The world is shaken by global cataclysms. From this, the psyche of many can not stand it. Today, every eighth person in the world has one or another psychopathology. How to stay sane in these difficult days, protect yourself and your loved ones? What is being done for this at the state level?

Our expert – psychiatrist, psychologist, director general of the National Medical Research Center for Psychiatry and Narcology named after N.N. V. P. Serbian Ministry of Health Doctor of Medical Sciences Svetlana Shport.

“No walls!”

Elena Nechaenko, : Svetlana Vyacheslavovna, how many people with mental disorders do we have in our country?

Svetlana Shport: Officially, about 3 million 900 thousand, 1 million 400 thousand of them are under dispensary observation. But, since many people turn to private rather than public institutions due to the stigmatization of psychiatry, the statistics may be incomplete. And this situation needs to be changed.

— This year’s Mental Health Day (October 10) was held under the WHO slogan “No Walls!” What does it mean?

– Emphasis was placed on the availability of psychiatric care. After all, even if it is available from state institutions, people are still afraid to turn to psychiatrists for fear of being limited in their rights, of being isolated from society. To remove these barriers, it is necessary to bring psychiatric care closer to the population, to make it more comfortable and accessible.

Closer to the people

— What needs to be done so that people are no longer afraid to turn to psychiatrists?

– In 2023, the “Procedure for the provision of medical care for mental and behavioral disorders” will come into force, in the development of which the employees of the Center named after. V. P. Serbian. Of the innovations that will appear there, one can name the organization of psychological counseling rooms on the basis of district polyclinics. Qualified medical psychologists will advise citizens and, if necessary, redirect them to receive psychotherapeutic and psychiatric care. It also provides for the possibility of opening offices of suicidologists and other specialists in the outpatient department.

– Will these rooms replace psycho-neurological dispensaries (PND)?

– No, dispensaries, as a rule, are treated by people with severe mental problems. And it is very difficult for a person with neurotic disorders to decide to cross the threshold of PND. By the way, it is proposed to rename PND to mental health centers, which will also help to remove the barrier. Patients are clearly differentiated into five observation groups. This will protect people from unlawful dispensary observation and make the doctor’s work more structured.

Let’s protect the children!

– Does the new procedure provide for psychological assistance for children?

“Children, especially teenagers, need it like no other. Of course, there is no need to create a psychiatric service in every school, but it is necessary to train qualified school psychologists and organize the interaction of education with the psychiatric service. Our experts, psychiatrists and medical psychologists have developed criteria for identifying groups of children who first need to consult a psychologist or psychiatrist. A project has already been developed to introduce an interdepartmental program aimed at identifying risk groups for aggressive behavior.

Also, our service, together with other departments, is developing the examination of computer games.

– Should psychiatrists be responsible for patients who have committed serious crimes if they were not isolated from society in time?

– This is a difficult question. After all, according to statistics, only 1% of people with mental disorders commit crimes, and out of this small number, only 20–30% of patients use physical aggression. One of the new documents will spell out all the duties of a psychiatrist to comply with the required frequency of observation of patients from each dispensary group, the number of activities that need to be carried out.

Don’t heal yourself

Are there enough psychiatrists in our country?

– Todayin world there are more than 12 thousand psychiatrists and about 1250 psychotherapists (private doctors do not count). Therefore, one of our goals is the development of a psychotherapeutic direction and an increase in the number of medical psychologists. Today, each graduate can complete a two-year residency in psychotherapy, sexology, forensic psychiatric examination or narcology. But after 2 years of study, a graduate who has received the qualification of a narrow specialist (narcologist or sexologist) cannot work in general psychiatry. Now the question is being considered that already after the first year of residency training, the doctor could work in general psychiatry, and would receive a certificate of a narrow specialist in the second year of training. This will give him the opportunity to combine positions.

— Where can one turn today for psychological support in difficult times?

“In all regions of the country there are telephone hotlines where psychotherapists and psychologists can provide psychological support or provide guidance in finding psychiatric help. Recently, the number of calls to the telephone “hot line” of the Center. V. P. Serbsky doubled. The anxiety among many citizens is increased primarily by the lack of information, which creates a feeling of uncertainty. And the task of a specialist is to find out what exactly caused the problem and reduce the level of anxiety.

And one more important recommendation: talk to each other – with children, with friends, with loved ones. A sincere, confidential conversation in which a person shares his thoughts, fears, anxieties is one of the most effective methods of psychotherapy. When we verbally express our experiences, we are partially freed from them.

You can’t self-medicate and take psychopharmacological drugs on the advice of friends – you need to go to a psychiatrist. He will recommend the right remedy, including plant-based. Physicians can also prescribe psychopharmacological drugs, but only within the framework of clinical recommendations, and for this you first need to make a diagnosis. Unreasonable intake of these drugs can lead to side effects and even disability of the patient.