THE CURRENT STATE OF MENTAL HEALTH IN THE XXI CENTURY IN THE CONTEXT OF HEALTH CARE REFORM

Abstract

The monograph provides a comparative analysis of the medical and demographic situation in Ukraine in recent years: population, birth and death rates, natural increase (decrease) in citizens, average life expectancy at birth, disability, morbidity. Also, an analysis of the Human Development Index in Ukraine and other countries according to the UN (2018) is carried out. From the investigation of the report of statistical data of the Ministry of Health of Ukraine on the structure of hospitalized patients in hospitals of Ukraine for 2019 adult population among all diseases: the first place has occupied by diseases of the circulatory system – 23.19% (including coronary heart disease – 10.93%, cerebrovascular diseases – 5.95%, angina – 4.02%), second place-diseases of the digestive system – 9.07%, third place belongs to tumors – 8.96%, fourth place respiratory diseases – 8.04%. At the same time, the state of mental health of the population of Ukraine is not insignificant, and according to the statistics of the Ministry of Health of Ukraine in 2019, cerebral and behavioral disorders amounted to 4.54% and diseases of the nervous system – 4.16%. The average length of stay of adult patients in psychiatric institutions is from 33.3 to 48.7 days in Ukraine compared to European countries in Lithuania up to 20.8 days, in the Republic of Poland up to 20.3 days. In Ukraine, the treatment of patients with mental disorders and behavior remained as in Soviet times, the Semashko health care model, the priority of inpatient treatment in the old premises that have been building in the XVIII-XIX centuries, and therefore there is a crisis in the field of mental health and mental health. The reform of mental health facilities in European countries has been completing in 2000, and they have moved to a multidisciplinary model for the treatment of the mentally ill. For people with changes in mental health, new Mental Health Centers have been building, and the old premises of psycho-neurological hospitals have been reconstructing for comfortable stay of patients, creation of "therapeutic, healing environment" for quick marriage, return of patients to society. A comparative description of the provision of medical workers in the field of health care in Ukraine with similar indicators of the EU countries is provided. The study aims to analyze the ways of reform in the EU and Ukraine, to show mistakes in the incomplete health care reform of Ukraine and examples of overcoming the crisis and improving the mental health of the population as in European countries. Ukraine should learn from the experience of other European countries by increasing funding for health care and prevention measures to reduce disease and improve the mental health of the population. One way to overcome the crisis is to have a strong link between the various Ministries of Social Policy, Health to provide timely health care to vulnerable populations and to stratify socio-demographic and lifelong mental health indicators as in the EU. It is possible to strengthen the mental health care system through highly institutionalized services to public/religious organizations that are more person/ patient-oriented.