According to the Deputy Minister of Health Aurim Pečkauskas, forced hospitalization currently accounts for 3 percent. of all hospitalizations.
“It is important not to forget that the observance of human rights is extremely important when providing health care services, ensuring the patient’s dignity, safety, the right to be informed and to make their own decisions about the proposed treatment, especially for persons with mental health problems who need mental health care. Therefore, in order to reduce these statistics, it is necessary to take alternative ways to help the patient and enable him and his environment to recover, reducing the number of coercive measures”, says A. Pečkauskas.
In order to implement the principles of strengthening human rights in psychiatry provided for in the Government’s program, SAM has approved the action plan for the prevention of forced hospitalization, which provides comprehensive measures and services that will help implement the principles of human rights-based personal health care services.
Lithuanian experience is valued in Europe
When Lithuania takes over the Belgian good practice elements of the JA Implement project, teams providing community mental health care services are being created, and the case management model has been applied in mental health centers since the beginning of this year.
Lithuania’s experience in transitioning to measures that promote patient recovery is favorably evaluated and seen in the context of other countries. Lithuania is one of the first countries in Europe to implement a system for regular assessment of the compliance of mental health and social care institutions with human rights standards and performance improvement system, using the QualityRights methodology of the World Health Organization (WHO).
April 22-24 In the “QualityRights” trainings organized by the WHO in Lithuania for mental health professionals from all over Europe, Lithuania was presented as an example of implementing decentralized mental health care services focused on the patient’s recovery.
“It is well known that mental health problems affect more than one in six people across the European Union, and suicide is the second leading cause of death among young people. According to a new Eurobarometer survey, nine out of ten (89%) survey respondents believe that improving mental health is just as important as improving physical health. This shows the importance of mental health as an integral part of health and the need to focus on early diagnosis and prevention. The JA ImpleMENTAL network includes 39 organizations from 21 countries and more than 200 people working together, sharing knowledge and experience in improving mental health and ensuring access to services,” says Vasileia Konte, JA ImpleMENTAL project coordinator and National Public Health Organization of Greece representative
Case management is focused on helping the patient
In Lithuania, taking advantage of the European Union’s investments, from the beginning of 2024, the development of case manager services was started in nine mental health centers, where the focus is on patients:
- suffering from schizophrenia and having a low level of functioning and/or low motivation for treatment;
- experiencing the threat of suicide;
- suffering from a severe form of depression and having a low level of functioning and/or low motivation for treatment;
- suffering from a moderate form of depression or organic depression and having any other mental and behavioral disorder;
- patients with alcohol addiction;
- patients receiving inpatient treatment to ensure that the patient arrives at the Mental Health Center within 30 days of inpatient treatment.
According to Edita Bishop, advisor of the Mental Health Department of the Mental Health Center, the purpose of the case manager services is to ensure the provision of personalized services focused on the patient’s long-term recovery and needs, therefore, a very important part of the provision of these services is the creation of an individualized support plan.
“This plan is drawn up together with the patient, that is, together with him, his needs and goals are discussed and possible ways to achieve them, the patient’s personal strengths are assessed, and the patients are motivated together to achieve maximum recovery. Both the support plan and the changes in the patient’s condition are periodically discussed with the entire team of the mental health center – that is, a psychiatrist, a medical psychologist and a nurse, and everyone jointly decides what services or treatment are still needed,” says E. Bishop.
Support in the community will be provided by mobile teams
This year marks the start of preparations for a community-based mental and behavioral health service, a new support tool for patients at high risk of re-hospitalisation or involuntary re-hospitalisation. It is planned that next year it will be provided by special mobile teams consisting of 10 specialists with different qualifications – a psychiatrist, 6 mental health nurses, a social worker, a medical psychologist, and an occupational therapist. Full-size teams will be able to provide services for 200 patients, and half-size teams will be able to provide services for about 100 patients.
“People who often return to hospital (including involuntary treatment) due to their complex medical conditions, who find it difficult to adhere to a treatment regimen and apply independent living skills, will be able to receive long-term, continuous and mobile support. Services will be provided both in medical institutions and, if necessary, at the patients’ place of residence and in the community – so it will be even easier for the patient to get help,” says E. Bishop.
Until 2027 with the help of EU funds, the aim is to establish 19 community treatment teams (GBK) in all counties and county centers of Lithuania. 3.6 mln. EUR investments from EU funds. They will annually provide services to 2,700 patients with the most complex mental and behavioral disorders.
