Mental health in the Czech Republic: current problems, trends and future developments

The Czech Republic undergos many of the problems reported in other Central European and Eastern European countries with defer to to the care, treatment and prevention of mental ill health. greatest in quantity psychiatric care is provided in long-stay hospitals and the transition to a community-based service has at the same time to be made. Mental health services experience from chronic under-investment and there is a lack of mental health legislation protecting patients' rights and autonomy.The compressings of transition to a capitalist economy have brought their have problems, in the form of increased rates of addicitions, suicide, and other mental health riddles related to social, policitical and economic instability, and there is a pressing ne to address the position of mental health within public health services.

Key words

Czech Republic

mental ill health

mental health services

transition

public health

It is difficult to provide an accurate overview of public mental health in the Czech Republic. single reason is the cultural riddles in defining mental health; another is the lack of relevant research in this area. There is still no evidence concerning the mental health impact of transition upon the Czech society. Nevertheless, it appears that a number of risk factors for poor mental health are increasing in the Czech Republic, as well as in other transition countries. Among these are increasing squeezing to perform and win recognition in a market-oriented society, an emphasis upon competition and consumption as tokens of status, the risk of unemployment instability or a decrease in the socio-economic status of a certain number of groups, poverty, migration, corruption and political and economic instability. These factors have potential ends in the form of emotional deprivation, depressed self-esteem, disturbances of interpersonal and partner relations, emerging see the verb and development of addictions of all kinds, and increase in suicidal and parasuicidal behaviour, especially among a certain number of at risk groups - for example, adolescents.

Background and starting points

The Czech Republic is a signatory to the WHO Mental Health Declaration and Action Plan and is also committed to the WHO Health 21 programme, which includes mental health improvement as single of its goals. The goal aims to improve conditions for psychosocial well-being, render certain the availability of specialist services to nation with mental health problems and restore stigma and discrimination. Other goals relevant to mental health promotion include reducing the number of young race participating in health damaging behaviour of the like kind as drug, tobacco and alcohol consumption. The Ministry of Health, the Ministry of Education, Youth and Sports, the Ministry of Labour and Social Affairs, the Ministry of the Interior and the Ministry of Justice work together upon reducing drug abuse, co-ordinated by the agency of the Council of the conduct for Drug Policy Co-ordination.

The interpretation and delivery of psychiatric care in Western, Eastern and Central European countries has repeatedly been rather different. In rejoinder to reports of psychiatric abuse and the application of the Declaration of Human Rights to the field of medicine, there has been a growing move across Europe to de-institutionalise psychiatric care and to support race in the community through the provision of crisis midmost points day care, short stay hospitals, screened workshops and support with daily living. beneath ideal circumstances, psychiatric services should be able to provide mental health care support, prevention and treatment shut up to the patient's home, working in shut co-operation with the primary health care combination of parts to form a whole

Main problems of psychiatry

Profound political, social and economic changes after the extreme point of the communist rule in Central Europe in 1989 have also substantially influenced Czech psychiatry. In the former socialist Czechoslovakia the health care combination of parts to form a whole was fully state owned, state paid and organised in the so-called regional institutes of health care comprising inpatient as well as outpatient care facilities, including psychiatry, and serving a statutory catchment area of about 100000 inhabitants The main stretchs after the 1989 changes were decentralisation of the health care a whole rapid privatisation, especially of outpatient services, and financing from one side the newly set up health insurance corporations.

In 2002 Czech Republic had 10272503 inhabitants. The GDP was 24073 billion Czech diadems In the same year the health care package was 7.0% of the GDP (Health Statistics Yearbook 2002 2003) We estimate that les than 39% of the health care bag was allocated to mental health care, of which 522% went to psychiatric hospitals, 22% for remedys 15.6% to outpatient clinics and 96% to psychiatric departments of general hospitals (Commission for Realisation, 2004)

In novel years the number of physicians working in psychiatry (Health Statistics, 2004) has been increasing: in 2002 there were 1210 of them (118 by 10,000 population), mostly (49.8%) working in outpatient clinics. Since 1995 about 80% of psychiatric outpatient clinics have been in private hands. There is unrestrained access to these specialists, who have no catchment areas.