Mental Health Care Gap: The Case of the Slovak Republic


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.

Fig. 1
Fig. 2


  1. 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.

    Google Scholar 

  2. 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.

    Article  Google Scholar 

  3. 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.

    Article  Google Scholar 

  4. EPIC. (2014). Prehľadová štúdia o aktuálnej situácii v oblasti zamestnávania ľudí so zdravotným postihnutím v SR. ISBN 978-80-97181811-5-4 Accessed 15 Oct 2018.

  5. Hašto, J., Breier, P., Černák, P., & Rakús, A. (1999). Reforma psychiatrickej starostlivosti. Trenčín: Vydavateľstvo F.

    Google Scholar 

  6. Joska, J., & Flisher, A. J. (2005). The assessment of need for mental health services. Social Psychiatry and Psychiatric Epidemiology, 40(7), 529–539.

    Article  Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. 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.

    PubMed  PubMed Central  Google Scholar 

  9. 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.

  10. Maj, M. (2009). Physical health care in persons with severe mental illness: A public health and ethical priority. World Psychiatry, 8(1), 1–2.

    Article  Google Scholar 

  11. MPSVR. (2014). Národné priority rozvoja sociálnych služieb na roky 2015-2020. Bratislava: Ministry of Labour, Social Affairs and Family of the Slovak Republic.

    Google Scholar 

  12. Mueser, K. T., & McGurk, S. R. (2004). Schizophrenia. Lancet, 363(9426), 2063–2072.

    Article  Google Scholar 

  13. NHIC. (2016). Psychiatric care in the Slovak Republic 2015. Bratislava: Slovak Republic, National Health Information Centre.

    Google Scholar 

  14. OECD. (2010). Mental health, disability and work. Accessed 15 Oct 2018.

  15. OECD. (2014). Making mental health count. The social and economic costs of neglecting mental health care. Paris: OECD Publishing.

    Google Scholar 

  16. 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.

    Article  Google Scholar 

  17. 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.

    CAS  Article  Google Scholar 

  18. 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.

    Article  Google Scholar 

  19. Saxena, S., & Maj, M. (2017). Physical health of people with severe mental disorders: Leave no one behind. World Psychiatry, 16(1), 1–2.

    Article  Google Scholar 

  20. Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007). Resources for mental health: Scarcity, inequity, and inefficiency. The Lancet, 370(9590), 878–889.

    Article  Google Scholar 

  21. 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.

    Article  Google Scholar 

  22. 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.

    Google Scholar 

  23. 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.

    Article  Google Scholar 

  24. Waterhouse, J., Muir, C. S., Correa, P., & Powell, J. (Eds.). (1976). Cancer incidence in five continents (pp. 1–583). Lyon: IARC Press.

    Google Scholar 

  25. 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.

    Article  Google Scholar 

  26. 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. Accessed 15 Oct 2018.

  27. WHO. (2013). Investing in mental health. evidence for action. Geneva. ISBN 978 92 4 1564618. Accessed 15 Oct 2018.

  28. WHO. (2014). Mental health atlas 2014. Geneva: World Health Organization.

    Google Scholar 

  29. WHO. (2018). Mental health atlas 2017. Geneva: World Health Organization.

    Google Scholar 

  30. 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.

    Article  Google Scholar 

  31. 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.

    CAS  Article  Google Scholar 

  32. World Bank. (2018). Atlas of sustainable development goals. Washington DC: World Bank.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Alexandra Brazinova.

Ethics declarations

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.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

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).

Download citation


  • Mental health
  • Care gap
  • Slovak Republic
  • Psychiatric disorders