Abstract
Abstract The article aims to describe the key events in the development of mental health care policies after 1990 in the two countries and identify the main reasons for stagnation or incremental changes to the institutional setting in the field of mental health care. The process of mental health care reform is explained using the framework of historical institutionalism. The explanation shows that the lack of political interest in combination with the tradition of institutional care resulted in poor availability of psychiatric care, outdated network of inpatient facilities and critical lack of community care facilities in both countries. Even though Slovak Republic adopted national programme at the governmental level, it still struggles with its implementation. The ongoing reform attempt in the Czech Republic may bring some change, thanks to a new approach towards strategic governance of the mental health care system and the mechanism of layering that the promoters of the reform use.
Highlights
The system of mental health care in the Czech Republic (CR) has not seen any fundamental systematic change since the 1990s
We decided to compare the development of mental health care policies in the CR and Slovak Republic (SR), as both countries have very similar healthcare systems, which provides for easier transfer of policies (Marmor et al 2005)
The Psychiatric Care Reform Strategy (PCRS) (Ministry of Health 2013) addresses the problems identified in the Revised Framework of Psychiatry of 2008 and responds to earlier strategic documents, as well as many international documents, primarily the UN Convention on the Rights of Persons with Disabilities of 2008, which was ratified by the Czech Parliament and the President of the Czech Republic, incorporated in the Czech legal system, and the European Mental Health Action Plan (2013), a guideline for the creation of national mental health policies, endorsed and ratified by World Health Organisation (WHO) (Hollý 2014)
Summary
The system of mental health care in the Czech Republic (CR) has not seen any fundamental systematic change since the 1990s. The Ministry of Health is currently working on plans for implementation of the new Psychiatric Care Reform Strategy which addresses the above mentioned problems. The implementation of the reform depends on various factors, both within and outside the field of psychiatry. In this respect, the CR could learn from the experience of other countries. We decided to compare the development of mental health care policies in the CR and Slovak Republic (SR), as both countries have very similar healthcare systems, which provides for easier transfer of policies (Marmor et al 2005). Our article aims to describe the key events in the development of mental health care policies and explain the main reasons for stagnation or incremental changes to the institutional setting in the field of mental health care in both countries.
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