Biomedical and psychosocial interventions in the mental health care system in Lithuania: "Leaving the psychiatrist's clinic -- with at least a couple of prescriptions".

Aims: The aim of the study was to evaluate the mental health care system from the perspective of experts, as well as a subjective review by patients in mental health centers of the treatment they are receiving. Methods: This article includes data from two studies performed in Lithuania: expert and patient research. Research participants were 20 experts (non-governmental organizations, academics, service workers, decision makers, central government) and 30 patients (heterogeneous according to their demographic characteristics, diagnoses, forms of treatment received). Results: According to the patients, psychotherapeutic treatment requires a much higher degree of patients' active involvement and input; medication-based treatment contributes to the patient's passive position regarding their healing process. Experts' opinions regarding the balance between psychotherapy and medication focused on the following topics: the availability of psychotherapy in bigger cities and its lack in rural settings; the supply of private providers and lack of public services; a progressive youth and a conservative older generation of psychiatrists; a paradoxical concentration of psychotherapy in inpatient facilities and its lack in the community. Conclusions: Though mental health care requires a clear and ethical balance of biomedical and psychotherapeutic interventions, a transparent and public dialogue about the efficacy and advantages of different treatments is needed, but this consensus is still not achieved in many countries, including Lithuania. Both psychotherapy and medication-based treatments are regarded as useful elements of treatment from both the expert and the patient perspective. However, there is lack of availability of psychotherapy services in the mental health system in Lithuania. [ABSTRACT FROM AUTHOR]