Each year all chairmen and six-year delegates from the Nordic and Baltic associations meet for a general assembly. Even though this year’s meeting was held online, as a virtual meeting, it still managed to offer the same intensity and a positive atmosphere it always does.
Apart from issues regarding the Nordic-Baltic collaboration, each chairman reported what is going on in the field of psychiatry in their country. So, from here you can read about the newest information from your neighbour country – and your own.
DANISH Psychiatric Association
Annual report for the period May 2020 - May 2021 from the Danish Psychiatric Association – DPA
We are about 1100 members of DPA. The DPA Board consists of 8 members and 1 deputy.
Our annual meeting is still held without the sponsorship of the pharmaceutical industry. This year we had to hold the meeting virtually because of Covid-19. We chose to have the meeting over 4 days from 1 pm to 4 pm every day to ensure that as many of our members as possible could attend. Of course we missed the socializing and all the conversations we are used to when we meet irl, but despite that we had a good meeting. On the last day we held our General Assembly from 4 pm also virtually, and we had match choices for the board, so we had to vote too.
Our website has been redesigned so that it is now up to date and we can have podcasts, videos ect. We created a log-in for our members so that part of the page is public and part of it is for members only. Behind the log-in, our members can see some of the presentations from our annual meeting, they can discuss psychiatric problems, they have access to The Nordic Journal of Psychiatry etc.
Until Covid-19 there was a lot of focus on psychiatry, and we were promised a 10-year plan for psychiatry. The plan that we and the Psychiatric Alliance has been asking for for several years. As you also know we received 600 mill. Kr. pr year for the next 4 years and a promise that more money would follow the plan. Unfortunately it has been shown that some of our five regions have spent some of the acute millions on things other than psychiatry.
In August 2020, The National Board of Health began the work with the 10-years plan, but in November it was interrupted again by Covid-19. About 50 people from different organizations have to meet on Teams to discuss the plan, so the work has been quite a challenge. Therefore DPA have had several bilateral meetings with The National Board of Health, and we work closely together with the Danish Medical Association.
The rapport is called “Professional proposal for a 10- year plan for mental health and mental illness”. It is our concern that mental health will fill more of the plan than psychiatry.
In terms of Covid-19 we have seen some who have gotten worse, some has gotten better, and late sequelae of Covid-19 is being researched.
ESTONIAN Psychiatric Association
Annual report 2020
Members
There are 234 full members in Estonian Psychiatric Association and 5 different subsections: sections of biological psychiatry, out-patient care, child and adolescent psychiatry, forensic psychiatry and section of young psychiatrists and trainees.
Activities
Main working goals have been finishing update of Development Plan of Psychiatry and Child and Adolescent Psychiatry; giving input into Green Paper of Mental Health written by Ministry of Social Affairs; co-operation to create national quality indicators of use of benzodiazepines, successful piloting of e-consultation in child and adolescent psychiatry. Together with Estonian Society of Family Doctors were written suggestions to regulate use of hypnotics and sedatives.
Together with Health Insurance Foundation we started preparations of pilot project for better integration of family doctors and psychiatrist in out-patient treatment. Department of Psychiatry in Tartu University continued with regular meetings of training centers and supervisors to increase and equalize training, which also included corrections of curriculum of psychiatry training.
Association Board took several steps to correct problems with psychiatric medications. Applications to start intranasal ketamine treatment for treatment resistant depression, mental health nurse out-patient appointments for children and adolescents and transcranial direct current stimulation (tDCS) treatment were sent to Health Insurance Foundation.
Trainees organized and started voluntary mental health counselling network.
Suggestions to handle psychosocial crisis due COVID-19 pandemic were given to Ministry of Social Affairs. COVID-19 pandemic took piece of our energy and pushed us to virtual reality including our annual conference but we managed rather well.
FINNISH Psychiatric Association
Membership, office, and organization
By end of the year 2020, the Finnish Psychiatric Association (FPA) had 1341members.
The Association has an office in Helsinki. In 2020, preparations were made for a temporary move of the office to other premises in early 2021 because of plumbing repairs.
The FPA is governed by the Executive Board. The organs of FPA comprise 3 committees, 12 sections, 5 task forces, 2 competence boards and the ethical council.
The members of Executive Board of the FPA in 2020 included President Erkki Isometsä, Vice President Tarja Melartin, General Secretary Sami Räsänen and Treasurer Jukka Kärkkäinen, plus members Elina Hietala, Irma Myllylä, Hanna Tytärniemi, Laura Häkkinen and Markku Lähteenvuo. The Executive Board had 10 meetings plus a day for strategic planning.
Foci of activity
A central task for the Association is to ensure continuity by maintaining and expanding membership, particularly recruiting young colleagues to become members. Enhancing transfer of information, participation and member democracy are important aims.
The FPA has actively followed planning of the national health care reforms, and gave several official statements related to legislation and national treatment guidelines. The FPA nominates chairs and members to national psychiatric treatment guideline groups, in collaboration with the Finnish Medical Society Duodecim.
The FPA hosts the 2021 Nordic Congress of Psychiatry and planning the event has been a major task. After careful consideration of risk related to the COVID-19 pandemic, the FPA decided to organize the congress as a virtual event.
Education
The Educational Committee organizes semi-annual FPA meetings, which are the largest psychiatric educational events in Finland. In 2020, the number of registered participants were 279 in March and 232 in October. The Friday 13th March program had to be cancelled because of the emerging COVID-19 pandemic and acute safety measures launched by the Finnish Government. The October meeting was successfully organized a fully virtual event.
The FPA Schizophrenia Network symposium was first delayed and then organized as a shortened halfday webinar in December.
The FPA grants annually scholarships for young researchers, award for the best psychiatric dissertation of the past year, a clinical lifetime achievement award, and an educator award.
The DSM-5 translation
In collaboration with the Finnish Foundation for Psychiatric Research, the DSM-5 Desk Reference-book and the DSM-5 criteria were translated into Finnish in 2019 and published in early 2020 as an e-book. However, the format turned out to be perceived as awkward, and therefore a paperback will be published in 2021.
ICELANDIC Psychiatric Association
The report
In the beginning of 2020, the IPA had planned several meetings and conferences for the remaining of the year. Everything changed when the first person was diagnosed with COVID-19 in Iceland 28th February and marked the start of the first wave of COVID-19. Regulations on the restrictions of gathering forced the IPA to cancel almost all meetings, including the biannual Scientific Conference, that will be held this October instead.
The Icelandic Psychiatric Association held its annual meeting on 29th August 2020, later than usual because of COVID-19 restrictions. This was the only meeting members were able to meet face to face. Óttar Guðmundsson stepped down as chairman and Karl Reynir Einarsson was elected in his place. Halldóra Jónsdóttir was elected as a 6-year delegate of the NPA.
The IPA currently has 70 active members. The vast majority works in the two main hospitals in Iceland in Reykjavik and Akureyri, in primary care or in the private sector. In the last decades most of Icelandic psychiatrists got their speciality training abroad, mostly in the Nordic countries, UK or USA. This seems to be changing thank to the efforts made by Prof. Engilbert Sigurðsson and his colleagues in the department of psychiatry in Landspitali University Hospital. They have developed a psychiatry speciality program that now includes 18 doctors in training.
Currently there are 28 psychiatrists working in the private sector. The mean age is 62 years and 36% are 67 years or older. Only five are under the age of fifty. For the last decade, the total number of visits to private psychiatrists has reduced from 39 thousand to 30 thousand. The private sector usually has a contract with the Icelandic Health Insurance (IHI), that pays on average about 75% of the cost of each visit. The last contract expired three years ago and negotiations between parties have been unsuccessful. However, the IHI has continued to pay according to their own tariff which has become increasingly more unacceptable to the doctors in private practice. Some of them decided to stop sending bills to the IHI from 1st May and charge their patients full price for their service. Many fear that this will mark the beginning of a two-tier healthcare in Iceland, one for the general public and another for the rich.
For the last four years the position of the Minister of Health has been held by Mrs. Svavarsdóttir, a member of the Left-Green Movement. Mrs. Svavarsdóttir policy has been to improve mental health in primary care. As a part of that policy, three mental health teams have been founded in Reykjavik and a few in more rural areas. Currently there are seven psychiatrists working in the primary care in Reykjavik and three part time in other areas. This new competition for psychiatrist has been difficult for the University Hospital because the primary care has been able to offer better salary and work conditions. As a result, there are many vacant positions in the hospital and the workload on the remaining psychiatrists has increased.
The IPA sent a memo to the Icelandic Health Ministry complaining about the unacceptable condition of the University Hospital Department of Psychiatry. One of the opposition parties in Alþingi (parliament) submitted a bill that would force the Health Minister to put together a committee to prepare the construction of a new psychiatric hospital in accordance with modern requirements. At present this bill is still for a discussion in one of Althingi´s committees, and the IPA remains cautiously optimistic.
LATVIAN Psychiatric Association
The LPA has 242 members at the beginning of 2021.
LPA organized conferences with CME every month- in total 2020 there were 9 conferences (6 of them virtual) which covered a wide topic of psychiatry as well included a collaboration with other specialties as neurology, addiction medicine, psychotherapists. There were held 2 conferences for forensic psychiatrist. In 2021 there has been already 5 LPA conferences, there is impression that psychiatrists become tired form insufficient communication, so the virtual events with possibility to interact in online discussion or chat rooms are highly appreciated. LPA is the only organization which ensures the specific psychiatric continuing education. In collaboration with Latvian Pharmacological company Grindex, LPA created an application “Mood tracker” an instrument for patients to evaluate the mood symptoms and in easy way to report results and get feedback from their psychiatrist.
In November 2020 there were election of new board of LPA and all organizational structures (certification committee, committee of ethics, committee of revision, certification committee of forensic psychiatry). The LPA has a new board with president M.Taube and two vice-presidents E.Terauds un E.Rancans. the new elected president has set main priorities – to continue an active collaboration with Ministry of Health to develop a further Action plans in Mental health, to develop a standard for psychiatrist as specialist (full time equivalents for psychiatrists, in Latvia there is no regulatory document of workload in psychiatry) and the third priority is to involve more actively early career specialist in LPA organizational and educational work.
During COVID-19 pandemic in Latvia psychiatric health care worked without exception, only psychiatric Day clinics and rehabilitation was stopped from on-site work with patients for 6-week May-June 2020, all other mental health services continued work. In psychiatric hospital the wards were reorganized in three levels: covid-19 positive, contact with covid-19, transition ward (unknown covid-19 status) and covid-19 free wards. All medical staff working in psychiatric emergency wards and in wards with covid-19 patients or high-risk patients received additional financial bonus up to 100% from monthly salary. Out-patient centers continued during pandemic face-to-face consultations (as well as distance consultations via phone, skype or zoom). So far from statistics we can see that there are increase in first-time visits of patients with neurotic spectrum disorders and first episode depressive disorders. Empirically we observed that the patient with chronic disease has reoccurrence of depressive or psychotic episode even if they previously reached the remission.
In the December 2020, the action plan COVID-19 crisis about psychological help accepted by Government and there was given additional funding for Ministry of health. First time in Latvia there were given financial funding for psychological crises individual consultation for patients with general practitioner referral. LPA took an active part in Ministry of Health organized working groups, also LPA developed algorithms for general practitioners for easer recognition and management of psychiatric disorders in following topics: acute with stress related disorders, Neurotic (Anxiety) disorders, depression, and eating disorders. Separate algorithms were developed for child and adolescence. There was started initiative to improve collaboration between psychiatrists and general practitioners- the distance consultations were implemented and the checklist for psychiatric disorders were developed. Addition funding was given for psychological workers in governmental health care facilities.
On March 16, 2021, the Ministry of Health included patients with psychiatric disorders (Schizophrenia spectrum, Affective disorders and psychiatric disorders which causes severe deteriorating of functioning) as a priority group for COVID-19 vaccination. From May 2021 the patient vaccination will be started also in psychiatric out-patient centers.
The critical deficit of child and adolescence psychiatrist (CAP) is still an actual problem, but there is improvement in CAP training. From 2019 started to work residency programme for CAP where in 4 years of training the resident will have CAP certificate without a general psychiatry certificate as it was previously. The training for CAP now is 4 years instead of 6 years, it is hoped to improve the situation and attract more resident to train and work in child and adolescence psychiatry. Now there are 12 young CAP doctors in training process.
Main issues to work with:
The lack of psychiatrists, especially in regional hospitals. The is risk of burning out of psychiatrist remains still high because of overload of work.
The financial project about medical workers salary “got frozen” again in governmental level.
The question about National level register of persons with mental disorders remains still unclear.
Lithuanian Psychiatric Association
We have an increasing number of the members – 447 at present.
Better situation with the annual fees; no delays. The strategy behind it: continuous medical studies events free of charge for those members who have paid the annual fee.
Financial balance is quite good as association receives incomes from the qualification events (those, who are not members of association pay).
We have journal of the association “The Psychiatric News” regularly published twice a year.
Pandemia changed the profile of the conferences and seminars; we have a lot on-going. Main trends: interdisciplinary (1), together with universities (2), foreign lecturers included (3), oriented both to theory and practice (4) (even had a case analysis in Zoom).
Association is involved in many legislation activities in the Ministry of Health.
Up-coming board elections in early autumn: quite a challenge as it has to be done live (according to the by-laws).
NORWEGIAN Psychiatric Association
Members
Working as psychiatrists: n= 1441; Residents (in training): n= 571. Total number of active members: n= 2012.
President
Ulrik Fredrik Malt (end of four-year term April 30th, 2021).
Standing committees
1: Old age psychiatry; 2: Biological psychiatry, and neuropsychiatry; 3: Ethics and fundamental issues in psychiatry; 4: Consultation-Liaison psychiatry and psychosomatics; 5: Forensic psychiatry; 6: Social psychiatry; 7: Psychotherapy; 8: Transcultural psychiatry. There is also a Committee for residents’ specialization and review of training facilities.
Main activities during 2020
There is a shortage of psychiatrists in Norway, but not clinical psychologists. Through media and contact with health officials and politicians, Npa acts to increase the awareness of this fact and thus pave the way for more positions for residents in psychiatry.
The number of beds to care for the most severely affected subjects with mental disorders, in particular schizophrenia and severe mood disorders, is too low. Npa has conveyed this fact to the health authorities.
One of the main activities during 2020 has also been establishment of Continuous professional development (CPD) for specialists in psychiatry. This work is ongoing. A report in which several options for CPD are discussed, is available in Norwegian only. Copy may be requested by contacting nina.finstad@legeforeningen.no.
A guide how to reduce dose of antipsychotic medicine has been published (in Norwegian only): click here to view or download.
A task force on how to further develop telepsychiatry has been established.
A survey of how psychiatrists perceive their work / working condition / role, was conducted for the first time in 2020. It will be an annual survey in the future.
A joint meeting between the Swedish and Norwegian psychiatric associations in 2024, replacing each association’s national meeting that year, is under discussion with the Swedish Psychiatric Association.
Position statements (“hearings”) to several proposal for change in mental health policies and laws is an important and continuous task.
SWEDISH Psychiatric Association
Annual report 2020
The Swedish Psychiatric Association (SPF) has 981 members. There are 613 specialists and 346 seniors (over 65 years). The association has 22 honorary members. The association has three subdivisions; The Swedish Society for Bipolar Disorder, Consultant Psychiatry and the Swedish Association for Elderly Psychiatry whose members are also members of SPF.
Content
Composition of the Board of Directors
Work of the Board of Directors
Main areas of work
Education Committee
Referrals
Collaboration
Journal of Swedish Psychiatry
International cooperations
1. Composition of the Board of Directors
Chairman: Alessandra Hedlund (2019-2021), Martin Hultén (2021-)
Vice Chairman: Martin Hultén (2019-2021), Maria Larsson (2021- )
Secretary: Linda Martinik
Treasurer: Denada Aiff
Editor in chief, Journal of Swedish Psychiatry: Tove Gunnarsson
Scientific Secretary: Jonas Eberhard
Chairman of the Education Committee: Lotta Sandström (2019-2021), Matilda Naesström (2021- )
Chairman of the Section for Residents in psychiatry: Karl Axel Lundblad (2019-2021), Johanna Hansson (2021- )
Members: Tarmo Kariis, Cave Sinai
Adjunct member (administrator of website and social media): Karl Axel Lundblad
2. Work of the Board of Directors
The Board met on 11 occasions during 2020. Most of the meetings were held via digital platform Zoom.
3. Main areas of work
During 2020, the Board of Directors has worked with the following main areas of work:
Swedish Psychiatry Congress: arranged in Gothenburg 11-13 March 2020 under extraordinary circumstances. 764 participants had registered with Congress. However, the pandemic took off when the congress started and a number of the notified participants therefore chose to abstain physically or were prevented by decisions from the employer.
Education activities: Due to the pandemic, SPF was unable to arrange training arrangements in normal physical form. 2020 was used to reshape planning and ensure technical solutions for future digital training activities.
Conference for Residents in Psychiatry: arranged in Stenungssund I January 2020 with about 180 participants.
SPF´s website
Social media and debates: SPF has been visible on social media, mainly the association's Facebook page, but also through debate posts in e.g. daily press.
Safe suicide prevention: Ullakarin Nyberg is responsible for the project Safe Suicide Prevention, which is carried out together with LÖF (The County Council's Mutual Insurance Company).
4. Education Committee
The Education Committee covered issues relating to medical education and internships. The introduction of 6-year medical training, so called BT service, and a new ST regulation entails major changes. The Education Committee monitored local and regional development work.
5. Referrals
13 referrals from mainly The Swedish Medical Society, The Swedish Medical Association and The National Board of Health and Welfare have been answered during 2020.
6. Collaborations
SPF regularly collaborates with Swedish Medical Society (SMS) and Sweden's municipalities and regions. For example, SPF contributed to the programme for Sweden's first scientific meeting on COVID-19 organized by SMS and the Swedish Infectious Diseases Medical Association on 15-16 December 2020.
7. Journal of Swedish Psychiatry
During the year, the journal published 4 issues.
8. International Collaboration
European Psychiatric Association (EPA), Nordic Psychiatric Associations (NPA) and World Psychiatric Association (WPA). □