Some of the Montenegrin health centers do not have full-time psychiatrists and psychologists, while in other municipalities, at the primary level, mental health specialists provide up to 9.000 services per year (first and control examinations, prescription of therapy...).
Data from "Vijesti" show that there is usually one psychiatrist, psychologist or psychotherapist working in primary health care institutions. On the other hand, in certain municipalities, such as Andrijevica and Kolašin, there are no permanently employed staff who could provide psychological or psychiatric help to the residents.
The health centers in Bar, Mojkovac, Bijelo Polje, Cetinje, Danilovgrad, Nikšić, Podgorica and Tivat have not provided "Vijesta" with data on the staff and the number of services they provide, even after three months.
The last strategy for the protection and improvement of mental health refers to the period from 2019 to 2023, and the new one was not adopted, despite the appeals of the civil sector. In the old strategy, it is stated that there are eight centers for mental health within the health centers, while the health centers in Herceg Novi, Budva, Danilovgrad, Mojkovac and Plav have centers for mental health on paper, but they do not meet the personnel standards.
According to the Rulebook on closer conditions in terms of standards, norms and methods of providing primary health care through a team or selected doctor, an average of 22.000 insured persons are expected per psychiatrist specialist in mental health centers.
They examine thousands of patients annually
According to the answers from the Budva Health Center, that institution employs one psychiatrist and one graduate psychologist-psychotherapist. They say that on a daily basis, a psychiatrist examines between 15 and 20 patients, and a psychologist between five and six. This indicates that up to 8.000 patients are examined annually.
The Health Center in Herceg Novi said that last year the psychiatrist had 7.000 services, and the psychologist had 2.000 services. In that institution, there is a full-time psychiatrist and consultant who prescribes twice a week, one psychologist, while no psychotherapist is employed.
Data from the Beran health center "Dr. Nika Labović" show that there are two psychiatrists working in the Center for Mental Health, as well as two psychologists in that organizational unit and the Center for Children with Developmental Disabilities.
The psychologist at the Center for Children with Developmental Disabilities has 42 patients who have been coming continuously for a long time.
On the other hand, they explain, the number of patients that one psychologist at the Mental Health Center can adequately monitor and provide support varies depending on various factors, but it is often considered to be between four and eight users.
The activities of psychologists at the Center for Mental Health in accordance with professional education relate to diagnostic interviews, individual surface psychotherapy, data collection with psychological tests, assessment of limitations, neuropsychological testing, assessment of intellectual abilities, team processing of the patient, processing of results and writing of findings.
From the Health Center in Berane, they said that the psychiatrists of that institution also conduct a methadone program for addicts every day.
In the Rožaje Health Center, two psychiatrists are foreseen by systematization, and one position has been filled. They don't have a psychologist, and they haven't provided the number of services. A similar response was sent from the Kotor Health Center, which has a psychologist and a psychiatrist.
Two neuropsychiatrists work at the Health Center in Pljevlja. The permanently employed doctor examined 285 patients in two months, and the substitute doctor examined eight. The psychologist, who is finishing her second year in RE and CBT psychotherapy, worked with 84 patients from mid-January to the end of March.
The Ulcinj Health Center said that one employed psychiatrist examines 1.900 patients a year, and a psychologist examines 550.
There is also a specialist in psychiatry working in Plav, who provided 508 services during one month, and an employed psychologist provided 105.
Andrijevica and Kolašin without employed psychiatrists
In Andrijevica and Kolašin, they do not have employed psychologists and psychiatrists. From the Health Center in Andrijevica, they said that the Center for Mental Health was not even overlooked by systematization, so they refer patients to Berane.
On the other hand, the Kolašin Health Center hires psychiatrists, neuropsychiatrists and psychologists from other institutions based on additional work contracts in order to provide specialist services and issue medical certificates.
Thus, 280 first psychologist examinations were registered in that institution last year. The psychiatrist performed 61 first, 49 follow-up examinations and 301 shorter psychodiagnostic interviews, while the neuropsychiatrist who additionally works at that institution in 2023 had 31 first examinations and 315 follow-up examinations.
Staffing problems at a higher level as well
The treatment of patients with psychiatric problems is often the focus of defenders of human rights and freedoms. In the annual report for 2023, the ombudsman notes problems in the health system that concern both personnel problems and hospital treatment.
The protector states that within the existing health institutions there are no conditions for hospital treatment of children with mental health problems, which is a serious problem.
He also notes that even in the Special Hospital for Psychiatry in Kotor, where patients requiring hospital treatment are accommodated, the poor financial position, infrastructure and lack of staff have been pointed out for years.
Over the years, the protector has pointed out that the staffing situation in the hospital in Nikšić, where a suicide occurred at the end of April after a patient repeatedly unsuccessfully sought psychiatric help, is unacceptable and has a potentially serious negative effect on the quality and scope of the provision of health services to those who are undergoing hospital treatment.
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