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Progress and challenges in mental health reforms: a governmental view

Progress and challenges in mental health reforms: a governmental view. H. Hinkov, National center for public health, Sofia, Bulgaria. General background. Reforms in the health care sector - NHIF Privatization and corporatization Leading philosophy of the reform

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Progress and challenges in mental health reforms: a governmental view

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  1. Progress and challenges in mental health reforms: a governmental view H. Hinkov, National center for public health, Sofia, Bulgaria

  2. General background • Reforms in the health care sector - NHIF • Privatization and corporatization • Leading philosophy of the reform • Implications on the mental health care

  3. Legacy from the past and reasons for change

  4. General population

  5. Birth rate, death rate, natural grouth

  6. Age of the population

  7. Mental health financing State Municipal budget NHIF private Psych.hospitals dispensaries Group & individual practices Group & individual practices

  8. Number of mental health facilities 1. Psychiatric hospitals 11 2. Dispensaries 12 3. Psychiatric wards in general hospitals 15

  9. Number of beds • 1. Psychiatric hospitals 3075 • 2. Dispensaries 1566 • 3. Psychiatric wards 1199

  10. Number of patients per year(2001) • 1. Psych hospitals 11653 • 2. Dispensaries 14607 • 3. Psychiatric wards 10549

  11. Length of stay (days) Psych. hospitals 71 Dispensaries 30.9 Psychiatric wards 33.6

  12. Number of psychiatrists • Psychiatrists (2000) 750 • Psychiatrists (2001) 646

  13. Doctors/nurses ratio

  14. Lack of information

  15. Psych. hospital Outpatient service (Dispensary) Nursing home Individual practice patient community

  16. Amnesty international reports

  17. The governmental answer to chalenges

  18. National mental health program

  19. Stability pact mental health project

  20. Mental health policy and action plan

  21. PHARE project

  22. Changes in the legislation Act for social assistance Mental health chapter in the Act for health More than 50 regulations to be elaborated

  23. The current situation Outpatient services private Contracts with NHIF Increased number of outpatient psychiatrists Decreased number of beds Changes in the structure of the hospitalized patients

  24. New pharmaceutical products available

  25. Role of the NGO’s

  26. Professionals’ involvement

  27. Public attitude

  28. Conclusion

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