Abstract
The aim of this publication is to analyze the organizational units of mental healthcare for adults based on the data on the services reported to the National Health Fund in 2010-2016. The following organizational forms of care were analyzed: mental health outpatient clinics, general psychiatric wards, general day care psychiatric wards, community mental health teams, and psychiatric emergency rooms. These organizational units were analyzed in terms of their number, utilization and accessibility. In addition, a preliminary simulation of the expected Mental Health Centers was carried out. In Poland, in 2010-2016, the number of mental health service providers under contracts with the National Health Fund increased by 5%. The most robust growth was observed for community mental health teams, whose number increased by 282%. However, this organizational form was used by a marginal (1.9%) percentage of patients. The highest rate of admission to general psychiatric wards was observed in districts where a general psychiatric ward and a mental health clinic were available with no day care psychiatric wards or community mental health teams. Asmall number of entities providing comprehensive care was in operation in 2016. The preliminary simulation has shown that in 2016 a total of 156 MentalHealth Centers should have been in operation, assuming that each of them would have provided care for 200,000 inhabitants. It would be advisable to analyze the exact geographic distribution of units, human resources in individual organizational units, and to take financial outlays for mental healthcare in their various forms into consideration.
Highlights
Thornicroft et al [1] distinguish three periods in the history of mental healthcare in developed countries: the establishment of mental health hospitals, the decline of mental health hospitals, and the development of decentralized community psychiatry embedded in the local community
The number of organizational units for mental healthcare provided for adults In Poland, there were 1,560 entities providing services as part of psychiatric care and treatment of addictions under contracts with the National Health Fund in 2016
It is notable that the increase in the number of providers is observed for organizational units providing community care
Summary
Thornicroft et al [1] distinguish three periods in the history of mental healthcare in developed countries: the establishment of mental health hospitals, the decline of mental health hospitals, and the development of decentralized community psychiatry embedded in the local community. In the context of the ongoing debate about the positive and negative aspects of deinstitutionalization, re-institutionalization and trans-institutionalization [2] it is becoming more and more important that community psychiatry is not a specific institution or service. Rather, it is a way of thinking about the psychiatric patient, their needs and rights, while ensuring access to the healthcare system and to the broadly defined presence in the society. They point out the need to obtain exact information about the characteristics of the patients provided with services, to perform a long-term analysis of treatment paths, and to study the effectiveness of activities in order to develop evidence-based principles for providing mental healthcare
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