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Poland has just launched the WHO Mental Health Gap Action Programme (mhGAP), an evidence-based approach to scaling up capacity and services for mental health conditions, under its National Health Programme, in a major step towards addressing the unmet mental health needs of the population. Poland, like other countries in the WHO European Region, has significant challenges when it comes to ensuring access to mental health services. 60% of patients who have reported needing mental health support say they do not seek help due to stigma. There are just 9 psychiatrists per 100 000 population in the country and waiting times are long. 3.7% of the Polish national health budget is spent on mental health care, which is low compared to some other European countries. Today, Polish children have one of the lowest rates of mental well-being and one of the highest rates of attempted suicides in Europe. In 2022, police investigated 2031 suicide attempts by those under the age of 18, an increase of 148% since 2020. Recognizing the need for urgent change, the Polish Government is taking urgent steps to reform the mental health protection system, including for children and adolescents. Since 2018, the Government has quadrupled spending on child and adolescent mental health to over PLN 1 billion (EUR 200 million) to address the need. "In the past, mental health needs have not been given the same attention as physical health, not only in Poland, but across the WHO European Region. We are now starting to understand the cost of that inattention to our society, the economy, communities and families," explained Dr Nino Berdzuli, WHO Representative in Poland and WHO's Special Envoy for the Ukraine Emergency Response in refugee-hosting countries. "However, the Polish health authorities are taking action - their current and future plans show that we are now on the right path," Dr Berdzuli added. Mental health has long been considered less of a priority than physical health in the Region and globally. Stigmatization and stereotypes towards mental health needs, along with a lack of adequate funding for services and long waiting lists for treatment, have created significant barriers to accessing care in many countries. In Poland and across the Region, primary health care is the entry point to the health system for patients with any health condition. That's the very reason why integrating mental health services into primary health care is one of the most effective ways for reducing unmet need for mental health - through early identification of those at risk, conducting rapid assessment and facilitating referral to services. "General practitioners (GPs) in Poland need to become front-line actors in community-based mental health provision, helping to alleviate pressure on the over-stretched psychiatry sector," explained Dr Berdzuli. The mhGAP programme will equip Polish GPs with the knowledge and skills to recognize symptoms of common mental health conditions, such as depression, stress-related conditions, substance addiction and suicidal thoughts. Specialist training is intended to give them confidence to manage these conditions or, if appropriate, refer patients to psychologists and psychiatrists at community mental health centres. "This programme will bring mental health services closer to the people; this is about giving mental health the attention it deserves," added Dr Berdzuli. Poland is the latest country in the Region to implement mhGAP, joining its neighbour Ukraine, which also has begun implementing the toolkit at the national level. More than 100 countries implement mhGAP worldwide. "The preparation of the programme started more than a year ago, and now we are glad to welcome the start of the mhGAP programme in Poland. The Ministry of Health is glad that we have a first pilot group, and these skills and knowledge will be useful for all of Poland," said Joanna Głażewska, Deputy Head of the Department of Public Health. The programme will be initially piloted in the Poldaskie and Mazovietskie regions with further plans to roll out countrywide. Ukrainian refugees will also be assisted by the programme. A survey conducted by Statistics Poland and the WHO Country Office in Poland found that at least 1 in 10 Ukrainian refugees reported significant mental health issues, and of those who reported issues, more than half would benefit from treatment. "In addition to the Polish population, support for mental health will be extended to the significant numbers of Ukrainian refugees. Refugees' mental health and well-being is a pressing concern, and with the generous financial support of the United States government, WHO and the Ministry of Health of Poland have taken proactive steps to address the issue," Dr Berdzuli explains. Mental health is one of the flagship pillars of the European Programme of Work (EPW) 2020-2025, the blueprint that guides much of what WHO/Europe does. Under the EPW, WHO/Europe has created the Pan-European Mental Health Coalition, bringing a range of stakeholders together to advocate with governments and policy-makers to invest in mental health. Urgent need for better mental health services
Primary care increases access
Extends access for refugees as well