Hllgren J, sby U, Westman J, Gissler M. Mortality trends in external causes of death in people with mental health disorders in Sweden, 19872010. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Healthy life expectancy at birth is 59 years for males and 68 years for females (World Health Organization, 2005). A previousstudy on determinants of male suicide in Lithuania confirmed that lower educated, unemployed or economically inactive, non-married, residing or being born in rural areas experience a particularly high risk of suicide [13]. 2g and h). Accessibility We provide a wide array of financial products and technical assistance, and we help countries share and apply innovative knowledge and solutions to the challenges they face. Popul Space Place. Deaths with unknown ages were excluded from the analysis. 2016;3(2):1718. 2017;50(4):191209. J Affect Disord. Please check for further notifications by email. The per capita total expenditure on health is $478 (international $) and the per capita government expenditure on health is $337. However, in this study, we have used a short list of the most numbered substance use-related causes of death such as alcohol or drug poisoning, alcohol liver disease, and others. WHO mortality database. Gailien D. Lithuanian faces after transition. Google Scholar. 15 April 2022 | Technical document. 2018;224(6). Country overview The Lithuanian health system is organized around a single insurance fund providing health coverage to nearly the entire population (98% in 2018). For example, the dominant cause of death was mental and behavioural disorders due to use of alcohol (F10) in mental disorders group (86.6%) in Estonia in 2007. We also included external causes of death in our analyses dedicated to examining the burden of mental illness and substance use-related mortality. Analysis of contextual factors revealed high levels of social pathology . Alcohol in blood was found among 56.8% of individuals who died from external causes of death [23]. Search for other works by this author on: The Author(s) 2020. Cited 2022 Feb 15. the contents by NLM or the National Institutes of Health. On one hand, it is very difficult to estimate the exact fraction of external causes of death related to alcohol use or mental health problems. Mirza, I While the same indicator in France was 16, Germany 24, Netherlands 36 deaths per 100,000 population [8]. Now it is becoming obvious that GPs need to be involved as gatekeepers in primary mental healthcare, as the municipal mental health centres are receiving too many referrals of common cases. The https:// ensures that you are connecting to the 2007;102(2):2516 Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1360-0443.2006.01687.x. Alcohol use is important factor related to high mortality from external causes of death. Health systems reviews (HiTs) and Health system summaries. A particular attention will be given for children's mental health. Global Health Estimates Technical Paper WHO/HIS/HSI/GHE/2013.4. In our analysis, causes of death were classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th edition. We found a substantial decrease in ASYR from alcohol and drug use-related causes of death for both males and females in Lithuania. "coreDisableEcommerce": false, The relation between different dimensions of alcohol consumption and burden of disease: an overview. Inclusion in an NLM database does not imply endorsement of, or agreement with, Years of life lost due to premature deaths is acknowledged as an accurate measure for assessing the impact of specific causes of death on premature mortality [28]. [1] estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32.4% of years lived with disability (YLDs) and 13.0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21.2% of YLDs and 7.1% of DALYs [6]. Furthermore, a persisting masculinity culture and traditional gender role models [16], stigmatisation of mental health problems [17], large share of the prison population and population living in big institutional social care homes may also have contributed to the unfavourable mental health situation in the Lithuanian population [15]. CAS The number of deaths with unknown age constituted less than 0.01% of all deaths. Recently the problem of bullying in schools has been recognised as a serious issue (it appears that more than half of all schoolchildren in Lithuania are involved in bullying). Cited 2022 Feb 11. This tradition of monitoring the amount of processes as if they were outcomes creates a vicious circle in which a system of services that do not meet the modern requirements of a public mental health approach and the needs of patients becomes a serious obstacle to the formulation, development and implementation of new mental health policies. The mental health system has been reliant on excessive institutionalization and medicalization since the Soviet era in Lithuania [15]. Vallin J, Jasilionis D, Mesl F. Does a turbulent history lead to turbulent life expectancy trends? French Institute for Demographic Studies MPI for DR. Human cause-of-death database. Social work is developing as a new specialty. In all three Baltic States, major mental health indicators and characteristics of health care systems were quite similar in the 1990s, but they started diverging following different paths of the health system reforms [7, 8]. Ikiai gyvendinant Lietuvos psichikos sveikatos politik; 2013. p. 1151. Recent attempts include strategic reorientation towards social and emotional well-being, stronger focus on prevention and promotion and primary care, intensifying efforts to reduce suicide rates, and implementation of strong regulatory measures to reduce alcohol use. Research in the field of psychiatry and mental health is not very well developed, mainly because of a lack of research capacity and the absence of research institutions in these fields. Thirty years of democracy and independence have not fully abandoned the effects of that legacy. This draft new mental health policy is currently being debated. Psychological consequencesof cultural trauma. . People across the world are facing mental disorders in both sexes and across all age groups [5]. Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Available from: https://www.who.int/data/data-collection-tools/who-mortality-database. An improvement is required in the governance of the systems in order to make mental health systems accountable and effective and to enable them to meet the needs of patients. Organisation mission is to promote humane, ethical and effective mental health care, to protect human rights, to initiate and implement necessary reforms. OOP payments consist mostly of direct payments because the role of Voluntary Health Insurance is very small, albeit increasing. Psychological autopsy studies of suicide: a systematic review. 2015;386(9995):743800. Federal government websites often end in .gov or .mil. Topic: ethanol emotions advertising alcohol drinking capitalism drug administration routes Arch Suicide Res. Moreover, meta-analyses and population-based studies reported that mental disorders are independently associated with a substantial excess in all-cause mortality risk [4]. Nevertheless, standardized mortality rates for other mental health-related causes of death such as suicide and alcohol-related mortality remains very high in the Baltic States when compared to othe EU countries [8, 32]. Available from: https://apps.who.int/iris/bitstream/handle/10665/341648/9789240025707-eng.pdf?sequence=1. Terms and Conditions, After economic decline in the 1990s, the economy started to grow significantly after 2000. Grigoriev P, Jasilionis D, Stumbrys D, Stanknien V, Shkolnikov VM. Male ASYR from suicide has decreased from 2502 (4.3%) in the year 2007 to 1649 (4.1%) in the year 2018 in Lithuania (see Table 1; for additional details on the calculation of age-standardized years of life lost, see Additional file 1). Psychol Med. LESINSKIENE, S. Africa; Americas; Eastern Mediterranean; Europe; Cited 2022 Feb 15. A case-control study in India. World Health Organization data show [8] that thenumber of psihciatric hospital beds per 100,000 population was exceeding the EU average in both countries. 2017;12(7):e0181622. Jasilionis D, Grigoriev P, Stumbrys D, Stanknien V. Individual and contextual determinants of male suicide in the post-communist region: the case of Lithuania. However, it was much higher when including suicide, substance use-related causes of death, and external causes of death. Department of Psychiatry, Vilnius University, email: This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license (, Jenkins, R., Tomov, T., Puras, D., et al. The report, which was presented today in the Seimas of the Republic of Lithuania, was carried out with funding from the European Commission. The proportion of the population under the age of 15 years is 18%, and the proportion above the age of 60 years is 20%. Completion of a country profile (Puras et al, 2004) was a very important exercise in the country, which is looking forward to developing and implementing an evidence-based mental health policy and improving both the performance of the mental health system and indicators of population mental health. https://doi.org/10.24095/hpcdp.38.6.02. 2018;54(1):1128. Regions. However, all three Baltic States experienced consistent and remarkable growth in life expectancy from 2007 to 2018 (Fig. Thirdly, the mental health . and official website and that any information you provide is encrypted statement and World Health Organization. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Wiley Online Libr. Cited 2022 Feb 15. Soc Moksl. PMID: 35742341 PMCID: PMC9245600 DOI: 10.3390/ijerph19127086 Abstract Background: Since the COVID-19 . Mental Health Links in Lithuanian. In order to ensure psychosocial well-being of people and more versatile assistance to persons with problems of mental health the Strategy on Mental Health of Lithuania is being developed. To learn more about cookies, click here. In the analysis, deaths and population exposure were divided into five-year age intervals from 0 to 85+ years. Analysis of contextual factors revealed high levels of social pathology (including violence, s Cited 2022 Aug 30. Available from: https://gateway.euro.who.int/en/datasets/european-health-for-all-database/. The lessons learned in Lithuania are of great relevance for other countries where the World Bank operates.. Suicide rates have been declining since 2013 but remain high. An official website of the United States government. and Thus, we suggest that improvement in suicide and substance use-related mortality lagged behind the improvement in overall mortality in Estonia and Latvia. Financial resources from large psychiatric hospitals were transferred to community-based clinics recently [20]. It varied from 0.2% for females in Lithuania in 2009 to 2.4% for males in Estonia in 2007 (see Table1; for additional details on the calculation of age-standardized years of life lost, seeAdditionalfile1). Mental health policies need to be based on the socio-political context of the specific country. Lancet. 2, 2021 European Observatory on Health Systems and Policies. Springer Nature. Our findings indicate that the burden of mental health-related mortality remained high and showed divergent temporal changes across the three countries. However, this has been achieved to a certain extent through the transfer of patients with a chronic mental illness from psychiatric hospitals (which are under the Ministry of Health and funded from obligatory health insurance funds) to psychiatric long-stay care institutions (which fall under the system of social welfare). We are encouraged by the Lithuanian Governments commitment to strengthening mental health services for the well-being of its youth. PubMedGoogle Scholar. His postdoc research topic is Demographic Loss Related to Mental Health in the Context of Changing Health Policy on Lithuania.2,3 Domantas Jasilionis is a research scientist at Demographic Data Laboratory, Max Planck Institute for Demographic Research, Rostock, Germany and Professor at the Vytautas Magnus University. In this context there is a need for responsible, transparent and evidence-based decisions over the allocation of resources. The burden of mental health-related mortality in the Baltic States in 2007-2018, https://doi.org/10.1186/s12889-022-14175-9, https://doi.org/10.1016/S2215-0366(15)00505-2, https://gateway.euro.who.int/en/datasets/european-health-for-all-database/, https://apps.who.int/iris/bitstream/handle/10665/108671/e72373.pdf?sequence=1&isAllowed=y, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534107/, http://www.fsf.vu.lt/dokumentai/Projektai/LMT/Sunkios_traumos_Gailiene/Lithuanian_faces_after_transition_c_1.pdf, http://www.fsf.vu.lt/dokumentai/Projektai/LMT/Sunkios_traumos_Gailiene/Lithuanian_faces_after_transition_c_1.pdf#page=218, http://andmebaas.stat.ee/Index.aspx?DataSetCode=RV56#, https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7265933/, https://doi.org/10.1787/health_glance_eur-2018-en, https://onlinelibrary.wiley.com/doi/full/10.1111/j.1360-0443.2006.01687.x, http://www.thelancet.com/article/S2215036614702214/fulltext, https://journals.sagepub.com/doi/10.1177/1403494818758912?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed, https://www.who.int/data/data-collection-tools/who-mortality-database, https://doi.org/10.1080/0161544020171338977, https://www.tandfonline.com/doi/abs/10.1080/01615440.2017.1338977, https://academic.oup.com/alcalc/article/44/5/517/182141, https://onlinelibrary.wiley.com/doi/full/10.1111/add.15470, https://www.tandfonline.com/doi/abs/10.1080/13811118.2021.1999873, https://www.bmj.com/content/362/bmj.k3096, https://doi.org/10.1192/j.eurpsy.2021.2219, https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2010.02899.x?casa_token=v4eWn3ng24cAAAAA:U61v6J2RD0RW5099XeRODqhvm48AU5bWRoawxeVx5vSmncso1xKAh6x82qga22bf3sIAlG4NfjtO_Y5Q, https://onlinelibrary.wiley.com/doi/abs/10.1111/add.13757, https://pubmed.ncbi.nlm.nih.gov/12701661/, https://pubmed.ncbi.nlm.nih.gov/10408261/, https://documents-dds-ny.un.org/doc/UNDOC/GEN/G17/076/04/PDF/G1707604.pdf?OpenElement, https://apps.who.int/iris/bitstream/handle/10665/341648/9789240025707-eng.pdf?sequence=1, https://digitallibrary.un.org/record/3873686, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. Jasilionis D, Mesl F, Shkolnikov VM, Vallin J. Rcentes divergences desprance de vie dans les pays Baltes. In addition, the state budget covers long-term care at home, health administration, education and training, capital investment and public health services. Events All . To estimate the children's mental health, we used the Lithuanian version of the Strengths and Difficulties Questionnaire (SDQ) for parents. Rahu K, Prna K, Palo E, Rahu M. Contrasts in alcohol-related mortality in Estonia: education and ethnicity. For selected participants from Ukraine - health and mental health professionals . Our findings indicate that during 2007-2018, the measurements of the burden of mental health-related mortality showed pronounced differences in patterns and directions of changes across the three seemingly similar countries still suffering from common problems from the soviet past. Primary care physicians play a gatekeeping function to more intensive levels of care; however, patients can go directly to specialists practising in publicly-financed settings. Across EU countries, the most common mental disorders were anxiety disorders (5.4% of the total population) depressive disorders (4.5%), drug and alcohol use disorders (2.4%), bipolar disorders (1.0%), and schizophrenic disorders (0.3%) [21]. An improvement is required in the governance of the systems in order to make mental health systems accountable and effective and to enable them to meet the needs of patients. 2021. The World Bank Group comprises five institutions: International Bank for Reconstruction and Development (IBRD), International Development Association (IDA), International Finance Corporation (IFC), Multilateral Investment Guarantee Agency (MIGA) and International Center for Settlement of Investment Disputes (ICSID). Cited 2022 Mar 1. Recently PhD theses have been defended on subjects such as eating disorders, autistic spectrum disorders, depression and suicide. Situation on Mental Health Suicide: Suicide rates in Lithuania are the highest in the world although they have been recently decreasing (41.1 cases per 100,000 population in 2003; 38.9 in 2004; 37.0 in 2005 and 28.9 in 2006) (EUROSTAT). It is notable that the observed decrease in this group of causes of death was mainly driven by a notable reduction in alcohol-related mortality. the Baltic states) seeing an improving economy but others experiencing greater economic difficulties. These findings may be useful for the development of modern mental health policies in the countries of Eastern and Central Europe, which were deprived for decades of the possibility of introducing evidence-based mental health policies and services. The .gov means its official. JEGOROVA, N. HMDB HMD. Cited 2022 Aug 30. Total loading time: 0 2004;4:37 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534107/. Such long-lasting contradiction persists despite a striking burden related to excess deaths such as suicides. Rehm J, Shield KD. The site is secure. "coreDisableSocialShare": false, In Estonia, the mental health care system has transformed into a more humane system which aims to improve patients quality of life in the 1990s. The largest proportion of physical and human capital is concentrated in psychiatric institutions, with large numbers of beds, psychiatrists and increasing funding for reimbursement for the new generation of psychotropic medications. 2001. Analysis of the findings from the country profile identified the gaps in the existing mental healthcare system and raised the question of the need for a national evidence-based mental health policy. Introduction, discussion, and critical revision of the manuscript: DS, DJ, DP. Data source: theHuman Mortality Database [9]. Health Systems in Transition. Most of the research in the field of psychiatry and mental health is carried out at Vilnius University and Kaunas Medical University, by PhD doctoral fellows and teaching faculty. Such apattern can be explained by thedifferent overall causes of death structure in Western Europe and post-soviet countries. Cited 2022 Aug 30. Fourth, the burden of mental disorders-related mortality is shifting from working age population (20-39 and 40-59years) to elderly population (60+ years) in all three countries from 2007 to 2018 (Fig. Cited 2022 Feb 15. RANCEVA, N. The same study also showed that residing in socioeconomically disadvantaged areas has an additional positive effect on increasing male suicide risk which persists even after controlling for major individual-level characteristics. Department of Psychiatry, Vilnius University, email: tl.uv.fm@sarup.suiniad. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (. As a part of international mental health policy, programmes and services project, the 'country profile' instrument was used for assessment of mental health policy and services in the Republic of Lithuania. The datasets analysed during the current study are available from the corresponding author on reasonable request. The health budget represents 6% of the countrys gross domestic product. National Library of Medicine Cited 2022 Mar 1. Lithuania is a country with an approximate area of 65 000 km2. Sreenivas, V The literacy rate is 99.6% for both men and women. Published online by Cambridge University Press: Changes in midlife death rates across racial and ethnic groups in the United States: systematic analysis of vital statistics. Better understanding what groups of causes of death related to mental health are the most responsible for years of life lost in population is particularly important for the post-soviet countries, where lacking comprehensive scientific evidence coincides with inadequate and/or poorly implemented policies. However, in Estonia and Latvia, the share of the burden of these deaths in the total ASYR remained high and even increased. ASYR from suicide and external causes of death were decreasing but remained very high in the international context. Historically, mental health systems in the region have been affected for many decades by the legacy of institutionalization, social exclusion, over-medicalization, and discrimination. The report provides suggestions for improving mental health service delivery in Lithuania. Close this message to accept cookies or find out how to manage your cookie settings. Stigma as an Obstacle to Paradigm Change in Mental Health Care in Lithuania DOI: 10.1016/j.eurpsy.2017.01.994 Authors: Egle Sumskiene Vilnius University Abstract The paper is based on the. Mental health issuesanxiety, depression, suicidal ideation and behaviorare prevalent among students of higher education. 2c and d). BMC Public Health 22, 1776 (2022). Globally, mental health disorders have increased by an average of 16% between 2005 and 2015 and will tend to rise . The country is in the higher middle-income group (by World Bank 2004 criteria). At the same time, Lithuania experienced systematic stagnation. The proportion of the population under the age of 15 years is 18%, and the proportion above the age of 60 years is 20%. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. The mental health system has been reliant on excessive institutionalization and medicalization since the Soviet era in Lithuania . 2e and f). 8600 Rockville Pike In the context of the Baltic States and other post-soviet countries, fractions of various external causes of death and alcohol-related causes of death should be considered in assessing the total burden of mental health-related mortality. The SDQ is a brief behavioural screening questionnaire that was designed to assess prosocial behaviour and emotional and behavioural problems in children on 5 scales. Vilnius, Lithuania - International Organization for Migration (IOM), Missions in Ukraine and Lithuania, supported 145 specialists working with war-affected people across Ukraine to join the international Rethinking Mental Health Care conference focusing on enhancing accessible and acceptable mental health care. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. The risk of mental disorders starts in early childhood with idiopathic intellectual disability and autism spectrum disorders and continues into older ages with depressive disorders, anxiety disorders, and schizophrenia [5]. Vijayakumar L, Rajkumar S. Are risk factors for suicide universal? Arunas Germanavicius. Two vertical grey dotted lines show the start of the period in 2007 and the end of the period in 2018. Lithuania is a country with an approximate area of 65 000 km2. Provision of community-based mental health care, Latvia: ncbi.nlm.nih.gov; 2020. The COVID-19 pandemic has taken a toll on the mental health of young people globally, said Gallina A. Vincelette, World Bank Director for the European Union Countries. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the global burden of disease study 2013. The most recent data on persons who died from external causes of death in Lithuania [45] shows that the share of positive blood samples remains very high (54.7%). Mental health-related disorders such as substance use-related illnesses may lead to death. Since we focus on the potential role of mental health in the systematic improvement of life expectancy in three countries, we choose the year 2007 as it was a starting point of consistent change in life expectancy after the period of fluctuations in Latvia and Lithuania.
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