What's next for mental health centers? The team is finalizing its work, and the ministry is awaiting a report.

Deputy Minister Katarzyna Kęcka participated in the 1st Congress of Psychiatric Hospitals, which took place on September 18th and 19th in Warsaw. Under the new leadership of the Ministry of Health, she will be responsible for mental health issues, as the Department of Public Health reports to her. "Psychiatry in Poland will be a priority for me; it's one of our three priorities. I want you to know that while certain issues may not be addressed at certain times, it doesn't mean we're not working on them," she told the congress participants.

Referring to the recent publicity surrounding mental health centers (MHCs), she emphasized that she, too, "is eagerly awaiting the recommendations that will be developed by the systemic affairs team."

This involves a team appointed late last year by former Minister Izabela Leszczyna to develop solutions that will enable the smooth completion of the pilot program without limiting access to services provided by the Social Insurance Fund. The team is currently finalizing its work.

- I am waiting for it as impatiently as you are and I hope that I will receive these recommendations by the end of September - said Katarzyna Kęcka.

What does the future hold for mental health centers?

As a reminder, mental health centers have been operating under a pilot program since 2018. It has already been extended several times, and in June of this year, the ministry extended it until the end of 2025. However, this will likely need to be extended again, as solutions to include mental health centers in the guaranteed benefits package have not yet been developed.

The issue of ending the pilot program sparked strong emotions at the end of last year. In early December, a protest took place in defense of the mental health centers. The community around these facilities—their residents, employees, and co-creators of the reform—feared for their future. Currently, mental health centers (CZPs) serve half of Poland's population. However, implementing them systematically as the dominant model of psychiatric care—a plan consistently declared by the Ministry of Health, regardless of changes in the ministry's leadership—means changes, including in the financing of the CZPs. Previously, the Ministry of Health and the National Health Fund (NFZ) announced changes to the model, which currently relies on a flat-rate per capita payment. The aforementioned team will work out the details of exiting the pilot program.

His appointment, however, has not allayed concerns. The CZP's patients and employees continue to demonstrate periodically in defense of the existing model. This week, they warned that next year's National Health Fund (NFZ) budget will allocate PLN 1.2 billion less for psychiatry than this year's budget. The Fund and the Ministry of Health explained that the pilot program is currently scheduled to run only until the end of the year, so no funds have been allocated for this purpose next year (PLN 2.5 billion was allocated this year). Currently, there is no basis for planning the CZP's funding – either under the current or new formula, but the NFZ assures that funds will be available for this purpose.

Despite these declarations, the Polish Association of Mental Health Centers announced an Extraordinary Mental Health Congress for October 9 this year.

Corps of officials or term of office?

During the Congress of Psychiatric Hospitals, Katarzyna Kęcka was also asked what she thought about the idea of ​​introducing a corps of officials, hospital directors, and perhaps also ministers, to protect them from the "political broom" and ensure the continuity of decisions in the system.

"There's a need for stability in the system. For many years, we've been grappling with the effects of constant change, which is certainly not good for the system as a whole," she admitted. "We know perfectly well that until now, whenever the government has changed, the leadership of the ministries has also changed. I myself became deputy minister at a difficult time. We only have two years left (until the next parliamentary elections – ed.), so there's little time, and a lot of work," she added.

According to the new deputy minister, it would be worth considering introducing a term of office for senior officials on the same basis as is currently the case for judges, and thus defining the duration of their term of office.

"Honestly, I don't know what the ruling party and its coalition partners think about this. Why would this be a good solution? If we have people in the system who have an idea for reform and are starting to implement it, it would be good to have time to evaluate the effects of the changes they have introduced. And unfortunately, today it often happens that there are great ideas for what to change in the system, but there is not enough time to implement them and observe their effects. I would certainly like to be able to observe the consequences of my own decisions, which I will soon make, but I am also a realist," emphasized Katarzyna Kęcka.

She admitted that such a solution would be very helpful in planning the ministry's work.

"In such a situation, resources are distributed completely differently, with a greater focus on the long-term impact. Of course, there are many pressing problems and these fires need to be extinguished, but public health requires the implementation of well-planned measures, which should be evaluated in a few years to ensure they are well-adapted to the real health needs of communities in individual regions," said the deputy minister.

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