7.5 Mental health
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In 2007 the Parliament of Republic of Lithuania approved the National Mental Health Strategy. This national strategy covers a wide range of principles, priorities and recommendations. Sections (see 30.5; 30.12) focus specially on the youth and children: to improve the protection and care of children and young people with mental health through targeted preventive, treatment and rehabilitation programs aimed at increasing the resilience of children, families and communities and preventing the negative consequences of socialization. In the public health programs, the most attention should be paid to addressing the most pressing problems currently under way - prevention of children's mental health, emotional and social development disorders, proper education of parents for the education of parents, prevention of suicide, addiction and violence, and the resolution of youth health problems. The main principles of the strategy are stated as follows: 1) a special focus on human rights of mentally disabled persons; 2) modern services which meet the needs of the patients; 3) a balance within a development of a bio-psycho-social model; 4) support of principles of autonomy and participation; 5) cases of common mental health disorders should be managed by primary and other non-specialist care sectors; 6) mental health promotion and prevention of mental disorders should become an integrated part in the implementation of general health, education and social welfare policies; 7) strengthening of the role of patients and non-governmental sector. The National Mental Health Strategy acknowledges that mental health promotion and prevention of mental disorders is an integrated part in the implementation of general health, education and social welfare policies. A set of priority programmes are identified, which include programmes aimed at preventing suicides, alcoholism, drug addiction and smoking; programmes that promote mental health of children, youth and old people and programmes aimed at promotion of mental health in workplaces.The Interinstitutional Action Plan for the implementation of the Mental Health Strategy has measures of the National Mental Health Strategy implementation. Other policy documents related to the National Mental Health Strategy include Children and Youth Socialization Program which focuses on life skills and non-formal education for youth and children and The Action Plan for for 2014-2016 for the Implementation of the National Youth Policy 2011-2019 Program which has a clear goal to develop the healthcare system for young people, improve youth health monitoring, promote health and physical activity, and ensuring the prevention of various forms of addiction.
According to the 2020 Study on Youth Mental Health the network of interdepartmental cooperation has not been formed in Lithuania, there is a need for young persons' support system to ensure the continuity of support services for young people and their mental health monitoring and coordinating the existing network of organizations providing assistance to the individual. There is a need for professionals whose field of activity is focused specifically on youth mental health problems. The complexity of the system and the diversity of functions involved in tackling individual mental health problems among young people might also hinder the effective support to young persons.
Negative attitudes towards people with mental health ailments prevail (48.2% of the population would not want to live in the neighborhood of a person with a mental disability, and 45.2% would not want to work together); Young people avoid solving their mental health difficulties or topics related to personal mental health well-being. The study also reported that more attention is paid in Lithuania to the negative consequences of mental health (intervention), but not the causes that arise from the young person's early childhood, family, school environment etc. Particularly little attention is paid to early prevention - early parenthood education for young families, mother’s well-being during and after pregnancy, pre-school strengthening the resilience of children to mental health. Service barriers include limited access to the services a) lack of specialists (child psychiatrists, psychologists); there is no mechanisms to ensure that young people have access to quality service (sufficient number of consultations to achieve change; highly qualified specialist (eg psychotherapist) services are too expensive for young people, etc.); b) telephone support (emotional support) or e-mail. measures insufficient in emergencies (e.g., the need for a youth line increased significantly during a pandemic). Young people fear stigma related to mental health, bullying, distrust psychologist, social pedagogue. Young people do not have the ability to (i) recognize mental health problems and become aware of them and (ii) consult appropriate professionals. The general education schools do not always have the conditions to ensure the confidentiality of the visits to a psychologist. Legal restrictions also exist - a young person under 16 years of age cannot apply to a psychologist without parental consent.
Reforms now aim to bring mental health care closer to communities through the establishment of mental health care centres within municipalities and the creation of an effective community-level network of social psychiatric structures, with NGOs included in service provision. The implementation of the reforms raises many challenges, however, particularly in relation to the younger population. There are no reliable statistics on the young population prevalence of mental and behavioural disorders in Lithuania because no epidemiological surveys have been carried out among the young or adult populations. Data collected by the State Mental Health Centre are only available on cases registered by the state mental health institutions.
Establishment of the Suicide prevention bureau in 2015, as a state institution for in-depth analysis of the suicide situation and root causes, as well as for planning and coordination of complex measures by involving different sectors and social partners in suicide prevention and postvention, is very important step forward in field.
Most important preventive mental health programmes for young people are implemented with the involvement of NGOs. Lithuania has been participating since 1993 in the European network of health promoting schools (ENHPS). Wide spectrum of mental health programmes are offered for teachers and other who work with young people.
Campaigns such as “Childline” and “Stop bullying” are good practice examples of successful initiatives. They aim to create safer school environments for children and promote friendly and respectful communication that does not involve humiliation and bullying. Other projects like “Teenagers in action” are aimed at encouraging involvement of youth volunteers to provide crisis interventions and education for peers. “One-day centres against risk behaviour” have been set up to reach the teenagers at greatest risk of self-destructive behaviour. There is no system of state funding, however, to guarantee sustainability of these preventive programmes.