The Ministry of Health is working to improve the system of psychiatric care and develop services in communities - Viktor Liashko

A year of full-scale war affected literally everyone, affected the overall mental health of the nation. During this time, the demand has increased not only for psychological, but also for psychiatric care. Currently, both types of assistance can be obtained free of charge in medical institutions that have signed an agreement with the National Health Service of Ukraine (NHSU) to provide services under the appropriate packages.

Specialized psychiatric care is covered by the medical guarantee program under the package "Psychiatric care for adults and children in inpatient settings". It can be obtained in any oblast of Ukraine. This does not require a doctor's referral. Under this package, the NHSU has already contracted 97 medical institutions, most of them are multidisciplinary clinical hospitals, and only 17 are included in the list of special institutions for providing psychiatric care.

“Taking into account the relevance of the request for psychiatric care, the Ministry is involved in improving the conditions of stay of patients undergoing treatment in psychiatric institutions. As part of the implementation of the New World Bank project, it is planned to modernize such institutions into regional mental health centers. Such centers will become modern centers where patients will be able to address any mental health problems. The specialists who will work in them will accumulate experience in this area, improve their knowledge and coordinate the services available in communities to support mental health at the oblast level,” said Minister of health Viktor Liashko.

Last year, expenditures on subventions from the state budget to local budgets to support individual institutions and activities in the healthcare system amounted to almost UAH 2.2 billion. More than UAH 122 million of subventions and UAH 152.4 million from local budgets were allocated to pay for the current expenses of special institutions.

In order for healthcare institutions financed by subventions from the state budget (including special institutions) to be able to charge medical workers a salary of at least 20 thousand UAH for doctors and 13.5 thousand UAH for secondary medical workers, the cost of the subvention was increased by 762.5 million UAH.

To provide high-quality medical care, purchase of medicines, food, protective impact-resistant film on glass, services for the protection of premises and fire alarm systems and payment of preferential pensions, additional expenses were provided for Vinnytsia, Dnipropetrovsk, Kyiv, Poltava and Rivne oblasts in the amount of more than UAH 3.2 million.

However, the Ministry’s work is aimed not only at providing material support to institutions, but also at building a fundamentally different system of providing psychiatric care. From the system that Ukraine inherited from the Soviet era, the so-called punitive system, a humane European-style system should be created.

“As part of Ukraine’s European integration steps, the Ministry of Health is working to improve the psychiatric care system and develop services in communities. This is how many countries of the world work, and we want to use this experience in Ukraine,” Viktor Liashko stressed.

Patients who have been treated for acute conditions can already receive support from a family doctor. For example, if a patient needs a new prescription as part of the treatment prescribed by a psychiatrist, or has any concerns or questions about their mental health, they may seek primary care.

In addition, people with post-acute conditions can receive psychiatric care from mobile multidisciplinary teams. Such a package, “Psychiatric care for adults and children provided by mobile multidisciplinary teams”, is also provided by the medical guarantee program, and the NHSU pays for services. 67 medical institutions have signed contracts for this package.

Hospitals plan to create mental health centers where everyone can apply for help. Such centers are already starting to work in Lviv, and it is planned to open a center in Chernivtsi.

At the end of 2021, the state program “Affordable Medicines” for people with mental and behavioral disorders was extended. It includes 30 trade names of drugs that can be obtained free of charge or with a small surcharge, for example, in the case of post-traumatic stress disorder (PTSD), depression, neurotic disorders, affective disorder, and schizophrenia.

With a prescription, the patient can contact any pharmacy that has a contract with the NHSU. In Ukraine, 11,539 pharmacies sell drugs for the treatment of mental and behavioral disorders. Since the beginning of 2022, 74,513 thousand prescriptions have been issued for this group of drugs, 62,349 (83%) have been repaid, and a total of 22,603 Ukrainians have received the necessary drugs.  The total amount of repaid prescriptions is UAH 15 million 737 thousand.

All these steps are aimed at taking care of the mental health of Ukrainians to a new level. Assistance in case of suspected mental disorders should be available in every corner of the country, even in the case of more serious conditions and diseases.