Lithuania introduced the next generation of mental health services
At the final conference of the international mental health project JA ImpleMENTAL in Athens last week, representatives of the Ministry of Health (MoH) presented the good practices that Lithuania has started to implement: case manager services and community treatment teams.
"The three-year project has had a major impact in helping Lithuania and other participating countries to introduce innovative, recovery-oriented, human rights-based services and to raise awareness about suicide prevention. Lithuania has been actively involved in this project and as a result, case manager services are already being piloted in mental health centres, and the first community-based treatment teams will start working with more severe patients next year", says Deputy Minister of Health Edgaras Diržius.
According to the Vice-Minister, the final conference in the Greek capital drew attention to and welcomed the changes taking place in Lithuania, which were identified by experts as crucial for ensuring the provision of human rights-oriented services.
The JA ImpleMENTAL project involved 21 European Union (EU) countries, 11 of which, including Lithuania, have implemented selected elements of the Belgian mental health reform good practices.
Case management - patient-centred
In Lithuania, case manager services have started to develop in nine mental health centres from the beginning of 2024, with the help of European Union investment, targeting patients with schizophrenia or severe depression, low functioning or low motivation to seek treatment, suicidal, alcohol dependent, etc.
The case manager works with the patient to develop an individualised support plan that focuses on the patient's needs and long-term recovery. The case manager discusses with the patient his/her needs and goals and possible ways to achieve them, assesses the patient's personal strengths, motivates the patient to work together to maximise his/her recovery, and monitors and discusses with the patient the results achieved.
The support plan and changes in the patient's condition are discussed periodically with the whole mental health centre team - psychiatrist, medical psychologist and nurse - who decide together what further services or treatments are needed to ensure the patient's long-term recovery.
The services of a case manager can be provided not only to the patient, but also to the patient's family members or relatives, if necessary, so that the family members can contribute to the patient's maximum recovery.
Mobile teams will provide support in the community
This year, preparations began for the launch of a community-based service for the treatment of mental and behavioural disorders, a new support tool for patients at high risk of re-hospitalisation or involuntary hospitalisation. It is planned that it will be launched next year by special mobile teams of 10 professionals with different qualifications - a psychiatrist, 6 mental health nurses, a social worker, a medical psychologist and an occupational therapist. Full teams will be able to provide services to 200 patients, while half-size teams will be able to provide services to about 100 patients.
People who, due to their complex health condition, often return to hospital repeatedly (including for involuntary treatment), who find it difficult to adhere to their treatment regimen and to apply independent living skills, will be able to receive long-term, continuous and mobile support. Services will be provided both in medical facilities and, where appropriate, in the patient's home and community, making it even easier for the patient to get help.
The project, supported by EU funds, aims to establish 19 community-based treatment teams in all Lithuanian counties, in county centres by 2027. EU investment of €3.6 million is foreseen for the establishment of the teams (premises, vehicles, etc.). They will provide services to 2,700 patients with the most complex mental and behavioural disorders each year.
Lithuania's experience is valued in Europe
Lithuania's experience in moving towards recovery-enhancing measures has been seen and welcomed in other countries. Lithuania was one of the first countries in Europe to introduce a system for regular assessment and improvement of compliance with human rights standards in mental health and social care services, using the World Health Organisation's (WHO) QualityRights methodology.
After assessing Lithuania's experience in mental health care reform, JA ImpleMENTAL project coordinators chose to visit Lithuania to learn about the organisation of mental health care services in Lithuania and to organise the QualityRights training. Mental health professionals from the JA ImpleMENTAL project countries from all over Europe came for this study tour and training on 22-23 April. During the training, WHO experts presented Lithuania as a model for the implementation of decentralised, recovery-oriented mental health services.