Pathways to psychiatric care in Eastern Europe

Abstract

BackgroundThere has been almost no research into mental health services in Eastern Europe. A pathways study is a quick and useful starting point, requiring few resources.AimsTo improve understanding of prior care-seeking and treatment of new patients seen at mental health services.MethodPathways diagrams were drawn showing the routes of care-seeking for 50 new patients in eight centres. Patterns of care-seeking, durations and previous treatments were compared for ICD–10 diagnostic groups.ResultsThe diagnoses varied according to the organisation of services. Major pathways included general practitioners, direct access and hospital doctors. General practitioners have a limited role as ‘gatekeeper’ in centres in Albania, Croatia, Macedonia, Romania and Serbia–Montenegro, and rarely prescribed treatment, except sedatives, for mental disorders.ConclusionsFindings highlight areas that require attention if aspirations for community-oriented mental health care are to be realised, particularly integration of mental health into primary care.