Citation

Ivezić S, Jukić V, Grbić D, Ćelić I, Brečić P, Radić MS, Bagarić A, Ćurković M. Acta Med. Croatica 2018; 72(2): 179-188.

Copyright

(Copyright © 2018, Croatian Academy of Medical Sciences)

DOI

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PMID

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Abstract

AIM: Issues surrounding mental health and mental disorders are characterized by high prevalence globally, as well as in the Republic of Croatia. Besides its high prevalence, the bare nature of mental disorders, which often seizes workforce or economically active population, considerably contributes to the burden of diseases. This makes organization of comprehensive care for persons with mental health disorder an imperative, including all measures of prevention, treatment and rehabilitation. The aim of this paper is to present the condition, shape and trends in organization of care for persons with mental health disorder in the Republic of Croatia, and to provide guidelines for its improvement according to fi ndings and recommendations of the Twining project under the title Ensuring Optimal Health Care for People with Mental Health Disorders.

METHODS: For the purpose of this paper, data from the Croatian National Institute of Public Health were used, including data on the number, rates and characteristics of hospital treatments for mental disorders in total and separately for particular diagnostic categories during the 2000-2016 period. Age-standardized rates of suicides were analyzed for the Republic of Croatia and some European countries. Review of the literature, current guidelines, and scientific papers were used to determine the condition and shape of the organization of mental health services in the Republic of Croatia. Analytical-descriptive methods were used in analysis.

RESULTS: According to estimates of the burden of diseases for the Republic of Croatia, mental disorders rank third in the leading group of diseases. In addition, mental disorders are the main cause of hospital morbidity in active population, while morbidity at the level of primary care is 4%-5% of all causes of morbidity. Age-standardized rates of suicides for the Republic of Croatia are higher than the average ones for other European Union member states. Although there was a continuous decline in hospital days from 2000 to 2016, the total number of hospitalizations increased from 2000, which is especially evident for depressive disorders. Patients with schizophrenia are still leading by the number of days spent at the hospital. Examples of good practice are reviewed and presented. Most of them are related to rehabilitation from first psychotic disorders, treatment of first psychotic disorders, addiction, and programs addressing issues of stigma and self-stigma.

DISCUSSION: According to the indicators displayed, it is concluded that mental disorders are a growing issue in the Republic of Croatia, which is most evident from the trend of rising hospitalization rates and number of days spent in the hospital.

CONCLUSION: There is a need for mental health reform by ensuring balance and coordinated inpatient and outpatient system of care. Recommendations developed within the Twining project can serve as guidelines for the development and implementation of evidence based and applicable strategies of mental health services that should be grounded in recovery, which includes full social participation in the life of community. © 2018, Academy of Medical Sciences of Croatica. All rights reserved.

Language: bs

Keywords

human; mental health; Croatia; Mental disorders; depression; prevalence; schizophrenia; psychosis; hospitalization; stigma; morbidity; mental disease; health care organization; community care; length of stay; mental health service; health care; outpatient care; Article; job stress; hospital mortality; all cause mortality; Community treatment services; Hospital treatment services; Organization of health care services; Outpatient treatment services; Republic of Croatia