This study explored unmet mental health and social care needs in the Slovak Republic and their adverse human rights consequences. We estimated treatment gap for persons aged 15–64 years in year 2015 affected by depressive, anxiety, substance use and schizophrenic disorders by comparing local treated prevalence rates with population estimated rates for Europe. Two-thirds of people with depressive disorders and over 80% of those with anxiety disorders and alcohol dependence were not receiving treatment. There was no treatment gap for persons with schizophrenia. Fifty-one percent of those eligible for disability pension on the grounds of mental disorders failed to receive it. We discuss the implications of the estimated gaps in mental health and social care and consequent human rights violations that may result from the current system of mental health care in Slovakia.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Danelia, M., Gyr, N., Boer, W., Zurabashvili, D., Chigladze, L., & Tsereteli, D. (2011). Mental disorders of people with disability pension in Georgia. Georgian Medical News, 198, 62–67.
Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291(21), 2581–2590.
Drew, N., Funk, M., Tang, S., Lamichhane, J., Chavez, E., Katontoka, S., et al. (2011). Human rights violations of people with mental and psychosocial disabilities: An unresolved global crisis. Lancet, 378(9803), 1664–1675.
EPIC. (2014). Prehľadová štúdia o aktuálnej situácii v oblasti zamestnávania ľudí so zdravotným postihnutím v SR. ISBN 978-80-97181811-5-4 https://tenenet.sk/wp-content/uploads/Prehladova_studia_vych.stavu_zamestnanosti_EPIC.pdf. Accessed 15 Oct 2018.
Hašto, J., Breier, P., Černák, P., & Rakús, A. (1999). Reforma psychiatrickej starostlivosti. Trenčín: Vydavateľstvo F.
Joska, J., & Flisher, A. J. (2005). The assessment of need for mental health services. Social Psychiatry and Psychiatric Epidemiology, 40(7), 529–539.
Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T. B. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20(4), 359–364.
Kohn, R., Saxena, S., Levav, I., & Saraceno, B. (2004). The treatment gap in mental health care. Bulletin of the World Health Organization, 82(11), 858–866.
Lora, A., Kohn, R., Levav, I., McBain, R., Morris, J., & Saxena, S. (2012). Service availability and utilization and treatment gap for schizophrenic disorders: A survey in 50 low- and middle-income countries. Bulletin of the World Health Organization, 90(1), 47–54, 54a–54b.
Maj, M. (2009). Physical health care in persons with severe mental illness: A public health and ethical priority. World Psychiatry, 8(1), 1–2.
MPSVR. (2014). Národné priority rozvoja sociálnych služieb na roky 2015-2020. Bratislava: Ministry of Labour, Social Affairs and Family of the Slovak Republic.
Mueser, K. T., & McGurk, S. R. (2004). Schizophrenia. Lancet, 363(9426), 2063–2072.
NHIC. (2016). Psychiatric care in the Slovak Republic 2015. Bratislava: Slovak Republic, National Health Information Centre.
OECD. (2010). Mental health, disability and work. https://www.oecd.org/els/45008308.pdf. Accessed 15 Oct 2018.
OECD. (2014). Making mental health count. The social and economic costs of neglecting mental health care. Paris: OECD Publishing.
Patel, V., Chisholm, D., Parikh, R., Charlson, F. J., Degenhardt, L., Dua, T., et al. (2016). Addressing the burden of mental, neurological, and substance use disorders: Key messages from Disease Control Priorities. The Lancet, 387(10028), 1672–1685.
Pathare, S., Brazinova, A., & Levav, I. (2018). Care gap: A comprehensive measure to quantify unmet needs in mental health. Epidemiology and Psychiatric Sciences, 27(5), 463–467.
Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., et al. (2007). No health without mental health. The Lancet, 370(9590), 859–877.
Saxena, S., & Maj, M. (2017). Physical health of people with severe mental disorders: Leave no one behind. World Psychiatry, 16(1), 1–2.
Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007). Resources for mental health: Scarcity, inequity, and inefficiency. The Lancet, 370(9590), 878–889.
Shidhaye, R., Lund, C., & Chisholm, D. (2015). Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: Strategies for delivery and integration of evidence-based interventions. International Journal of Mental Health Systems, 9, 40.
van Ginneken, N., Tharyan, P., Lewin, S., Rao, G. N., Meera, S. M., Pian, J., et al. (2013). Non-specialist health worker interventions for the care of mental, neurological and substance-abuse disorders in low- and middle-income countries. Cochrane Database of Systematic Reviews, 11, 009149.
Viola, S., & Moncrieff, J. (2016). Claims for sickness and disability benefits owing to mental disorders in the UK: Trends from 1995 to 2014. BJPsych Open, 2(1), 18–24.
Waterhouse, J., Muir, C. S., Correa, P., & Powell, J. (Eds.). (1976). Cancer incidence in five continents (pp. 1–583). Lyon: IARC Press.
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., & Erskine, H. E. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. The Lancet, 382(9904), 1575–1586.
WHO. (2011). Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Report By the Secretariat. World Health Organization Executive Board. http://apps.who.int/gb/ebwha/pdf_files/EB130/B130_9-en.pdf. Accessed 15 Oct 2018.
WHO. (2013). Investing in mental health. evidence for action. Geneva. ISBN 978 92 4 1564618. http://apps.who.int/iris/bitstream/10665/87232/1/9789241564618_eng.pdf. Accessed 15 Oct 2018.
WHO. (2014). Mental health atlas 2014. Geneva: World Health Organization.
WHO. (2018). Mental health atlas 2017. Geneva: World Health Organization.
Winkler, P., Krupchanka, D., Roberts, T., Kondratova, L., Machu, V., Hoschl, C., et al. (2017). A blind spot on the global mental health map: A scoping review of 25 years’ development of mental health care for people with severe mental illnesses in central and eastern Europe. The Lancet Psychiatry, 4(8), 634–642.
Wittchen, H. U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., & Jonsson, B. (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21(9), 655–679.
World Bank. (2018). Atlas of sustainable development goals. Washington DC: World Bank.
Conflict of interest
The authors declare that they have no conflict of interest.
Research Involving in Human and Animal Rights
The research did not involve human and/or animal experimentation.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Brazinova, A., Hasto, J., Levav, I. et al. Mental Health Care Gap: The Case of the Slovak Republic. Adm Policy Ment Health 46, 753–759 (2019). https://doi.org/10.1007/s10488-019-00952-z
- Mental health
- Care gap
- Slovak Republic
- Psychiatric disorders