Transforming mental health services in primary health care in Slovenia

Abstract

Background: Strengthening mental health, preventing development of mental health disorders and accessible mental health services for all are crucial tasks of health system, both from individual and societal point of view. In year 2015 the mission of the World Health Organization, Regional office for Europe, to Slovenia recommended i.a. (a) strengthening mental health services in primary care for improved accessibility; (b) improved access to community treatment of persons with severe mental health disorders; (c) strategic workforce planning in mental health and increased number of clinical psychologists; (d) improved access to psychotherapy. Based on these recommendations the first strategic document on mental health was adopted in 2018, The National Mental Health Programme 2018-2028. Methods and Objectives: Eight strategic objectives of the National Programme address implementation of policies in supporting mental health, intersectoral cooperation, implementation of evidence-based programmes and interventions, suicide prevention, alcohol related mental health disorders, community-based services, integration of social care and health care programmes, shortages of workforce. Results: Between 2018 and 2023 several mental health promotion programmes were introduced (e.g. Incredible Years, Cool Kids, This Is Me / To Sem Jaz). School counselling services and programmes for vulnerable adolescents and young adults were strengthened. Strategy for deinstitutionalization of long-term social care facilities was adopted. There are already 22 multidisciplinary Children and Adolescents Mental Health Centres and 18 Adults Mental Health Centres operating in primary health care, out of 30 and 25 respectively. Adults Mental Health Centres also provide community services for persons with severe mental health disorders according to the FACT (Flexible Assertive Community treatment) model. Out-patient and hospital programmes for non-chemical dependencies were introduced. Conclusions: Mental health is high on political agenda in Slovenia since 2018. Major investments in health care, social care and education system increased access to mental health programmes and services.