Ambulatory Psychiatry Center “Pardaugava”, Riga, Latvia
Physicians with 3 basic specialties are working in psychiatry in Latvia – psychiatrists (283), psychotherapists (38) and narcologists (58). Psychiatrists have 2 sub-specialties – child and adolescent and forensic psychiatrists. Part of psychiatrists has certificates in psychotherapy or narcology. There is insufficient number of psychiatrists in Latvia due to ageing of psychiatrists, increased retirement and emigration of young doctors to EU countries. The situation is even worse with psychiatric nurses.
There are 85893 patients with psychiatric disorders (F00 – F99, ICD-10) who are registered in Latvia in 2016 (4,3% from entire population), who have been consulted by psychiatrists. Most of them are „severely mentally ill patients” 22,7% (F2), 25,7% (F0), 20,7% (F7). Register data show a slight increase in first time registered patients with organic mental disorders, neurotic and affective disorders from 2015 to 2016. GPs consult approximately 150 000 patients per year, mostly neurotics. According to data from research project 10,2% of patients of family physicians in Latvia currently suffer from depression. Narcologists treat 9149 patients with substance use disorders in 2015.
Latvia is in the 3rd place in Europe with respect to suicides rate; data from Estonia are better, but in Lithuania – worse. High suicide risk has been observed in cases of unidentified and untreated depression, other mental and social problems.
Outpatient care in Latvia for persons with mental disorders is provided by outpatient mental care centers, outpatient departments in hospitals and psychiatrist’s practices. An important role in the psychiatric care is played by GPs who must be the first ones who approach patients in early stages of the psychiatric diseases. Unfortunately Latvia has one of the lowest financing for GCM per inhabitant in Europe. It also affects mental health care, for example – expenses for governmental compensate medicines in the Baltics – 60 Euro/2014/inhabitant (in Lithuania 74 Euro, in Estonia 93 Euro).
Latvia is in the fifth place in Europe by the number of psychiatric beds (12,6 / 10000), in Lithuania this number is 10,7, in Estonia 5,5. The said amount of psychiatric beds includes also the long term (chronic) psychiatric beds and compulsory psychiatric beds.
Positive developments in Latvia psychiatry during the last 5-10 years are continuation of the process of deinstitutionalization and destigmatisation, improvement of access to psychiatric outpatient services, opening of modern Acute Psychosis clinic in Riga Centre of Psychiatry and Addiction Disorders, second outpatient mental health care centre in Riga, renovation of regional psychiatric hospitals.