25 per cent of the population have some problems with a mental health at a certain stage in life and mental diseases constitute one fifth of all diseases in Europe. According to Psychiatry and Neurology Institute data, almost 8 million of Poles in the age of 18-64 must tackle smaller or bigger mental disorders. The Mental Health Integration Index, in turn, indicates that mental diseases in Europe bring about substantial human and economic costs and they are not properly treated. Poland is on the 15th place in the index and it is defined as a country running so called aspiration politics in the area of mental health. This fact means a discrepancy between regulations and programs in Polish psychiatry (10th place) and accessibility to medication (22th place).
We have good law solutions, however, they are not followed by adequate financing. For instance, the National Mental Health Program is a very good and modern solution but at the same time it needs an adequate financing – says Medical Doctor Sławomir Murawiec, psychiatrist and psychotherapist.
According to report, the level of education concerning Polish psychiatrists and psychotherapists is really high. Moreover, the accessibility to registered medicines at the global level is theoretically good. The problem is underfunding this branch of medicine which results in the fact that sick people have often limited accessibility to both doctors and medicines.
The example is a situation of people suffering from schizophrenia – there are ca. 380-400 thousand people struggling with this disease in Poland. The disorder needs perennial treating but still 60-70 per cent of patients do not follow prescriptions of doctors, especially those concerning taking of medicines every day. Therefore, psychiatrists have been more and more often prescribing medicines with a prolonged effect in the last years. They may be administered, for instance, in the form of an injection every two weeks or once a month. Doctors emphasize that it has an influence on improvement of well-being of a patient and gives some chances for an active life. However, their application in Poland is limited. In spite of the fact that medicines with a prolonged effect are fully registered, their application is characterized by numerous limitations. These are medicines, the refund of which is much higher. Therefore, doctors are afraid of inspections and imposing a fine by the National Health Fund – says MD Sławomir Murawiec.
The application of medicines with a prolonged effect allows to cut some costs borne by a state budget due to this disease. Schizophrenia has been for years on the fourth place among diseases which generate the greatest expenses of the Social Insurance Institution right after circulatory system diseases, cancers and osteo-articular system diseases. The Social Insurance Institution intends nearly one billion zlotys every year for services connected with inability to work. Moreover, it addresses a half of this amount to refund of medicines for schizophrenics. The medicines with a prolonged effect are a little bit more expensive than oral pills taken every-day. According to experts, this discrepancy would be compensated by cutting social costs resulting from a wrongly treated disease. There are no so much hospitalizations and intervention visits because application of these medicines enables a stable functioning and a longer improvement of health. Therefore, there is also a possibility of taking a job by sick people – says MD Sławomir Murawiec.
Social costs related to schizophrenia include not only direct costs, connected with a visit in a hospital, but also indirect costs, related to a person who falls out of a labor market. According to survey, even 93 per cent of hospitalized patients lose their jobs at least five times, and over 70 per cent of them receive a pension. The application of medicines with a prolonged effect may help in maintaining a professional activity of a patient.