The present and future of psychiatric aid in Estonia

Abstract

The present paper was presented at the XXIIIrd Nordic Psychiatric Congress in Helsinki, Soumi/Finland, 4-7 August 1991. At the time when the paper was written, Estonia was still a republic within the Soviet Union, struggling for its freedom. Today, Estonia is a free republic, recognized by the United Nations. However, the description of the present and the future of Estonian psychiatry is still of considerable interest. In the present paper the general situation in Estonia in August 1991 and the financial situation at the time are described. The in- and out-patient facilities for psychiatric patients are described, and the difficulties and problems are discussed. In Estonia there are about 180 psychiatrists. The psychiatric care is given at 9 hospitals, 18 outpatient departments, and 14 invalid homes. The authorities do not prohibit the foundation of institutions based on private capital, but the number of psysicians practising privately is small. In the 9 psychiatric hospitals there are a total of 2840 beds – that is, 1.8 hospital beds per 1000 inhabitants. In the hospitals psychopharmaco-therapy prevails. Psychotherapy has started to develop recently. The main problems are insufficient integration with somatic medicine, insufficient qualification and inadequate training of the personnel, and the lack of appropriate legislation.