Funds lacking for care of mentally ill

The Department of Health (衛生署) yesterday said that deficiencies in the national health insurance plan have led to difficulties in its efforts to improve mental health care in Taiwan.

Between 16 percent and 28 percent of the adult population in Taiwan suffer from various kinds of mental health problems, according to health officials.

The department has estimated that the prevalence of serious mental illness among adults is approximately one percent of the population, while depression has reached 2.8 percent.

In other words, between one and 1.2 million people in Taiwan are sufferers of serious psychiatric diseases.

The health department started a national network for mental health services in 1986 to strengthen mental health care. Since then, resources have been better integrated and made more accessible to patients.

The number of beds available to sufferers, for example, has increased from 11,066 to 25,146 in 16 years. The number of hospitals with mental health facilities has grown to 213 from 79 during the same period.

But treatment of mental diseases is hampered by the inadequacy of national health insurance, the department said.

"Problems relating to the shortage of subsidies are always a nuisance for professionals and hospitals," said Tan Kuy-lok (陳快樂), superintendent of the department's Tsaotun Psychiatric Center (草屯療養院).

Because of the national health insurance plan's poor coverage of mental health services, hospitals can barely recruit the psychiatrists they need, Chen said.

For instance, psychiatrists receive subsidies of NT$400 for each patient, which is the same as doctors with other specialties, "but we need 30 minutes to an hour for each patient," Chen said.

"That's why many students prefer dermatology or other specialties rather than psychiatry -- they carry a lighter work load with the same standard for subsidies," Chen said.

According to the department, the number of psychiatrists available for each 100,000 members of the population was 3.6 in 1999, while the US had reached 9.2 per 100,000 in 1995.

"The situation has not changed much in the last two years," said Chen, who held a press conference for the department yesterday.

"For more than two years, we have been unable to recruit new psychiatrists," she said.

The relatively poor coverage, moreover, has led to a failure to provide sufficient institutions for follow-up care after patients leave the hospital.