Services for patients with intellectual disability and mental health problems in Poland.

BACKGROUND: Poland is a democratic, sovereign state in Central Europe, member of the European Union. The healthcare in Poland is delivered to patients mainly through a public contributor called the National Health Fund, supervised by the Ministry of Health. The care for people with disabilities, including intellectual disabilities in Poland is coordinated by the Governmental Program on Activities for People with Disabilities and their Integration with the Society. The system of care for people with intellectual disability in Poland is constitutionally guaranteed. The aim of this review was to analyze the different forms of care for persons suffering from intellectual disability and mental health problems in our country. METHODS: Analysis of available documents on the policy and organizations of systems of services for this group of patients was performed. RESULTS: Non-governmental organizations play an important role in taking care of people with disabilities. In Poland there are no special psychiatric services dedicated for patients with intellectual disabilities. The comorbid psychiatric disorders are treated in general psychiatric wards or hospitals or in outpatient settings. Offenders with intellectual disabilities in the penitentiary system are referred to therapeutic settings in wards for convicts with non-psychotic mental disorders and intellectual disabilities. Training of medical students and young doctors offers only very limited basic knowledge on intellectual disability within psychiatry curriculum. The is no separate specialty in mental health in intellectual disability within psychiatry. CONCLUSIONS: The main conclusion of this review is that the specialist working with persons suffering from intellectual disabilities in Poland face many challenges regarding the need to introduces positive changes in this field.

Development of vocational training systems for patients with intellectual disability in Poland.

BACKGROUND: The problem of employment of people with intellectual disabilities is present in many countries. The literature on this topic draws attention to the fact that the improvement of the situation in this area is conditioned by changes in government policies, practices of employers and adequate preparation to undertake professional duties by persons with intellectual disabilities. OBJECTIVE: The objective of this review was to explore the changes in vocational rehabilitation forms in Poland. RESULTS: As one of the ways to solve this problem since 1991 in Poland the so called Workshops of Vocational Therapy have been created. According to the regulations the Workshops were designed for adults with intellectual disabilities, aged over 16 years with a total incapacity of gaining an employment, for which occupational therapy was a form of social rehabilitation. The further step in this process was the establishment of Vocational Activation Centers, with which high hopes were associated. They were expected to be an intermediate link in the creation of career paths from rehabilitation forms ultimately to open labor market. In practice it turned out that the creation of these Centers in Poland has been too slow. CONCLUSIONS: This raised the necessity to change the attitude from the concept of matching the participant to work and to the new environment, which frequently ends as a trauma, to the concept of matching jobs to people. New initiatives and new rehabilitation programs are developed based on this attitude.