Estonian Psychiatric Association, Tallinn, Estonia
Estonia is still struggling with the financial contingency of the health care system. Waiting – lists are getting longer and the Health Insurance is trying to cut the costs by technical means, ignoring the medical necessities. The Psychiatric Association has been trying to safeguard the interests of the speciality and advocate for better services (i.e. for better availability of treatments for long – term patients). The digitalisation in health care is moving on fast; from this year on it is possible for the family doctors to consult a psychiatrist by via e-consult system. The government has introduced new treatment modalities – free of charge – for alcohol use disorder and is also taking steps to control the market in the sales of liquor that has been very liberal until now. The new mental health has been put on a hold, but there have been initiatives for some more narrow areas. i.e. in forensic psychiatry. There is a debate going on about who can provide psychotherapy and whether it should be linked to medical treatment. Shortage of specialists in health care is already an old story, with little prospects for improvement. Psychiatry is one of the most problematic areas and the situation is getting worse as for the last 3 years there have been very few applicants for the trainee posts.