality from mental disorders in the period 2008-2017 decreased by 2.7 times to 2.3 cases per 100,000 population. However, in 2021 it was already 2.4. According to the second stage of the health care reform, there is a reduction in inpatient psychiatric facilities and their bed fund (by 40-50% on average). Medical facilities that provide psychiatric care lack qualified specialists (53-73% of positions are filled). Conclusions. Deinstitutionalization, which is carried out in Ukraine, is consistent with the Concept of the state target program of mental health care in Ukraine for the period until 2030. When reducing beds in psychoneurological hospitals, it is necessary to create conditions for alternative treatment of mentally ill patients in order to maintain the availability of care. The dynamics of changes in mental health indicators and the activity of healthcare institutions have regional features that must be taken into account when calculating the need for various types of psychiatric care. Optimizing psychiatric care is hindered by a lack of psychiatrists and psychologists, but the involvement of family doctors in the provision of psychological care and the introduction of mobile interdisciplinary teams will help.