Epidemiology (prevalence) of mental disorders
For a long time, mental disorders were considered chronic and “incurable”, while psychiatrists and psychiatric clinics consulted “secretly”. However, attitudes towards such diseases have changed – the importance of mental diseases is reflected in public self-awareness, their economic importance has played a significant role in this process: the treatment of mental diseases is one of the most costly, costs in this category are about 22 billion euros per year, equal to 10% of all direct health care expenditures in Germany.
Every 4th patient observed in private clinics, every 3rd patient of general hospitals suffers from mental disorders that are either not detected or not subjected to adequate treatment.
The latter, in turn, is one of the main causes of early disability. It is increasingly noted that treatment aimed primarily at stopping emergency conditions (the so-called radar syndrome: the patient suddenly appears on the “radar screen” and later “disappears”) is not adequate, given the chronic course of many mental (and somatic) diseases.
Patients with mental disorders and illnesses initially contact their family doctor (that is, a general practitioner). Based on this, every doctor should master the basics of psychiatry.
What definition can be given to this medical discipline? In psychiatry can be identified:
– clinical neurophysiological approach to the disease;
– mental-therapeutic (in the narrow sense of the word) approach to the patient (patient’s personality).
The first to whom patients with mental illness turn are mainly general practitioners and family doctors in the community. They play an important role in the primary diagnosis and initial therapy, as well as in the direction of treatment in specialized institutions.
The specialized outpatient care in the EU (Germany) is not given enough attention, the necessary funding and proper distribution of services are lacking: there are about 700 thousand mentally ill patients for 18 thousand psychotherapists and psychologists, about 4 million patients suffering from (severe) mental illness (1 psychiatrist per 17 thousand inhabitants at the rate of 60 euros per patient per quarter)!