Pathways to psychiatric care in Eastern Europe.
BACKGROUND
There has been almost no research into mental health services in Eastern Europe. A pathways study is a quick and useful starting point, requiring few resources.


OBJECTIVE
To improve understanding of prior care-seeking and treatment of new patients seen at mental health services.


METHODS
Pathways diagrams were drawn showing the routes of care-seeking for 50 new patients in eight centres. Patterns of care-seeking, durations and previous treatments were compared for ICD-10 diagnostic groups.


RESULTS
The diagnoses varied according to the organisation of services. Major pathways included general practitioners, direct access and hospital doctors. General practitioners have a limited role as 'gatekeeper' in centres in Albania, Croatia, Macedonia, Romania and Serbia-Montenegro, and rarely prescribed treatment, except sedatives, for mental disorders.


CONCLUSIONS
Findings highlight areas that require attention if aspirations for community-oriented mental health care are to be realised, particularly integration of mental health into primary care.
Gater
Richard
R
University of Manchester and Lancashire Care NHS Trust, Preston, UK. richard.a.gater@manchester.ac.uk
Jordanova
Vesna
V
Maric
Nadja
N
Alikaj
Valbona
V
Bajs
Maja
M
Cavic
Tamara
T
Dimitrov
Hristo
H
Iosub
Diana
D
Mihai
Adriana
A
Szalontay
Andreea Silvana
AS
Helmchen
Hanfried
H
Sartorius
Norman
N
D000328:Adult; D003156:Community Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005061:Europe, Eastern; D006801:Humans; D001523:Mental Disorders / Q000628:therapy; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires