Prof. Milanova, what is the project you are working on?
-This is a new project in which the Medical University – Sofia participates, and more specifically The Clinic of Psychiatry of Aleksandrovsk Hospital This project is aimed at professionals who work in community, and the aim is to improve their ability to work with people who have mental illness outside of hospital. Six European countries participate in the project - Austria, Germany, Greece, Spain, Great Britain and Bulgaria.
How long will it last?
- He is three years old, according to the "Ravmus" training program. The project started in the fall of 2014 and I can already tell you interesting things from its first stage. An analysis was made of the current situation in the 6 participating countries, comparing them, and it can be said that according to some of the indicators, Bulgaria is in the middle of the table compared to some countries, compared to others it is a little lower. What I want to point out is that in terms of the duration of the training of such professionals, we are like the rest of the countries - on an equal footing. But on the other hand, our tuition is the cheapest. However, it is noticeable that the satisfaction of people who work in this field is very low. Unfortunately, here, both the pay and the funds that go into this activity are much less than in other countries.
From the analysis, is there anything we are first in?
- In other countries, to go for an examination with a specialist - psychologist, psychiatrist, you have to wait for months, but in Bulgaria it happens very quickly - within 10-15 days at most, the patient can have access. This contrasts sharply with the other participating countries. All specialists are impressed by how quickly we have access to each specialist.
In terms of their pay, where are we?
- Reimbursement for these services is extremely low. While in Germany almost all psychotherapy is reimbursed, in Austria – partially,
in Bulgaria such specific activities are not paid
In my opinion, it should be paid for by our He alth Fund, there should be packages, there should be greater access and equality for people who need it. This shows the assessment of the situation on this indicator in the six countries.
Regarding the time in which the specialists are trained, the countries are equal. But the price paid for one patient in our country is much lower than in other countries. Maybe because they have a lot of he alth funds and a lot of he alth funds.
Do you think that Bulgarian specialists will be interested in this type of training?
- Yes, there is already interest in training people in outpatient care how to work with people with mental illness. These professionals must be willing to upgrade their training - these are social workers, psychiatric nurses, etc. In our country these services are very few, limited, we lack the day centers where patients can engage in art therapy and other activities. The goal of the project is for us to look for the best experience, good practices to be implemented in our country.
Are you optimistic that this is how the conditions for the mentally ill in our country will change?
- Of course I am an optimist - this will improve services for people with mental illness, especially outside hospitals. A comprehensive media campaign should be done, doctors and media together, to make our society more sensitive, more supportive in our workdays. And not only when something tragic happens to a mentally ill person, to be the news of the day.
Together we must overcome the social stigma of Bulgarians
I know it will be a long process because things cannot change overnight. The idea is to know more, to have enough funds for these people. I really wish that the good practices were also shown, and how many good things we have done for our patients, and how many of them received adequate help, and not just the bad.
After training on this project, only the severe cases will come to you…
- The idea is this - people who have reached remission, have opportunities to adapt well in the community, to have someone to take care of them. If we have a good network to support these patients, a very small fraction of them will end up in the hospital. Regardless of what is said and written in our country, our psychiatry has come a long way. We have many new tools, new medications, we have opportunities for people with mental illnesses to live fully outside, among their loved ones, and spend very little time in a hospital.
But unfortunately, we lack this particular network to take them after they leave the hospital. With the training of specialists, this network will be built - this is the goal of the project. I will mention that 80% of the sick can live outside! There are such medications - taken once a day, or at a certain period, by injection or by pill, with which our patients can be maintained. These drugs are easy to tolerate, have no side effects, and are paid for by the He alth Insurance Fund. People can feel fulfilled even if they work.
