[Potential directions of development of the Hungarian Mental Health System].

Abstract

The provision and coordination of good quality care in mental health represents a major challenge worldwide. The direct and indirect costs of psychiatric disorders, including costs due to substance use disorders are very high in the countries of the European Union. The prevalence of both mental disorders and substance use disorders is significant in Hungary. Leaders of the psychiatric profession joined forces and assembled a complex plan for the development of mental health care in Hungary. The National Programme of Mental Health represents both challenges and opportunities for this area. The main objective is a stepped care and collaborative care model for individuals with psychiatric disorders that incorporates the primary care system (general practitioners) and the community psychiatry providers. Primary care needs to develop competence to identify and treat people with common mental disorders, supported by a new care model of clinical psychologist counseling services. The tasks of these psychologists include screening (assessment interviews), giving information, leading patients to the optimal therapeutic pathways, psychoeducation and low-intensity psychological interventions. The psychologist represents a bridge between the family doctor and psychiatric care. The programme aims to shift mental health services from hospitals to community mental health facilities services. However there is a parallel organization of health and social care systems in Hungary that inhibits the complex care of patients. It is necessary to develop a closer coordination (or collaboration) of out-patient psychiatric care and the community-based services, to provide more and better facilities for reintegration of patients. Continuity of care can beestablished by psychiatrists being responsible for treatment plans and pathways, including the frequency of follow-up visits or the need for transferring patients to family doctors or to psychiatric hospitals. In some areas there is an important need for the development of specialized teams or units (for example crisis intervention service, forensic psychiatric unit, mother-child unit, psychiatric emergency rooms, high security wards). Human resources represent a major problem, the numbers of psychiatric nurses and psychiatrists are insufficient. The dysfunctional distribution of human resources leads to the deterioration of services. This is principally financial question. In the future the psychiatry should take advantage of the possibilities offered by digital technology. In this paper we present the main elements of the National Programme of Mental Health. We hope that the programme can be realized in the coming years with financial support of the Hungarian Government.