* 57 psychiatric wards in general hospitals (3,700 beds),

* 112 day centres

* 20 mobile community teams,

* 603 mental health outpatient clinics,

* 228 community self-help homes

* 50 to 60 centres providing community specialist services.

* 312 occupational therapy workshops,

* 2480 psychiatrists, 1500 psychologists, 400 other mental health professionals with a college or university education, and 450 social workers.

New standards of psychiatric treatment suggest that the basic venue for caring for the mentally ill should be the community and the major goal of psychiatric care should be improving the quality of life of patients with chronic mental health disorders. There has been a significant reduction of beds in the large psychiatric hospitals. Small psychiatric wards are being opened in general hospitals, which are more accessible to patients' homes; and mobile community teams, day treatment hospitals, and sheltered workshops have been established. Within the framework of community psychiatric care, associations of patients, their families, and friends have been organised and are having an impact on decisions taken by local and central governments. The associations have promoted the treatment of patients in their own communities, raised funds, helped find jobs, apartments etc. Rapid crisis intervention centres have been opened to deal with the sudden onset of psychological problems.

The only available figure on the cost of psychiatric inpatient care is the figure for national expenditures quoted in the state budget. In 1998, this was PLN 535,8 million (about USD 134 million), which corresponds to 0.4 % of the national budget and 2.8% of expenditures on the entire health care system.

No figures are available on private insurance or social security expenditures for the treatment of depression.

Definitions and diagnostic procedures

 

DEFINITIONS OF MENTAL HEALTH DISORDERS

Poland has always used international classifications to define mental health disorders and has always applied international standards to their treatment. Currently, the 10th revision of the International Classification of Diseases (ICD-10), introduced in Poland in 1997, is in force.

Definitions of mental health disorders, including depression, are applied in accordance with the ICD-10, which has been translated into Polish and is officially used in all institutions dealing with the treatment of mental health disorders. Basic manuals, such as Clinical Description and Diagnostic Guidelines, Diagnostic Criteria for Research, or Handbook for Primary Care Practitioners, have also been translated into Polish.

There are no specifically Polish terms to define stressful situations and depressive states. The definition of "psychological stress" contained in the Leksykon Psychiatrii is similar to Selye's, i.e. "a non-specific response of the organism to demands," and to Lazarus's concept of a "a set of transactions between the subject and community."⁶ These terms have the same meaning in Poland that they do in other countries. The Lexicon of Psychiatric and Mental Health Terms, published by WHO in 1989, is being translated into Polish.