Public vs Private: Comparing resource availability and practitioner preferences in treating individuals diagnosed with Personality Disorders in Iași, Romania
M. Hugianu-Cozma, R.-D. Hugianu, P. R. DobrinIntroduction
Personality disorder (PD) is defined as an enduring, pervasive, and inflexible pattern of inner experience and behaviour that deviates markedly from the expectations of an individual’s culture, leading to significant distress or impairment. (DSM-5) The first-line treatment for PD is psychotherapy, but medication may be used to manage co-occurring psychiatric symptoms.
Objectives
We aim to explore the differences in the availability of resources for treating individuals with PDs between the Public (Pub) and the Private (Pri) sectors of mental health services in Iași, and how this is influencing the practitioners in supporting this vulnerable category. We also wanted to gain more clarity on the practitioners’ overall strategies of addressing this, and their subjective views on the shortcomings.
Methods
The study is designed as an exploratory one, utilising a 16-item survey that we created specifically for this study. Questions are addressed in a closed manner, giving the respondents items to select from, and 2 of them have quantitative answers. Inclusion criteria consist of: being a fully trained psychiatrist, practicing in Iași – Romania, and acceptance of informed consent. Surveys were anonymous and distributed in person by the authors. The answers were centralised and analysed through descriptive statistics.
Results
There was a total of 49 respondents, of whom 29 are working in the public sector. The most frequent PD cluster was B (82.75% Pub, 70% Pri). All respondents have access to medication; Psychotherapy is available for 27.58% Pub and 75% Pri; Counselling 65.51% Pub and 85% Pri; Occupational therapy 17.24% Pub and 5% Pri; Social worker for 13.79% Pub and 0 Pri; No therapeutic groups in Pub and 30% Pri. All respondents in Pub are using medication as first line, compared to 50% in Pri; 24.13% in Pub consider psychotherapy as first line compared to 60% for Pri. Average waiting time for psychotherapy, including if collaborating with someone outside their service, was 2.37 weeks Pub (11 respondents) 1.88 weeks Pri (17 respondents). Only 24.13% of respondents were satisfied with the availability of resources in their practice for Pub, and 85% for Pri.
Image 1: Long description.