Almost 80 percent in one year the number of suicide attempts undertaken by children and adolescents increased, by 20 percent. the number of deaths due to this in this group. The psychiatric care system has been reformed for several years; further changes are planned for the coming years.

During the press conference organized on the occasion of the World Suicide Prevention Day at the PAP Press Center, experts from the Office for the Prevention of Suicidal Behavior of the Institute of Psychiatry and Neurology presented the latest data on the scale and dynamics of suicidal behavior in Poland, as well as presented information on planned reforms in the field of psychological care -psychiatric.

“Due to various recent events, both in the world and in the personal lives of many people, the growing problem of chronic stress, loneliness, sleep disorders, addictions, people experience mental crises with which they cannot cope. According to WHO, suicide is a more common cause of death than diseases such as malaria, AIDS or death due to hostilities or homicide. It is the leading cause of death in the population of 15-29 years old “- said Prof. Agnieszka Gmitrowicz, chairman of the Working Team for the prevention of suicide and depression at the Public Health Council of the Ministry of Health, head of the Department of Child and Adolescent Psychiatry of the Central Teaching Hospital of the Medical University of Lodz.

According to the available data of the Central Statistical Office of Poland, 4,553 suicides occurred in Poland in 2020, and these data do not include suicide attempts. Data on suicides and attempted suicides is collected by the Police Headquarters.

KGP data on the population of children and adolescents under the age of 18 for 2021 indicate that there has been a significant increase in the number of suicide attempts compared to 2020 – by as much as 77%. In the same period, it increased by 19%. number of attacks on one’s own life ended in death.

“Among the most common motives are mental problems (but not mental illness), emotional failures, family conflicts, very often violence. The basic life-saving intervention is limiting the availability of methods (suicide – ed.) And greater attention to the behavior of children in their environment: at school and at home. Among adolescents, it is dangerous to imitate auto-aggressive behaviors, including self-mutilation of the body, which significantly increases the risk of suicide “- points out Prof. Gmitrowicz.

In other words: if a child starts to mutilate, it means that he is in a deep crisis and he should be helped immediately. It should be remembered that there is no single reason why a person decides to take his own life.

Quick, close, no referral

In Poland, attempts have been made to reform psychological and psychiatric care for several years.

“The Institute of Psychiatry and Neurology has been selected as the institution that implements a large part of the tasks of the Suicidal Behavior Prevention Program implemented as part of the National Health Program for 2021-2025. And there, the entire catalog of activities coordinated by the Institute was proposed “- said prof. Halina Sienkiewicz-Jarosz, director of the Institute of Psychiatry and Neurology in Warsaw, head of the 1st Neurological Clinic of the Institute of Psychiatry and Neurology.

As experts emphasize, the most important word in a suicide crisis is: “immediately”. Such fast and free help can be obtained, among others in mental health centers that operate under the pilot of the National Mental Health Program, which has been running since 2018. Unfortunately, this assistance is not available all over Poland; Currently, there are 47 centers, 81 of them by the end of the year. According to the plan, the center is to operate in each district by the end of 2027. The support of the center is addressed to adults living in its area of ​​operation (usually residents of one poviat).

Where the centers currently operate, what area they look after and what is the contact with them, you can check on the website czp.org.pl and on the centre’s profile on Facebook: Pilotage of Mental Health Centers.

“This is to be help that is quick, available without a referral, close to home, involving the help of the patient and his relatives. Medical and non-medical support is provided there. A mental health center helps you manage your symptoms, recover, and stay healthy. The centers cooperate with local authorities, social welfare centers, community centers and libraries to support people in crisis in their return to social roles. There are psychiatrists, psychologists, psychotherapists, community therapists, care coordinators and recovery assistants, some Centers also employ a dietitian or job coach. Each Center has an application and coordination point which is the point of first contact. There, in a conversation with a psychologist, a support plan is developed that is tailored to individual needs. If the case of the person seeking help is considered urgent, the help is implemented immediately – the patient goes to a psychiatrist or to a general psychiatric ward, ”explained Dr. Anna Depukat, head of the Pilot Office of the National Mental Health Program, Institute of Psychiatry and Neurology.

On non-working days and outside the opening hours of the point, support can be obtained immediately at the emergency room of psychiatric wards.

Currently, work is underway on diagnostic and therapeutic standards so that the patient’s path in all centers is similar. Preparations are also underway for legislative changes to adapt the law to this transformation of the mental health care system in Poland, and this requires, inter alia, an amendment to the Mental Health Act.

Plans for comprehensive child and youth care

A reform is also underway to create a comprehensive nationwide system that provides support to underage mental patients and their families.

“Since I have been working in the profession, i.e. for 18 years, there has been talk of a collapse in the psychiatry of children and adolescents. This crisis was deepening year by year. 2018 was an important event for us, when the team for the mental health of children and adolescents at the Ministry of Health was established. It consisted of experts from various fields with extensive experience and practice. Together, we thought about how to organize and reorganize psychiatric care for children and adolescents, because we all know that it works in a way that does not meet expectations and does not meet our patients’ needs. Until then, community care was not functioning, and we all know that 80 percent. of our children and adolescents admitted to the ward, most likely, if they had received help at the right time and at the right level, “says Aleksandra Lewandowska, MD, national consultant in the field of child and adolescent psychiatry, head of the Psychiatric Ward. for Children in the Specialist Psychiatric Healthcare Complex in Łódź.

As it was said during the conference, one of the basic assumptions of the reform is focusing on community care and building a network of centers in which not doctors, but psychologists, psychotherapists and community therapists work. These centers of the first level of reference, which currently operate in Poland nearly 340, and ultimately there will be at least 400 of them. Importantly, patients can take advantage of the offer of these centers without a doctor’s referral.

Such centers will help those children who do not need a psychiatric diagnosis or pharmacotherapy, and it should be remembered that for many childhood psychiatric disorders, effective help can be provided through interventions such as individual or group psychotherapy, family therapy or work with peer group.

“The first such centers were launched on April 1, 2020, i.e. at a very difficult time of the first lockdown. And yet, somehow it worked, which is supported by the statistical data, because it turns out that despite the increase in the number of children up to 13 years of age by half, children’s wards had fewer patients than before the pandemic. This means these children have taken over the community care centers. Unfortunately, it did not work for young people, among whom the number of people in need of psychiatric help increased by nearly 60%. and it can be seen when the youth departments are occupied “- points out Dr. Lewandowska.

The Ministry of Health plans to have such a center in each poviat.

In addition to level I centers, level II centers are also to be established, where medical care will be provided, and patients requiring more intensive interactions will be able to take advantage of the day ward services. One such center will support several neighboring poviats. Currently, 66 clinics and 46 clinics with a day ward operate at this level, and their number should ultimately double.

Finally, centers for highly specialized, twenty-four-hour psychiatric care are to function at the highest level of referentiality. Patients requiring the most specialized help will find help there, including those in a life-threatening condition, who are admitted urgently. Currently, there are 25 of them, and ultimately one such center is to function in each voivodeship.

PTSD treatment centers

As announced by Dariusz Poznański, director of the Public Health Department at the Ministry of Health, a pilot of centers with support for people with PTSD, i.e. post-traumatic stress caused by various traumatic life events, will soon be launched.

“When we look at the number of legal changes taking place in psychiatric care, there are a lot of them. From our perspective, the most important thing is deinstitutionalization, i.e. moving closer to the place of residence of the patient and his family. We also deal with issues such as de-stigmatization, i.e. changing the approach to psychiatric care. People in crisis must know about it and be willing to use this help. Hence the campaigns aimed at disenchanting the subject of psychiatry, ”said the representative of the Ministry of Health.

Dariusz Poznański also recalled another form of quick support: 24/7 helplines. For adults, they are organized, among others Itaka Foundation, Ombudsman for Children’s Rights for children, who, in cooperation with the police, have already helped many people in need.

Important!

If you are experiencing difficulties and are thinking about taking your own life or want to help someone at risk of suicide, remember that you can use the toll-free help numbers:

870 22 22 24/7 support center for adults in mental crisis
812 12 12 – Children’s Ombudsman for Children Helpline
116 111 – a 24/7 helpline for children and youth
116 123 – daily 2 p.m. to 10 p.m. emotional support telephone for adults
112 – emergency number in situations of danger to health and life
Other support telephone numbers can be found at www.zapobiegajmysamobojstwom.pl www.zwjr.pl/bezplatne-numery-pomocowewww.pokonackryzys.pl

Source: Press conference organized on the occasion of the World Day of Suicide Prevention by the Office for the Prevention of Suicide Behavior of the Institute of Psychiatry and Neurology, 08/09/2022 at PAP

Source of information: Serwis Zdrowie

Source of information: Serwis Zdrowie Psychiatric care reform in progress