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The aim of this work is to review the role of mental health care center and treatment center specialized in psychiatry in the Polish system of mental health care as a whole.


For many years in Poland, the process of transformation of psychiatric care model from the institutional (inpatient setting, most expensive) to community care model (personalized, much cheaper), has been taking place. The effective - coordinated system of community care should significantly improve cooperation in the treatment, while the community forms of health care should ensure full availability, complexity, and continuity of care provision. In many cases, the community support is inadequate and cannot provide patient with care at his home environment. For mentally ill, there may be a need for the use of the long term health care centers specialized in psychiatry.


A long term mental health care center specialised in mental health plays an important role in long-term care for the mentally ill. As far as a mental health service user’s perspective is concerned, the continuity of care and treatment in the long term health care center (as a health care unit) appears to be more useful and satisfying compared to a residential home for people with chronic mental illnesses. There is a need for broad discussion on the special place of the long term health care center specialized in psychiatry in the present Polish system of mental health care and on the improving of care pathways between inpatient-, day care-and, community care package.


Background/Aim: The aim was to evaluate Diabetes Mellitus (DM) patients’ awareness of their risk for oral and dental complications, to evaluate their oral health behaviors, assess their sources of related information, and to detect the influence of their awareness on oral health and dental management.

Material and Methods: Total of 240 DM patients presenting to a university outpatient dental facility for routine care completed a self-administered questionnaire about demographic-socioeconomic characteristics, oral health care and awareness on oral complications of DM. Dental status of each patient was recorded. Data were analyzed with Chi- square test; p was set as 0.05.

Results: The patients’ mean age was 52.85 years; the majority had Type 2 DM (72.1%) and 61.7% were females. Two thirds of the patients had tooth loss; 65% brushed daily and used toothpick for interproximal cleaning (35%). Only 12.9% had regular dental visits and 37.5% reported their oral health as “poor”. DM patients rarely received guidance from their health care professionals regarding their oral health (28.3%). Even though 62.5% were aware of oral complications of DM, only 46.3% knew that oral health may affect DM. The patients with Type 1 and Type 2 DM had similar perceptions about their oral health status (p=0.15>0.05). However, insulin users were more aware of the interaction between oral health and DM (p>0.05), and were more likely to consider their oral health as “poor” (p>0.05).

Conclusions: DM patients’ awareness of the effect of DM on oral health was higher than that of the effect of oral health on DM management. Medical health care providers were failing to provide the necessary information regarding these issues when compared to dentists.

there was a major shift. Furthermore, community psychiatric nurses as a discipline only became prominent in the mid- to late-1990s after the closure of asylums and establishment of community care. In addition, the changes and the introduction of the 1983 Mental Health Act contributed to changes in the role of social workers. Current practice of psychiatry is a mixture of different modalities of treatments, and access to information from bulky books including British National Formulary is now in one’s mobile phone or laptop. The introduction of Psychiatric Intensive

community) population, and for a comprehensive support for patient groups ( 3 – 5 ). In this context, the role of non-governmental organizations within the development of community care in the mental health area needs closer attention. Non-governmental organizations (NGOs) are formally organized, private, non-profit organizations. Their role within the health care system is not always recognized. NGOs mostly differ from public organizations in their vision and mission (aims and objectives), management (professional staff, board members and volunteers), resources (fund


The article aims to describe the key events in the development of mental health care policies after 1990 in the two countries and identify the main reasons for stagnation or incremental changes to the institutional setting in the field of mental health care. The process of mental health care reform is explained using the framework of historical institutionalism. The explanation shows that the lack of political interest in combination with the tradition of institutional care resulted in poor availability of psychiatric care, outdated network of inpatient facilities and critical lack of community care facilities in both countries. Even though Slovak Republic adopted national programme at the governmental level, it still struggles with its implementation. The ongoing reform attempt in the Czech Republic may bring some change, thanks to a new approach towards strategic governance of the mental health care system and the mechanism of layering that the promoters of the reform use.

varstvene storitve pomoč na domu v Sloveniji (1991-2011). In: Kuzmanič Korva D, editor. Čas beži, a pušča sledi: 50 let centrov za socialno delo in 15 let Skupnosti centrov za socialno delo. Ljubljana: Skupnost centrov za socialno delo, 2012: 189-212. 6. Hlebec V. Oskrba starih med državo in družino: oskrba na domu. Teor Praksa 2010; 47: 765-85. 7. Hlebec V, Mali J, Filipovič Hrast M. Community care for older people in Slovenia. Anth Notebooks 2014; 20: 5-20. 8. Hlebec V. Kontekstualni dejavniki uporabe oskrbe na domu v Sloveniji. Zdrav Var 2012; 51: 120-7. 9. Aday LA

adjustment to having an ostomy resulting from colorectal cancer. J Wound Ostomy Continence Nurs. 2009; 36:299-305. 15. Popek S, Grant M, Gemmill R, Wendel CS, Mohler MJ, Rawl SM, et al. Overcoming challenges: life with an ostomy. Am. J. Surg. 2010; 200:640-5. 16. Richbourg L, Fellows J, Arroyave WD. Ostomy pouch wear time in the United States. J Wound Ostomy Continence Nurs. 2008; 35:504-8. 17. Black P. Stoma care nursing management: cost implications in community care. Br J Community Nurs. 2009; 14:350, 352-5.

receive long term care (1) . Owing to the fragmentation of long term system in Slovenia and separate and incomparable statistics about its usage, this figure is probably strongly underestimated and may be even around 11.9%, including institutional care, community care in and cash benefits (2) . Long term community care in recipients’ homes was received by 4.7% of the population aged 65 and over in 2011, including community nursing (representing 55.6%), social home care (31.6%) and other services (such as personal assistance, family attendance) (2) . All things being

References 1. McEvoy L, Duffy A. Holistic practice - A concept analysis. Nurse Education in Practice. 2008; 8(6):412-419. 2. Hajdinjak G, Meglič R. Sodobna zdravstvena nega. Ljubljana: Univerza v Ljubljani, Zdravstvena fakulteta, 2012, s. 1-364. 3. Holizem,, [accessed: 26. 7. 2012] 4. Carrier JM, Kendall I. Professionalism and interprofessionalism in health and community care: some theoretical issues. [in:] Owens P, Carrier J, Horder J, red. Interprofessional Issues in Community and Primary Health Care. London: Macmillan, 1995. 5

, Unit E. 4. GEMEENTE GRONINGEN (no date a), Fietsstad Groningen 2002 GEMEENTE GRONINGEN (no date b), Groningen doet mee aan ‘Europees Jaar van mensen met een Handicap’ GEMEENTE GRONINGEN (no date c), Symposium 19 April. Kan Groningen beter toegankelijk voor mensen met een handicap? GLEESON, B. (1997), ‘Community Care and Disability: The Limits to