Health minister, psychiatrists want mental, physical healthcare equated

Minister of Health and Labor Peep Peterson (SDE, third from left) and Anne Kleinberg (fourth from left) and their teams. November 17, 2022.
Minister of Health and Labor Peep Peterson (SDE, third from left) and Anne Kleinberg (fourth from left) and their teams. November 17, 2022. Source: Ministry of Social Affairs

Minister of Health and Labor Peep Peterson (SDE) met with representatives of the Estonian Psychiatric Association (EPS) on Thursday, where they discussed the nationwide shortage of psychiatrists and clinical psychologists in public medicine and agreed that mental healthcare has been playing second fiddle to physical healthcare in Estonia.

According to National Institute for Health Development (TAI) figures, a total of 228 psychiatrists were practicing in Estonia in 2019, more than half of whom were near or approaching pension age, the Ministry of Social Affairs said in a press release Friday. Under the psychiatry specialty development plan drawn up by the EPS, however, the ideal total should be 260, or 30-40 more than that.

At Thursday's meeting, Peterson and association representatives discussed the role Estonian Health Insurance Fund (Haigekassa, EHIF) prices could help keep mental health professionals on the labor market and in public medicine.

"We're no longer competing with foreign countries for workers; homegrown residency graduates prefer the private sector for financial reasons," EPS chair Anne Kleinberg highlighted.

Peterson also acknowledged that while societal expectations on psychiatrists and clinical psychologists are high, the latter nonetheless aren't highly valued in solidarity-based financing of medicine.

Both parties reached the consensus that, to date, mental health has been playing second fiddle to physical health in Estonian healthcare, and that psychiatrists' and psychologists' wage component needs to be increased to make it more competitive with the private sector.

Also discussed at the meeting was improving case management and patient journeys, which would help ensure that insufficient help wouldn't lead to a further increase in the burden on emergency care at hospitals belonging to Estonia's hospital network development plan as well as remove the burden of tasks unrelated to their profession from practicing psychiatrists.

"We must take care to ensure that the patient retains the possibility of reaching the top of the [mental health and psychosocial support services, MHPSS] intervention pyramid in severe cases and do everything we can to ensure that someone can receive them there as well," Peterson stressed.

The health minister and EPS agreed to meet again in January to specify further steps for implementing needed changes.

According to figures included in the "Green Paper on Mental Health" drawn up under the Ministry of Social Affairs, one in five people experiences mental health issues each year, with that figure rising to one in two over their lifetime worldwide.


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Editor: Aili Vahtla

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