Russian Federation: mental healthcare and reform

Краснов, В.; Gurovich, Isaak; Бобров, А. Е.

doi:10.1192/s1749367600005725

Cited by 5 publications

(3 citation statements)

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“…It has been described for Russia, and it may hold true for several other post-Soviet countries [38] , [39] , that psychiatric services are still largely hospital based [40] . Outpatient treatment is traditionally centralized in large “dispensaries” [41] . If there has been any reduction in bed capacities, it might have been less motivated by initiatives to establish decentralized community based care but rather by a lack of funding [42] .…”

Section: Discussionmentioning

confidence: 99%

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

et al. 2012

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BackgroundGeneral psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context.Methodology/Principal FindingsGeneral psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989–1999, 1999–2009 and the whole period of 1989–2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from −11% in Croatia to −51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989–2009, trends in the prison population ranged from a decrease of −58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations.Conclusions/SignificanceAfter the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as a general rule for most of the countries.

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Section: Discussionmentioning

confidence: 99%

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

et al. 2012

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“…During the last years in a number of regions the introduction of new developments in mental health care has led to changes in the structure of the mental health service with greater emphasis on the development of care in the community, where a system of psychosocial rehabilitation is organized, clinics of first episodes of disease, hostels and other types of protected housing are set up, interaction with social services is developed, assertive treatment departments (teams) are set up, and hospital at home, psychoeducation, psychosocial work with families are provided. NGOs are not yet sufficiently but more and more involving in mental health assistance (6,7). Theme Article ational studies as the main scientific task in their work.…”

Section: Theme Articlementioning

confidence: 99%

Psychiatry in Russia

Краснов¹

2014

Die Psychiatrie

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SummaryRussian psychiatry has dramatic history, and till now is at a transitional stage of development. It is facing the problems not only common in world psychiatry, but also specific for the Eastern Europe, in particular for Russia. Starting from the beginning of 1990s considerable changes have occurred in psychiatry, especially after 1992 when “The law on psychiatric care and guarantees of citizens rights in its provision was adopted”. It became the ideological and legislative basis for reforms. However there are the definite obstacles for structural reforms in psychiatry. They are as follows: unfavourable technical conditions in many psychiatric clinics, hypercentralization of psychiatric services, shortage of clinical psychologists and social workers in psychiatry, some difficulties in cooperation between psychiatric and general medical institutions. Economic difficulties of the transition period of Russia’s social development prevent overcoming these problem. They are being actively discussed and part of them is being gradually solved, e.g. organization of team work in mental health services, increasing number of specialists on social work, involvement of NGO’s in psychosocial rehabilitation.

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“… Tajikistan: Health system review Tajikistan 27. 2010 Krasnov, V., Gurovich, I., & Bobrov, A [ 36 ]. Russian federation: mental healthcare and reform Russia 28.…”

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confidence: 99%