of children under the age of 18 had not been receiving suitable treatment and help in the closed ward of
Ljubljana University Psychiatric Hospital in recent years, while the Paediatric Clinic refused to admit them.
The Ministry’s appeal was successful, and Ljubljana University Psychiatric Hospital informed the Ministry
on the same day that the Expanded Professional Board of Psychiatry and the Expanded Professional
Board of Paediatrics would meet at the request of the President of the Health Council. The meeting was
held on 10 May 2016 at Ljubljana University Psychiatric Hospital. It is evident from the minutes of the
meeting between Ljubljana University Psychiatric Hospital and Ljubljana University Medical Centre of 18
August 2016 that both managements harmonised their positions regarding the placement of an intensive
(closed) ward for child and adolescent psychiatry. The Ministry thus expected that the relevant ward
would finally be established after many years of discussion.
We recommended that Idrija Psychiatric Hospital ensure that the staffing composition on wards is
compliant with staffing standards. We also recommended that the hospital inform the competent
ministry in the event of problems when ensuring suitable staffing composition, or when it is believed
that staffing standards are not suitable.
In their response to the preliminary report, the management of Idrija Psychiatric Hospital stated
that they had been actively striving for several years to attain modern staffing standards in the field
of psychiatry, and the recognition of a higher staffing standard than the current one in psychiatric
hospitals, particularly in intensive and geriatric care. The hospital had submitted the need to adjust
the staffing standards to modern forms of treatment and the needs arising from the requirements
of international standards for treating persons with mental disorders several times to the Ministry
of Health and the Health Insurance Institute of Slovenia, but had not received anything more than
understanding about the situation and excuses regarding the lack of financial resources. Insufficient
and inappropriate staffing standards in psychiatry were particularly highlighted in the comments on
the Resolution on the National Health Care Plan 2015–2025 – Together for a healthy society, where
the lack of staff was displayed in a comparative table, which, according to the management of Idrija
Psychiatric Hospital, was self-explanatory.
Number per 10,000
residents
Great Britain
Austria
The Netherlands
Slovenia
No. of psychiatrists
1.1
1.18
0.90
0.53
No. of psych. nurses
10.4
3.78
9.90
0.58
No. of neurologists
0.1
0.82
0.37
0.08
No. of psychologists
0.9
4.90
2.80
0.16
No. of social workers
5.8
10.34
17.60
0.04
* Annex to the explanation of the Mental Health Act.
The management of Idrija Psychiatric Hospital explained that they had pointed out to the Ministry
that the need to expand and improve the staffing structure and make a better assessment of medical
treatment programmes in the existing mental health services had been completely overlooked
among the objectives and measures in the Resolution intended to improve the quality and safety of
treatment. The Resolution should have established a basis for adopting measures needed to enhance
and develop new programmes and improve their assessment at health programme providers working
in the field of mental health, and in particular, to improve the staffing structure in mental health
care. Regarding the fact that workers with appropriate expert knowledge are the only efficient means
of implementing various forms of therapeutic treatment, only a good staffing structure in treatment
procedures can guarantee safe and high-quality treatment. When planning the network and staff in
mental health services, it is imperative to observe all requirements for complex, timely, comprehensive,
interdisciplinary and continuous treatment, and the desired balance between hospital and out-patient
activities and services in the community and their interaction, including the current staffing deficit in
Slovenian mental health services. The management’s comments were not accepted, nor were the
comments made on the Dementia Management Strategy, where they also highlighted the need to
form a new standard for treating the psychological and behavioural disorders of dementia patients
in psychiatric hospitals, whereby the following factors in caring for such patients would have to be
observed: increased complexity and scope of caring interventions; higher costs of care; cooperation
of a specialist in internal medicine in treatment procedures; cooperation of special clinical pharmacy;
spatial and other conditions for improving safety etc. They also stated that they would further strive
IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2016
NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT
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