Medical self-government: Psychiatry needs immediate systemic action

The Presidium of the Supreme Medical Council (NRL), in a resolution dated October 17, 2025, asked the Minister of Health and state authorities to take urgent action to improve the functioning of psychiatric care and the conditions for training psychiatrists.

"The Presidium of the Supreme Medical Council appeals to the Minister of Health and state authorities to introduce changes aimed at immediate and real improvement of the quality of health care for patients of institutions providing 24-hour and independent services in the field of psychiatry, as well as to ensure proper conditions for the education of doctors undergoing specialization training in psychiatry," - the document reads.

The medical self-government points out that the current working conditions of psychiatric doctors, especially when on-call, pose a risk to patient safety. "The working conditions of specialist doctors and doctors in the course of specialization training in psychiatric hospitals, especially in terms of performing on-call duties, do not pose a risk to the safety of patients and the doctors themselves," it stressed.

Among other things, the NRL is calling for the introduction of regulations specifying the maximum number of beds that can be cared for by a single doctor during an on-call period, as well as a ban on being on duty simultaneously in more than one ward, especially in the situation of acute admissions.

Doctors also point to the need for 24-hour access to laboratory diagnostics, imaging tests and specialist consultations. Psychiatric hospitals should have appropriate equipment, including at least one cardiac monitor per ward. Meeting these conditions, according to the NRL, should be a requirement for obtaining public funding.

The medical self-government is also demanding that doctors in specialization have real supervision by a psychiatry specialist while on duty. As stressed, "ensuring proper patient care requires that a specialist doctor is actually available at the hospital where doctors in specialty training are on duty to provide clinical supervision, consult on tests, orders and the therapeutic process."

Another demand of the NRL is to put the implementation of the psychiatry specialty program under supervision. According to the self-government, the program should be adapted to the current structure of services and ensure both the safety of patients and the high quality of training for future psychiatrists.

The Bureau also stresses that organizational and staffing problems in psychiatry are largely due to underfunding of facilities. "The proper functioning of facilities providing 24-hour psychiatric care is not possible without their funding at an appropriate level," - it noted.

The position also included a reference to the voice of the young doctors' community. "Sharing the concerns and objections raised by the OZZL Residents' Agreement, the Presidium of the Supreme Medical Council expects the public authorities to urgently and factually analyze the problems raised and take measures to improve the quality of patient care in psychiatric institutions and ensure that future psychiatric doctors are properly prepared for independent work."

Source: NIL