| dc.description.abstract | Background: Mental health services (MHS) are inadequate in many countries of Eurasia, and resource allocation status is unsatisfactory. Since the beginning of this century, mental health reform has prompted the growing demands for providing mental health resources throughout the countries. Addressing these needs requires Eurasian countries to reflect on the current structure and availability of MHS and seek positive guidance from countries with successful mental healthcare practices, such as those in Scandinavia. However, evidence on the MHS research, including the health economy for Eurasian countries, is very limited. Information published on comparing MHS between Eurasia and Scandinavia remains absent. Driven by the lack of knowledge, this study attempts to identify the current state of MHS and how to best allocate the resources in place for Eurasian countries.
Methods: Using a cross-sectional analysis, this study analyzed the financial and personnel allocation of MHS between Eurasia and Scandinavia. In this study, Eurasia referred to Armenia, Georgia, Kyrgyzstan, and Ukraine, while Scandinavia was represented by Norway and Sweden. An online questionnaire, written in English, was designed and distributed by the Ukraine-Norway-Armenia (UNA) Partnership Project. Respondents were chosen based on their professionalism and leading roles in the national psychiatric associations (i.e., President, Vice President). This descriptive analysis was complemented by the follow-up interviews for respondents.
Results: The health expenditure was generally below 4% of GDP throughout Eurasia. Inpatient hospital care commonly exceeded 80% of the total budget on mental healthcare. While psychiatric beds remained numerous in Eurasia, the number of psychiatric personnel was scarce, especially psychiatric nurses (less than 0.1 per 1 000). Surprisingly, Georgia spent 10% of GDP on healthcare, with the percentage approximate to Scandinavia. Additionally, almost half of the mental health budget was spent on outpatient care, 47% of which spent on adults, and 37.7% on children and adolescents.
Conclusion: To our knowledge, this is the first cross-national comparison of resource allocation of MHS between Scandinavia and Eurasia. The study definitively identified an overall lack of financial support for healthcare and mental healthcare within the region, resulting in considerable out-of-pocket (OOP) costs. MHS are predominantly based in institutional care, while outpatient community services remain under-resourced and poorly distributed. Nevertheless, Georgia shows generosity in healthcare spending and has handed more priority outpatient services. The study calls for future initiatives to shift the focus of MHS, and expand financial support to stimulate sustainable capacity building.
Keywords: Mental health services, health economy, capacity building, financial resources, Scandinavia, Eurasia, Armenia, Georgia, Kyrgyzstan, Norway, Sweden, Ukraine | |