Browsing by Author "Mundt, Adrian P."

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    Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019 : A retrospective database analysis
    (2021-08) Mundt, Adrian P.; Rozas Serri, Enzo; Siebenfoercher, Mathias; Alikaj, Valbona; Ismayilov, Fuad; Razvodovsky, Yury E.; Hasanovic, Mevludin; Marinov, Petar; Franciskovic, Tanja; Cermakova, Pavla; Harro, Jaanus; Sulaberidze, Lela; Kalapos, Miklos Peter; Assimov, Marat; Nurmagambetova, Saltanat; Ibishi, Nazmie F.; Molchanova, Elena; Taube, Maris; Chihai, Jana; Dedovic, Jovo; Gosek, Pawel; Tataru, Nicoleta; Golenkov, Andrei; Lecic-Tosevski, Dusica; Randjelovic, Dunja; Izakova, Lubomira; Svab, Vesna; Vohidova, Mutabara; Kerimi, Nina; Sukhovii, Oleksii; Priebe, Stefan; Department of Psychiatry and Narcology
    Background: Numbers of psychiatric beds (general, forensic, and residential) and prison populations have been considered to be indicators of institutionalisation of people with mental illnesses. The present study aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period. Methods: We retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels. Findings: Primary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 33.8% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (24.7%), residential facility beds (12.0%), and for prison populations (36.0%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings. Interpretation: Most countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries. (C) 2021 The Authors. Published by Elsevier Ltd.
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    Changes in the provision of institutionalized mental health care in post-communist countries
    (2012-06-08) Mundt, Adrian P.; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Maris; Welbel, Marta; Priebe, Stefan; Department of Psychiatry and Narcology
    Background: General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. Methodology/Principal Findings: General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. Conclusions/Significance: After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as a general rule for most of the countries.