European Observatory on Health Systems and Policies, London School of Economics and Political Science, London WC1H 9SH, UK.
European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
Int J Environ Res Public Health. 2022 May 9;19(9):5774. doi: 10.3390/ijerph19095774.
Provision of mental health care in Poland has long been characterised by an overreliance on psychiatric hospitals and the underdevelopment of community care. The introduction of the first National Mental Health Protection Programme for 2011-2015, with the explicit goal to base provision of mental care on the community mental health centres, failed to achieve any tangible results. The ensuing critique led to the launch of the second National Mental Health Protection Programme for 2017-2022 and the establishment, from mid-2018 onwards, of 41 (33 in operation) mental health centres across Poland. These will be piloted until the end of 2022 but have already shown positive results in terms of access to non-stationary care and a small fall in hospitalisations. They have also performed well during the COVID-19 pandemic, allowing for a quick reorganization of care and continued provision of mental health services. Some of the key innovations of the new model include the introduction of recovery assistants (a new profession) and mental health coordinators (a new role); liaison with social assistance services; and a shift to budget financing. The key obstacles to the national rollout of mental health centres are the low financing of mental health care in Poland, which is among the lowest in Europe, and acute workforce shortages.
波兰的精神卫生保健长期以来一直以过度依赖精神病院和社区护理发展不足为特征。2011-2015 年推出的首个国家精神卫生保护计划明确将社区精神卫生中心作为提供精神卫生保健的基础,但未能取得任何实际成果。随后的批评导致了 2017-2022 年第二个国家精神卫生保护计划的推出,并从 2018 年年中开始在波兰各地建立了 41 个(33 个正在运营)精神卫生中心。这些中心将进行试点,直到 2022 年底,但已经在获得非固定护理和住院人数略有下降方面显示出积极的结果。它们在 COVID-19 大流行期间表现良好,允许快速重组护理并继续提供精神卫生服务。新模式的一些关键创新包括引入康复助理(一个新职业)和精神健康协调员(一个新角色);与社会援助服务的联系;以及转向预算融资。精神卫生中心在全国范围内推出的主要障碍是波兰的精神卫生保健资金不足,这在欧洲是最低的之一,以及劳动力严重短缺。