Modern mental healthcare in Poland has its foundations in the 19th century, when the country was subject to three different organisational and legal systems – of the Austrian, Prussian and Russian Empires. These differences prevailed even after the First World War. Professionals lobbying for a mental health act had no success. The Second World War left mental healthcare with significant losses among its professional groups. More than half of all Polish psychiatrists lost their lives; some of them were exterminated as Jews, some as prisoners of the Soviets. The Nazi occupation in Poland had dramatic consequences for people with a mental disturbance, as Action T4 turned into genocide on the Polish territory. The majority of psychiatric inpatients were killed. After the Second World War, the mental health system had to be rebuilt, almost from scratch. Major political changes in the country across the second part of the 20th century and revolutionary changes in mental healthcare around the world influenced psychiatric services. The purpose of this paper is to describe mental healthcare in Poland today.

Mental health policy and legislation

The national mental health policy emphasises promotion, prevention, treatment and rehabilitation; it was initially formulated in 1995 as the National Mental Health Programme. This was followed by the development of regional mental health programmes, specifying particular tasks in each of Poland's voivodships (provinces). However, their realisation is far from satisfactory.

The Mental Health Act enacted in 1994 regulates:

The Act also regulates involuntary treatment. Other acts concern the prevention of alcohol and drug misuse, rehabilitation and employment of people with disabilities; the Penal Code and the Civil and Care Codes also have a bearing on people with mental illness.

The treatment of severe mental disorders is largely free of charge (in-patient treatment, community care, consultations, psychotherapy, rehabilitation and a significant part of medication). Policy regarding the provision of therapeutic drugs is based on a parliamentary act that divides drugs into two groups: ‘basic’ compounds and ‘additional’ compounds. The latter include new drugs. The Minister of Health decides which drugs will be supplied free of charge, or at low or reduced prices for persons with specific disorders.