Putting the nationwide reform into practice: a pre-post evaluation of the Community Mental Health Center model in two counties

Purpose
This study aimed to evaluate the local impact of implementing the Mental Health Center (MHC) model in the Malbork and Sztum counties in 2024. The analysis focused on comparing patient numbers, types of services provided, and diagnostic patterns before and after the introduction of the MHC.

Methods
A retrospective quantitative analysis was conducted using data from psychiatric outpatient clinics and the psychiatric day ward for 2023 (pre-reform) and 2024 (post-reform). Variables included the total number of patients, individuals initiating psychiatric treatment, service types, and the most frequently recorded ICD-10 diagnoses.

Results
In 2024, the total number of patients increased by 12.9%, while the number of individuals initiating psychiatric care rose by 49.8%. The overall number of services grew by 22.4%, with the most notable increases observed in psychotherapy sessions (+230.5%) and initial diagnostic assessments coded as Z03. Psychological consultations declined by 15.5%. The newly established psychiatric day ward showed a consistent upward trend in utilization. There was a shift in the distribution of diagnoses, with a rise in F41.2 and F43.2 cases, and the emergence of F00.1 among the most commonly assigned.

Conclusions
In summary, our findings indicate that implementation in the Malbork and Sztum counties of the Mental Health Center model was associated with enhanced accessibility, earlier diagnosis, improved coordination, and a more comprehensive approach to psychiatric care. These outcomes are consistent with the guiding principles of Poland’s mental health reform and align with previous national evaluations, underscoring the practical value of community-based mental health services.