This material was presented in the 25th European Congress of Psychiatry which was organised by the European Psychiatry Association in Florence, Italy from 1-4th April 2017. I had access to the material as I attended the full Congress. Please note that this material remains the intellectual property of the European Psychiatry Association and its authors and any citation should include a full reference to it. For more information on the EPA and how to become a member, please visit: http://www.europsy.net/

1. Jerzy Samochowiec
Department of Psychiatry
Pomeranian Medical University Szczecin Poland
Country Specific Implementation of EPA Guidance: Example from the
Polish Psychiatric Association

2. How fast the growth of GDP was
Thanks to Poland’s accession to
the EU economic growth has
accelerated and within only 10
years Polish companies have
increased production by half. GDP
driving force was mostly fast
growing export as well as big
influx of foreign investments and
EU funds. The development,
however, has not been even –
wealthier voivodships, already
economically linked with the
western world, have gained more.
As a result, even though Polish
people all over the country have
got wealthier, the discrepancies in
income have increased.
How GDP
per capita
had grown
Poland’s
accessio
n to the
EU
The fall
of
Lehman
Brothers
Economic
crisis in
the
Eurozone
Eurocup
2012 in
Poland

3. State Total
score
GDP inflati
on
unem
ploym
ent
Profes
sional
activit
y
R&D
funds
Prisone
rs/100
000
The at-
risk-of
poverty
rate
Avera
ge life
expect
ancy
Infant
mortality
rate
Educati
on
index
Life
satisfacti
on
Divorce
rate
(/1000)
Suicide
rate(/10
0 000
Murde
r rate
(/100
000)
Holland
1
1952 128 0,4 7,1 77,2 2,16 82 15,0 79,3 3,6 0,931 7,5 2,0 8,8 1,1
Denmark
2
1946 125 0,3 7,0 75,4 2,99 73 19,0 78,1 3,4 0,924 7,8 2,8 9,9 0,9
Luksemb
ourg
3
1923 271 0,8 6,1 71,4 2,30 131 18,4 79,1 2,5 0,771 7,1 2,1 9,7 2,5
Sweden
4
1913 128 0,1 8,2 79,4 3,41 67 15,6 79,9 2,6 0,904 7,5 2,5 11,1 1,0
Germany
6
1888 121 1,0 5,0 76,7 2,92 77 19,6 78,6 3,4 0,928 6,7 2,3 9,9 0,8
Great
Britain
10
1714 110 1,9 7,2 74,2 1,72 149 24,1 79,1 4,2 0,815 7,0 2,1 6,4 1,2
France
12
1702 108 1,1 10,9 69,3 2,26 100 19,1 78,7 3,5 0,870 6,8 2,0 14,7 1,1
Italy
14
1591 98 0,4 12,9 61,0 1,27 101 29,9 79,8 3,2 0,856 6,4 0,9 5,4 0,9
POLAND
22
1413 66 0,7 9,9 64,7 0,90 208 26,7 72,7 4,6 0,822 5,8 1,7 15,3 1,1
Romania
27
1255 49 1,3 7,3 63,8 0,42 166 41,7 71,0 9,0 0,831 4,9 1,5 11,9 2,0
Bulgaria
28
1216 47 -2,1 13,1 63,0 0,64 151 49,3 70,9 7,8 0,802 4,2 1,6 9,3 2,0

4. Growth of the average income in
Poland
100% - EU average
What Polish people have more of
In 529% more
households there is a
dishwasher (Compared to
2003)
In 156% more households
there is a computer
In 34% more
households there
is a car

5. Polish citizens temporarily staying outside the national borders (both new and
“old” emigration – from before the year 2004)
Great Britain
Germany
Ireland
Holland
Italy
Norway
France
Belgium Sweden
Spain

7. Statistical Pole
38,7 years
Average age
(35,9 in 2003)
26% smoke
(31% in 2003)
53% are
overweight
(46% in 2003)
61% don’t
exercise / do
any sports
(59% in 2003)

8. Fewer children, more
pensioners
Changes since 2003
Pre-working age
Working age
Retirement age

9. Psychiatry in Poland–
numbers: what’s important..

10. Psychiatric beds in Poland
(x1000)
Statistical Bulletin 1973; 2009

11. Other facilities in Poland
Statistical Bulletin 2009

12. Trends in Poland: new
outpatients/100,000
Mental Health Statistics, 2009
10x
12x

13. National Mental Health Prevention
Programme
2011-2015
(three main objectives):
1. Access to effective community based psychiatric
services and assisted outpatient treatment
programmes
2. Mental health promotion and prevention
3. Research and statistics in psychiatry
The Governmental Act/Order; 28 DEC 2010

14. Health %
GDP
PPS
How
much for
psychiatr
y?
8% - UE,
7,7% - Spain
7% - Poland
% public
system
5.5% -UE,
5.0% - Spain,
3.2% - Poland*
Medicalnet 20.03.2012; Salvador-Carulla 2006 Eur J Psychiatry, *Plan for 2012 – National Health Fund

15. *NHF – National Health Fund since 2004 and predecessors
Expenditure for psychiatry (as % of NHF*
plans)
1999 2000 2001 2002 2003 2004 2006 2007 2008 2009 2010 2011 2012
2013
National
Programme

16. Professions Forecasts
rate/100,000 number
Status quo
Psychiatrists 10.0 3800 2700
Child and adolescent
psychiatrists
1.0 380 206
Clinical psychologists 9.5 3800 1400
Social workers 10.0 3800 300
Nurses 35.0 14000 10000
Occupational
therapists
8.0 3200 560
Certified
psychotherapy
specialists
2.0 800 500
Addiction treatment
specialists and
instructors
350 2000 1400
Expected employment
Vox Medici, 2011, 2,12-14

17. The rate of psychiatric beds per 100,000
population in 2008 in Poland’s regions

18. Long-stay mental health facilities in 2008
in Poland’s regions

19. In 2050 there will be 33,9 mln Poles and 1/3
will be over 65 years old

20. Medical Univercities in Poland

21. Why do we need guidances?

22. Guidances and standards of
treatment and diagnosis?

23. • 1. Position statement of the EPA on the value of antidepressants in
the treatment of unipolar depression
Korzyści stosowania leków przeciwdepresyjnych w leczeniu depresji
jednobiegunowej – stanowisko Europejskiego Towarzystwa
Psychiatrycznego
H.-J. Möller, I. Bitter, J. Bobes, K. Fountoulakis, C. Höschl, S. Kasper European Psychiatry , 2012, Volume 27,
Issue 2, 114–128.
• 2. EPA Guidance on the Quality of Mental Health Services
Wytyczne Europejskiego Towarzystwa Psychiatrycznego dotyczące
zapewniania jakości w służbie zdrowia psychicznego
W. Gaebel, T. Becker, B. Janssen, P. Munk-Jorgensen, M. Musalek, W. Rössler, K. Sommerlad, M. Tansella, G.
Thornicroft, J. Zielasek European Psychiatry Volume 30, Issue 3, 360–387
• 3. EPA Guidance on suicide treatment and prevention
Wytyczne Europejskiego Towarzystwa Psychiatrycznego (EPA)
dotyczące metod leczenia i prewencji samobójstw
D. Wasserman, Z. Rihmer, D. Rujescu, M. Sarchiapone, M. Sokolowski, D. Titelman, G. Zalsman, Z.
Zemishlany, V. Carli European Psychiatry 2012, Volume 27, Issue 2, 129–141

24. • 4. EPA guidance on the early intervention in clinical high risk states of
psychoses
Wytyczne Europejskiego Towarzystwa Psychiatrycznego (EPA) dotyczące wczesnej interwencji w
stanach klinicznie wysokiego ryzyka psychozy
S.J. Schmidt, F. Schultze-Lutter, B.G. Schimmelmann, N.P. Maric, R.K.R. Salokangas, A. Riecher-Rössler, M. van der Gaag, A. Meneghelli, M.
Nordentoft, M. Marshall, A. Morrison, A. Raballo, J. Klosterkötter and S. Ruhrmann European Psychiatry Volume 30, Issue 3, Pages 388–404
• 5. EPA guidance on the early detection of clinical high risk states of psychoses
Wytyczne Europejskiego Towarzystwa Psychiatrycznego dotyczące wczesnego
wykrywania stanów klinicznie wysokiego ryzyka wystąpienia psychozy
F. Schultze-Lutter, C. Michel, S.J. Schmidt, B.G. Schimmelmann, N.P. Maric, R.K.R. Salokangas, A. Riecher-Rössler, M.
van der Gaag, M. Nordentoft, A. Raballo, A. Meneghelli, M. Marshall, A. Morrison, S. Ruhrmann and J. Klosterkötter
European Psychiatry Volume 30, Issue 3, 405–416
• 6 EPA Guidance on Post-graduate Psychiatric Training in Europe
Wytyczne Europejskiego Towarzystwa Psychiatrycznego w sprawie
kształcenia podyplomowego psychiatrów w Europie
Mayer S, van der Gaag RJ, Dom G, Wasserman D, Gaebel W, Falkai P, Schüle C European Psychiatry Volume 29, Issue 2, 101–106.

25. Translation process
we pay special attention to the copyrights issues!
• Text translation Jun-Aug.2015
• Proofreading by experts – Polish professors Jun-Aug 2015
• Correction-making process Sep-Dec 2015
• Linguistic revision Oct-Nov.2015
• Second proofreading and critical remarks Nov-Dec.2015
• Lectures on the Congress of Wisla 10-12 Dec 2015
• The Guidance Committee has given its approval for the translated
documents. 09 Feb 2016
• Publication in Biblioteka Psychiatrii Polskiej (Library of Polish
Psychiatry) May 2016
• Lectures on the 45th Polish Psychiatrists Congress Katowice 16-18
Jun 2016 and distribution of Guidance translations at the Congress
• First Exams for polish psychiatrists including questions from the
guidances– Autumn 2016

27. Training curriculum

28. Training curriculum
 Specialty training in GAP lasts 5 years (60 months)
 During this time a trainee is obliged to attend certain
internships and courses.
 In 2014 the specialty training program has been
updated. New specialty program consists of 6
courses and 5 internships.
 The internship on general ward for adults in a
clinical ward and in an in-patient ward (40 months).
 Other internships include: neurology, CAP, neuroses
treatment and addiction treatment.

30. Training curriculum
 Specialist training in Poland does not contain
psychotherapy course.
 Following successful completion of 5 years of
training, a trainee will take the final exam.
 Once a trainee has passed the written and oral
exam, he becomes a specialist in adult psychiatry.

31. *
Thank you
Prof. Jerzy Samochowiec
Katedra i Klinika Psychiatrii PUM
samoj@pum.edu.pl
+48914541507