Beyond formal availability – determinants of real-world personalisation of psychiatric and psychotherapeutic care for children and adolescents in Poland

In Poland, access to psychiatric and psychotherapeutic care for children and adolescents remains territorially, organizationally, socially, and environmentally uneven. The aim of this article is to show that the real possibility of personalizing care depends on several interacting factors, including the patient’s place of residence, availability of local services, family resources, the role of schools, social barriers, and continuity of transition between levels of care. The article is a narrative review of the literature and system-level documents concerning service organization, access to care and determinants of help-seeking. Access is understood more broadly than the formal presence of services and includes waiting time, distance to facilities, indirect costs, continuity of treatment, the family’s readiness to seek help and the feasibility of the therapeutic plan. Personalized care therefore requires consideration of the child’s clinical, organizational, and environmental circumstances.