A visit to a child psychiatrist costs more than the exact same consultation for an adult. Mental health care for children and adolescents in Poland is in a catastrophic state.
We have already written about the dramatic situation in the field of child psychiatry due to the shortage of specialists throughout the country. There are only 521 active child psychiatrists in Poland, so there are more than 12,400 potential patients for each of them. There is therefore an average wait of around eight months for an appointment via the National Health Service (Polish: Narodowy Fundusz Zdrowia).
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Mental health care is a luxury in Poland
The problem has existed for a long time, but became particularly apparent when the need for mental health support for the youngest children increased as a result of the pandemic. Why are there so few specialists in child psychiatry? Because until recently, only few people chose this field of medicine. There are better-paid ones, including gynaecology, allergology or aesthetic medicine.
This is one reason why you pay more for a private visit to a child psychiatry specialist. In large cities, an initial consultation costs around 400-600 zlotys (€90-135). Cheaper visits are possible only to trainee psychiatrists. The appointment platform for specialists in this field offers very few options comparing to other doctors. In smaller towns, there are practically no psychiatrists or child psychiatrists.
It is not only salaries in the public health care system that determine that child psychiatry is not often the chosen path for medical students. Young psychiatrists (the 90% majority of whom are female specialists) also do not choose it for "systemic reasons".
Mental health problems most often have biological and environmental background. Genetic predisposition and social factors determine whether we become ill. The youngest children have very limited influence on the environment in which they function. To help them effectively in many cases the whole family should be involved in therapy. Not all parents are open to such solutions, however. As psychiatrist Dr Maja Krefft told the Business Insider, some parents expect to "fix their problem child" without them assisting.
The education system can sometimes be a source of mental health problems
Dr Kreftt also highlighted the role of the education system in the poor mental health of young Poles. Her patients are overtired and discouraged by the overloaded curriculum. Half of them come to the doctor at the age of 14-15. From the point of view of brain development, this is a difficult period in which teenagers and adolescents are naturally prone to melancholy.
"They also have to undergo the eighth-grade exam at this time, with parents and teachers pressuring them that their future depends on these grades. This pressure can make them feel uncomfortable. They may seek methods to reduce tension and reach for self-harm. Half of my patients declare self-harm, and just as many have suicidal thoughts," Dr Kreftt told the Business Insider.
On the other hand, Dr Kreftt pointed out that around 40% of the youngest patients who come to her for counselling do not need psychiatric intervention. Here, the blame lies, among others, with legislators who have not implemented proper regulations on the psychological profession. This causes a number of problems in the area of mental health care in Poland. In the context of adolescent care, only psychiatric doctors can formally diagnose autism spectrum disorder or ADHD.
Dr Kreftt and other psychiatrists also see young people who do not show any mental disorders or illnesses. They are healthy individuals who cannot cope with difficult circumstances, e.g. bullying. To help them, adequate knowledge and salaries should be provided to school educators, psychologists, and psychotherapists. In a well-functioning system, the psychiatrist’s office should be the last place where parents look for help.