Psychiatric care based on community care is the most effective form of providing assistance to patients – claim psychiatrists. This is how services are currently provided by mental health centers operating, for now, as part of a pilot program. Experts are uncertain about how these centers will operate from July, when the pilot program ends. The Ministry of Health assures that the financing method will not change and more centers will join the network. By the end of the year, they aim to cover at least 80% of the population.
“Mental health centers represent a form of care for patients in mental crises, based on the idea of community help and it is the most effective method of treating mental disorders. Our research shows this, and also those directly interested agree,” said Joanna Krzyżanowska-Zbucka from the Institute of Psychiatry and Neurology, Chairperson of the Organising Committee of the Mental Health Congress, in an interview with Newseria agency.
Mental health centers have been operating in Poland as part of a pilot program – the longest in Poland’s history, ongoing since 2018. The pilot is due to end on 1 July. The Ministry of Health has not yet revealed the details of how these centers would function after this date.
“We fear that the proposals currently being considered by the Ministry of Health may lead to changing the operating rules of these centers. Even if these centers continue to call themselves mental health centers, they will not be the centers being piloted under the basic psychiatric care reform. If we change the rules, availability will change, as will response speed, focus on recovery. Different rules will apply, mostly focusing on profit or attracting a certain number of patients. We are very worried that changing these foundational principles, on which community mental health centers are based, will effectively abolish this reform,” warns Joanna Krzyżanowska-Zbucka.
There are many doubts regarding the financing of the centers: whether it will based on the per capita coverage of a given center or a fee-for-service system. The health minister recently addressed these concerns in an interview with RMF FM, stressing that work is ongoing to establish these rules.
Adjustment financing gives the greatest freedom in offering help. Of course, the effects of such help are not achievable so quickly. There are comments from the National Health Fund that this is expensive. Proper health care must cost, and we are still below the European average. So this proposal that there should be financing per patient focuses the interest of those providing help on the sick person, and in financing per population we focus on prevention, early intervention, as well as on recovery. The patient then gets as much as he needs, and when he needs it, not when he is registered as a patient,” says the expert.
The mental health center pilot covers 51% of the Polish population. The health minister has announced that more facilities will join the network after the development of care standards and this year it will be possible to increase the reach to 80% of the population with the ultimate goal of full coverage. Both health officials and experts stress that even covering the entire population with CZP care will not be enough if we do not care about prevention and educating about the role of early intervention.
“Community care is not only about treating the ill but also about quick, near-home intervention for people experiencing a crisis, which may not yet be a disease, but a mental crisis related to some difficult situation in this person’s life. If they receive help quickly, efficiently, close by, if they knew beforehand where to apply for help and understood what is happening to them as part of the social education that prevention entails, we can reduce the number of illnesses. A number of mental disorders result from neglected crises, which, if not given adequate help in time, later require very intensive and medical intervention,” Joanna Krzyżanowska-Zbucka assures.
The EZOP II study shows that more than 26% of Poles have experienced mental health disorders at least once in their lives. Almost 8% experienced it within the 12 months preceding the study.
