Pathways to psychiatric care in Eastern Europe

Area of Science:

• Mental Health Services Research
• Healthcare Systems Analysis
• Psychiatry

Background:

• Limited research exists on mental health services in Eastern Europe.
• Pathways studies offer a resource-efficient method for initial investigation.
• Understanding patient care-seeking is crucial for service improvement.

Purpose of the Study:

• To enhance comprehension of prior care-seeking behaviors.
• To analyze treatment patterns for new mental health service patients.
• To map patient journeys within Eastern European mental health systems.

Main Methods:

• Utilized pathways diagrams to illustrate care-seeking routes for 50 new patients across eight centers.
• Compared care-seeking patterns, treatment durations, and prior interventions.
• Analyzed data based on International Classification of Diseases, 10th Revision (ICD-10) diagnostic groups.

Main Results:

• Significant variation in diagnoses was observed, correlating with service organization.
• Primary care physicians (general practitioners) acted as limited 'gatekeepers' in several countries (Albania, Croatia, Macedonia, Romania, Serbia-Montenegro).
• General practitioners rarely prescribed treatments beyond sedatives for mental disorders.

Conclusions:

• Findings underscore critical areas for development in community-oriented mental healthcare.
• Integration of mental health services into primary care is essential for future progress.
• Service organization significantly influences patient pathways and treatment access.