VERIFIED CONTENTAuthor: lek. Tomasz Nęcki

Polish child psychiatry is mentioned relatively often in various mass media - the main reason is its poor condition in our country. Not only is there a lack of appropriate specialists, but also places where the youngest patients could receive the help they need. What is Polish child psychiatry really like and in what areas are the greatest deficits noticeable?

Just as in the past it was believed that in the youngest mental disorders and diseases do not occur at all, it is definitely clear today that such individuals are most often encountered in them. We are talking here about problems that adults also face, such as schizophrenia or depression, but also about individuals that are considered typical of childhood, such as e.g. autism spectrum disorders, ADHD or selective mutism.

Children with mental disorders should be under the care of appropriate specialists, including psychologists. They should also be taken care of by a child psychiatrist - in Poland, however, as mentioned in the media relatively often, it is definitely not easy to get to such a specialist.

Child psychiatry in Poland: current status

For years it has been unfortunately emphasized that Polish child psychiatry is in a quite deep crisis. Literally everything is missing: both doctors and places where the youngest could be helped.

Currently, there are fewer than 500 specialists in child and adolescent psychiatry working in Poland. It is estimated, however, that there may even be more than 400,000 children in our country who require psychiatric help.

This means that there may be as many as 1,000 potential patients per psychiatrist. It is worth emphasizing here that the above-mentioned assumptions related to the period before the outbreak of the pandemic - currently, in line with all probability, the number of children requiring the help of a psychiatrist is most likely much greater.

The lack of doctors is not the only problem of Polish child psychiatry - there is also a lack of appropriate facilities. In many voivodships, there is only one 24-hour branchpsychiatric services for children and adolescents - this is the case in the West Pomeranian Voivodeship, for example, where patients from both Koszalin and Kołobrzeg have to go to Szczecin if necessary.

Such journeys may seem absurd, for parents of children with mental disorders they are not uncommon after all. The reason is that hospitals all over the country simply lack places for patients and desperate parents are looking for any facility across Poland that would be able to receive their child.

Poland lacks not only inpatient departments, but also other facilities offering psychiatric care. There are very few day wards for children and adolescents, but they are the places where children have the opportunity to benefit from various therapies, and at the same time they do not have to stay in the hospital all the time (in the case of day wards, the patient returns home every day) .

There is also an insufficient number of mental he alth clinics for children and adolescents - this is partly the result of too few child psychiatrists, and partly the fact that the financial outlays for this field of medicine are not too large.

In the end, the fact that you have to wait several months for an appointment with a psychiatrist has unfortunately become a Polish standard - it is worth adding here that the waiting time for an appointment under the National He alth Fund is so long, but it is often just as long when using from commercial benefits.

Child psychiatry in Poland: needs

Children - unfortunately - sometimes commit suicide and in 2022, according to the Polish police, as many as 107 young patients died this way. Most likely, at least some of these deaths could have been prevented if the children had been provided with the necessary help promptly. Ultimately, the basic need of child psychiatry in Poland is to increase patients' access to psychiatric care.

There is no doubt that in order to improve the condition of Polish child and adolescent psychiatry, long-term, wide-ranging activities are necessary. Every now and then, politicians announce spectacular changes or promise additional financial outlays, but in the end … not much changes.

More child and adolescent psychiatrists are needed - currently, however, still a small number of medical graduates choose this specialization. There may be many reasons for this, the main one may be that it is simply a difficult specialization.

Additionally, when it is heard everywhere that psychiatric wards are overloaded, doctors andNurses must be responsible for the safety of more patients than they are prepared for, it is not hardly surprising that the prospect of choosing such a speci alty may not be tempting at all.

There are also centers in Poland where children will be able to get help. It is now necessary to increase the number of both inpatient and day wards, it would also be beneficial to increase the number of mental he alth clinics for children and adolescents.

Child psychiatry in Poland may change, but it requires financial outlays and support from the government. But it just has to change. The situation in which there are about 40 patients in a ward with 25 beds, some of them in the corridor, is definitely pathological - unfortunately, this is the case quite often in Polish psychiatric hospitals for children.

Child psychiatry in Poland: social awareness

It often happens that a psychiatric hospital is the first place where a young patient with mental disorders goes. In an ideal world, such a patient would first go to a psychologist, if necessary to a psychiatrist, and only when outpatient treatment would not bring the expected results, it would be necessary to verify the diagnosis or the patient would start to endanger his life, he would be referred to the hospital. In Polish reality, however, things are different quite often, for several reasons.

Some children go to the hospital instead of the clinic because their parents are not able to enroll them in a mental he alth clinic - the lines, as mentioned earlier, can be absurdly long.

However, other caregivers, unfortunately, underestimate the problems of their children - it is not uncommon for a child to ask for a psychologist or psychiatrist, and parents, for not entirely clear reasons, do not agree to it.

Psychiatry is still controversial in Poland. Many parents are afraid of psychotropic drugs, assuming that all of them are addictive, and that they will change their child in some unfavorable way.

These fears may, moreover, be reinforced by various publications, which have been published recently in our country. Descriptions of the terrible conditions in hospitals or reports that child psychiatrists prescribe strong drugs that should not be used in children are definitely not convincing to psychiatry.

On the other hand, the authors of such articles seem to focus only on making their works loud and forgetting orThey deliberately ignore the fact that many drugs used in psychiatry of children and adolescents are used off-label and doctors do not write them out at random, but based on scientific reports and their own experience.

Child psychiatry in Poland: prospects

Some reforms in child psychiatry in Poland are already underway - one can even mention here how it was decided to create basic psychological help centers for children and adolescents. The initiative turned out to be absolutely necessary - there are no psychiatrists in these institutions, but they are to cooperate directly with, for example, schools and provide psychological support to children.

Properly introduced therapeutic interactions can prevent the development of more serious mental disorders - this is why it is so important how soon the child receives help.

What ultimately awaits Polish child and adolescent psychiatry is not really known. Organizations such as the Great Orchestra of Christmas Charity are trying to support it, but without the interest of the rulers, much will not change within this discipline.

The most likely consequence of the increase in financial outlays would be to increase the number of appropriate facilities, and ultimately to improve working conditions and increase the interest of medical graduates in specializing in child and adolescent psychiatry.

This specialization has its shadows, but it also has many shines - a situation gives a doctor a lot when his patient, previously struggling with suicide intentions, begins to plan his future and says that he is able to smile again and feel joy.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

Category:

Psychiatry