Pathways to psychiatric care and reform of the public health care system in Poland.

OBJECTIVE: - Since 01.01.1999 a reform of the health care system in Poland has been realised based on the general health insurance act. We attempt to use the pathway method, especially measuring of time intervals along pathways, as a way of making accessibility to mental health services operational.

METHOD: - In a period of 2 months all patients aged 15 and over who had not sought care from any public or private psychiatric service during the previous 365 days, were interviewed by psychiatrists, using the Polish version of the WHO Encounter Form.

RESULTS: - A total of 228 patients were seen. The study reveals that the median interval between first seeing a primary care giver and arrival at a mental health service was 12 weeks, which is much longer than all other European centres in previous studies.

CONCLUSION: - Making use of the pathway method and, in particular, median interval analysis between the onset of the mental health problem and seeing mental health professionals (MHPs) has shown practically limited access of patients, with a new episode of care to psychiatric services in both epidemiological catchment areas. This method seems to be a simple and inexpensive way of monitoring the accessibility to MHP in the period of health care reform.