A child in Poland has to wait 238 days to see a psychiatrist, activist says

Poland’s mental healthcare sector has improved in recent years, but there are still significant challenges to be overcome, with one activist highlighting a Polish child faces a waiting list of 238 days to see a psychiatrist.

Data from the National Chamber of Physicians, as of 30 September, indicates that there are just 4,585 professionally active psychiatrists in Poland. While, according to Eurostat, from 2017 to 2021, the number of psychiatrists in Poland increased from nine psychiatrists per 100,000 people to 12 in 2021, this is not enough to meet growing demand.

Germany boasts almost 30 psychiatrists per 100,000 inhabitants, while the Netherlands, Finland, and Greece each have 25 psychiatrists per 100,000 residents.

Polish statistics look even more grim for child and adolescent psychiatry.

Current data estimate that there are around 7 million children in Poland, with over 400,000 potentially in need of psychiatric assistance. However, the workforce in psychiatry is severely limited, with only 545 child psychiatrists currently practising.

“238 days – that’s the average waiting time in Poland for an appointment with a child psychiatrist,” Dominik Kuc, an activist with the GrowSPACE Foundation, which analysed national statistics, told Euractiv.

“The infamous record belongs to the centre in Bedzin, where the waiting time for an appointment is 2,441 days, which is…. more than six years”, he added.

Escalating mental health crisis in Poland

A recent survey conducted by the DIALOG Therapy Centre among primary care physicians across Poland revealed that over 94% of doctors believe the number of patients requiring psychiatric treatment in primary care has significantly increased in recent years.

The worsening of mental health issues is attributed to various factors, with surveyed doctors citing the COVID-19 pandemic (36%), the war in Ukraine (12.5%), and the accelerating pace of life (10%).

“The increase in the number of patients seeking specialised psychiatric and psychological help may suggest that there is a growing awareness in society that mental health should be cared for just as much as physical health”,  said Professor Marek Jarema, Director of Science in DIALOG Therapy Centre.

According to him, Poles are becoming gradually less ashamed to talk about their mental health problems; they are not afraid to seek help from specialists.

However, the consequences of still limited access to psychiatric care are dramatic. Polish children rank among the lowest in Europe for mental well-being, with one of the highest rates of attempted suicides.

In 2022, police investigated 2031 suicide attempts by individuals under 18, marking a 148% increase since 2020. In total – across all age groups – 5108 people in Poland took their own lives in 2022.

Increased funding is not enough to solve the problems

In response to these challenges, the Polish government has initiated a three-tiered support system as part of ongoing reforms, focusing on preventive healthcare, specialised care, and hospital-based treatment for the most severe cases.

The reforms were launched during the early days of the pandemic. However, the new system is still being formed and developed.

The lack of support in schools is also a problem.

“In Poland, a functional diagnostic system within schools is absent. The shortage of psychologists, coupled with a lack of training for teachers, compounds the challenge. Moreover, certain municipalities still face a deficiency in preventive programs that could be effectively implemented within educational institutions”, Dominik Kuc explained to Euractiv.

Despite the government’s efforts to address these substantial health needs by quadrupling spending on children and youth mental health over the past four years to over €200 million, experts argue that this remains a small fraction of the actual requirements.

Polish psychiatry faces not only a shortage of personnel but also financial constraints, leading to restricted service availability, long waiting lists, equipment shortages in hospitals, and a lack of collaboration between various centres and institutions, hindering the system’s efficiency.

The issue is further compounded by inadequate public education on mental health, perpetuating stigma and myths surrounding psychiatric disorders.

On 20 October, the Supreme Medical Council appealed to the Minister of Health, which called for urgent actions to ensure a substantial increase in funding for hospital services in paediatrics and child and adolescent psychiatry.

This underscores the recognition of the critical need for enhanced support and resources to address the specific mental health challenges faced by children and young people in Poland.

“There is a lot of talk about putting preventive health care first. Meanwhile, child psychiatry is the prevention of disorders that we later encounter in the offices of many specialists,” stressed the president of the Supreme Medical Council, Łukasz Jankowski.

Therefore, Poland has recently launched the WHO Mental Health Gap Action Programme (mhGAP).

This evidence-based approach aims to scale up mental health services, especially within primary healthcare, thereby reducing unmet needs. Integrating mental health services into primary care is crucial for early identification, rapid assessment, and facilitating referrals.

Dr. Nino Berdzuli, WHO Representative in Poland, emphasised the role of general practitioners in becoming front-line actors in community-based mental health provision to alleviate the strain on the overstretched psychiatry sector.

The mhGAP program will be initially piloted in the Podlaskie and Mazowieckie voivodeships, with plans for nationwide implementation.

(Paulina Mozolewska – Edited by Vasiliki Angouridi, Sarantis Michalopoulos | Euractiv.com)

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