REFORM OF CHILD AND ADOLESCENT PSYCHIATRY IN POLAND:CHALLENGES IN DIAGNOSIS AND SYSTEM TRANSFORMATION

This narrative review was undertaken in response to the need for systematizing the current state of knowledge regarding the organization of child and adolescent psychiatric care in Poland. Its primary objective was to provide a comprehensive analysis of the reform of this sector of health care, taking into account both the epidemiological context and systemic determinants. The first part presents an analysis of the initial conditions, highlighting key structural, organizational, and staffing deficits that formed the basis for the necessity of reform. Subsequently, the principles and implementation of the reform process initiated in 2018 are examined, with particular focus on the shift away from an institutional model toward a community-based model, as well as the implementation of a tiered system of mental health services. The following section evaluates the outcomes of the reforms to date, including increased availability of outpatient services, reduced waiting times for intervention, and the expansion of specialist training pathways. The study concludes by identifying key challenges and areas requiring further intervention, such as limited intersectional coordination, uneven service standardization, workforce shortages, and financial sustainability of the psychiatric care system for minors.