Psychiatry in Ostrava: From a Small Department to a Clinic and New Challenges

Will the transformation of the department into a clinic bring any major changes?

Becoming a clinic is more of a formal act. We had already been performing most of the activities before; it’s more a culmination of our long-term efforts and an official recognition of our status, which is important for both our organizations—the university hospital and the faculty of medicine. From now on, medical board certification exams in psychiatry will take place here, and certification for psychologists is also being considered. Until now, we were a bit of a “white crow” —⁠ operating within a university hospital but only as a department, which didn’t reflect the scope or requirements of our work.

Your team is also involved in research. Which areas are your priorities?

We systematically focus on several key areas. The first is monitoring plasma concentrations of psychotropic drugs—that is, studying how the drug’s availability in the body relates to its effectiveness or side effects. The second area is treatment approaches during the perinatal period, and the third is research on the effectiveness of repetitive transcranial magnetic stimulation for various diagnoses. The fourth area involves the use of transcranial ultrasonography in psychiatry. In addition, we are conducting smaller research projects in other fields.

Child and adolescent psychiatry is a very pressing topic today. Is that why you established the Center for Child Mental Health?

The number of children with mental health problems is rising rapidly, a trend accelerated by the COVID-19 pandemic. When planning our new pavilion, we wanted to expand services for children, especially outpatient programs that allow intensive treatment without hospitalization. We lacked the material and staffing resources for inpatient psychiatric beds, but offering intensive care while children can sleep at home is a great relief for many families. Today we provide a day-care program for younger children and adolescents, and for the most severe cases we have the Center for Mental Health, where doctors and psychologists work alongside social workers and special educators. They can also provide help outside the hospital, for example in schools or families. However, demand is extremely high, and there are currently no child psychiatric beds in the region—something we would like to establish in the future.

How does your clinic define its catchment area?

We primarily focus on children from the Ostrava region, where our capacity is already stretched. For outpatient care or the day-care program, we also accept children from outside Ostrava. It mainly depends on whether parents can bring their child daily. The purpose of mental health centers is to ensure maximum accessibility for children with the most severe issues, so each center has a clearly defined catchment area. If such centers admitted patients from distant regions, they would quickly reach full capacity and find it difficult to provide fieldwork. The organization of social services, which are regionally based, also plays a role. In practice, the catchment area is reserved specifically for the Center for Mental Health. However, given the huge demand, we must carefully assess whom we can admit to care. In many cases, the child’s condition can be managed by a general practitioner in consultation with a psychiatrist.

How has psychiatric care evolved during your tenure?

When we began developing the department fifteen years ago, we had sixteen beds and just a few doctors and psychologists. Today, we are a clinic with 66 beds, more than twenty doctors, and about ten psychologists. We’ve made great progress in capacity, services, and expertise. At the same time, the number of people with mental illnesses continues to rise, and the care network cannot keep up. Moreover, many psychiatrists are nearing retirement age, so access to services could worsen in the future. That’s why psychiatry is focusing on strengthening outpatient and community-based care, as well as improving cooperation with the social and educational systems. After decades of stagnation, the reform of mental health care is finally underway, bringing gradual change. Although resources are still insufficient and the number of patients is rising faster than capacity, the positive developments are more visible than before, and the field is becoming more attractive thanks to new treatment options.

Artificial intelligence is a hot topic today. How do you see its use in your practice?

I believe we’ll need to integrate it into our work. It can help us in many areas. We were surprised by how convincingly language models can communicate. I originally thought AI would first replace radiologists in image interpretation or that surgical robots would learn from surgeons—but not that AI would be able to communicate with patients in a systematic and empathetic way. Yet that’s becoming reality. Artificial intelligence could help us manage the excess demand, triage patients, and support those with mild and easily manageable issues. It could even monitor them to some extent while they wait to see a specialist. However, I still don’t believe AI can fully replace human contact and acceptance. We are only at the beginning, and these models need further development—and careful oversight.

Editorial Team, Medscope.pro