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21 October 2025 | Policy Analysis
Recent reforms in public health and prevention -
30 November 2020 | Policy Analysis
Psychiatric care reform: ongoing initiative, continuing of setting up new psychiatric care community centres
5.11. Mental health care
Mental health care is funded by SHI and provided in both inpatient and outpatient settings. Inpatient facilities include hospital psychiatric departments and specialized psychiatric facilities. In 2020, providers of psychiatric outpatient services gave medical treatment to approximately 5.9% of Czechia’s population (more than 628 000 patients; a 1.5% decrease from 2019). More women (62%) than men (38%) sought psychiatric outpatient treatment in 2020. Outpatient psychiatric care was provided by 2083 FTEs in 2020: 1017 physicians (of whom 883 were psychiatrists), 617 paramedics, 235 clinical psychologists and 178 other professional workers. Compared with 2019, there was an increase in the number of nurses and clinical psychologists, but a decrease of psychiatrists (ÚZIS, 2021).
In 2020, 22 specialized psychiatric inpatient facilities were registered in Czechia, of which 12 were reserved for adults, three for children, three were addiction treatment centres and four were other psychiatric facilities. In total, 8337 beds were reported, of which 210 were in the children’s facilities (the number of beds has decreased annually on average by 1.2% since 2010). The overall occupancy rate in all psychiatric facilities in 2020 was 84.2%, corresponding to 29 968 hospitalizations in psychiatric facilities. There are also 28 psychiatric wards in general hospitals, where the number of beds has remained rather constant in the past 10 years (ÚZIS, 2021).
Czechia is facing an acute shortage of child psychiatrists, both inpatient and outpatient. As there are no systematic data on waiting times, this shortage is emphasized especially by the physicians themselves. The chairman of the Association for Child and Adolescent Psychiatry informed MZČR’s working group in May 2021 that half of outpatient providers are unable to accept new patients due to capacity reasons, waiting times are 2–3 months and there are problems with placing children with acute problems into inpatient facilities. Accessible help is often not available, even for the serious cases. The then-director of one of the three specialized psychiatric inpatient facilities for children also warned about capacity and shortage problems in their facility (MZČR, 2021b). The system came under further stress during the COVID-19 pandemic and the backlog situation remains critical in 2022 (Deník, 2022).
Mental health services have undergone major changes following the psychiatric care reform launch in 2011, due to underfinancing and outdated organization focused on psychiatric hospitals providing neither sufficient support for patients in their own environment nor cooperation/coordination among care providers. The underlying goal has been to improve quality of life for people living with mental illnesses, mainly by deinstitutionalizing psychiatric care; that is, by shifting from psychiatric hospitals to community/outpatient settings, stressing the importance of multidisciplinary teams and the linkage between health and social services (MZČR, 2019).
The Strategy for the Reform of Psychiatric Care (MZČR, 2013) lists seven strategic aims: (1) increase the quality of psychiatric care by systematic changes in the organization of its provision; (2) destigmatize the mentally ill and the field of psychiatry in general; (3) increase user satisfaction with psychiatric care provided; (4) increase effectiveness of psychiatric care through early diagnosis and identification of hidden psychiatric illnesses; (5) increase success rates of full integration of mentally ill people into society (especially by improving conditions for employment, education and housing, etc.); (6) improve connection of health, social and other follow-up services; and (7) humanize psychiatric care. The specific procedures for achieving these goals are incorporated in three main strategic documents: the National Mental Health Action Plan 2020–2030, the National Action Plan for Alzheimer’s Disease and Related Diseases 2020–2030, and the National Suicide Prevention Action Plan 2020–2030, all of which are part of Health 2030 as well.
Programme implementation of the psychiatric care reform began in 2017, with mental health centres offering new health and social services to care for those with serious mental illnesses in their own environments. Multidisciplinary teams representing professions from the health and social care systems (psychiatrists, clinical psychologists, general nurses and mental health nurses, and social workers, among others) connect patients with any relevant local authorities responsible for assessing housing allowances and allocating social housing, curators, guardians, local and state police, and other local services (Svačina et al., 2021). The first mental health centres opened in July 2018 and by 2020 already cared for 3489 people (59% of them were treated for schizophrenia-related diagnoses) (ÚZIS, 2021); the goal is to have 100 functioning centres by 2030. Multidisciplinary teams have also been in operation since 2020, including teams specializing on children and adolescents, elderly people and persons struggling with addiction. After some psychiatric hospitals were forced to discharge long-stay patients during the COVID-19 pandemic, mental health care centres immediately started providing them with necessary support (Svačina et al., 2021).
As a part of destigmatizing the mentally ill, guidance materials were created by a group of specialists and distributed at the regional level (available at: https://www.psychiatrie.cz/deni-zdravotni-a-socialni-politika/deni-destigmatizace). Moreover, the NA ROVINU initiative was created as part of the project and promotes educational programmes for target groups, for example, people with mental illnesses, their family members, health and social care personnel, public administration employees and the communities around the emerging mental health centres (MZČR, 2019).
Prevention and protection of public health are essential for reducing disease burdens, improving population health, and ensuring a resilient and sustainable health system. Below are several examples of recently discussed and accepted measures targeting areas of prevention and protection in Czechia.
Primary care
In September 2025, the Ministry of Health, together with general practitioner representatives, introduced a reform of preventive check-ups and additional measures to strengthen disease prevention and the role of GPs in primary care. The reform aims to enable earlier detection of serious diseases and enhance cooperation between the Ministry and GPs. It expands laboratory testing – covering liver function, blood glucose, kidney function, lipid profile and ECG – and strengthens the early detection of dementia, osteoporosis and chronic kidney disease. Preventive check-ups will be more individualized, with greater emphasis on vaccination, screening and patient history. GPs will also play a more active role in informing patients about the importance of preventive programmes and the risks of non-participation.
Moreover, from 2026, dispensary care for people with cognitive disorders will be added to the existing monitoring by GPs of degenerative diseases of the central and peripheral nervous systems (amendment to Decree No. 39/2012 Coll. on dispensary care). This extension emphasizes the key role of primary care in early detection, ongoing monitoring and coordination of care for these patients. Dispensary care refers to specialized medical follow-up aimed at the systematic, long-term monitoring and management of the health status of patients who are at risk of, or suffer from, a serious disease, with the goal of preventing complications.
Focus on children
Effective from 2026, the amendment to Decree No. 39/2012 Coll. on dispensary care will also introduce regular monitoring of overweight children. The inclusion of overweight and obesity to the conditions subject to dispensary care by paediatric GPs reflects the growing prevalence of childhood obesity in Czechia and the need for systematic preventive and follow-up care. The amendment emphasizes long-term lifestyle guidance, complication prevention and family education. The amendment also expands the list of conditions regularly monitored by child and adolescent psychiatrists. The new monitoring includes anxiety disorders, cases related to child abuse or neglect, adolescent diagnoses such as self-harm, and severe non-organic encopresis and secondary enuresis. The aim is earlier diagnosis, timely intervention and ongoing support for children, helping prevent deterioration and further complications.
From 2025, early detection of serious eye disorders in children under three has been organized as a national screening programme, building on initiatives started in 2022. The first three years of life, particularly the first 12 months, are crucial for proper visual development. The programme aims to prevent permanent vision problems by identifying refractive errors such as myopia, hyperopia, astigmatism and other eye conditions at an early stage, including children with and without family histories of eye disorders.
On 1 September 2025, an amendment to the decree on school meals came into effect, introducing the most significant changes in over 30 years. The reform aligns school catering with the latest nutritional recommendations, improves menu quality and variety, and reduces excessive salt, added sugars and highly processed foods. These updates were developed with input from doctors, nutritionists and public health experts. Meals are designed to be nutritious, appealing and feasible to prepare in school canteens. A transitional period until 1 September 2026 allows schools to gradually implement the new rules, supported by a detailed methodology.
Mental health care
In September 2025, the Ministry of Health, together with the National Mental Health Council, introduced a new Concept for Child and Adolescent Psychiatry as part of broader efforts to improve access and quality of mental health care. The reform expands acute inpatient capacity, community and outpatient services, and introduces modern treatment approaches, including telemedicine and digital cognitive behavioural therapy. It also develops new acute and community services, day-care centres, and specialized adolescent wards, supported by an online information portal (nzip.cz/dusevni-zdravi) for families. The ministry addresses workforce shortages through expanded residency programmes, simplified specialty training, and new accreditation schemes for psychologists and psychotherapists.
In October 2025, the ministry launched a call for applications to pilot Acute Psychiatric Outpatient Clinics under the Development of Acute Psychiatric Care project. The 14-month pilot, funded for up to ten facilities, will test operational models, gather data for sustainable financing, and provide temporary care for patients with acute mental health needs who lack a regular psychiatrist.
Oncology
From 2026, preventive colorectal cancer screening will be covered by statutory health insurance for people aged 45 and over, expanding eligibility from the previous threshold of 50 years. However, for the first time, the programme will institute an upper age limit of 74 years.
From 2026, a new complex oncology centre will open in the Karlovy Vary Region, which has so far had among the poorest access to cancer care. The facility will allow most examinations and treatments to be carried out locally, reducing the need for long-distance travel while maintaining access to specialized procedures at higher-level centres.
Also from 2026, every complex oncology centre in Czechia will have a dedicated patient coordinator. These coordinators will help patients navigate the often-complex healthcare system – from the first contact to the start of treatment – by ensuring continuity of examinations, supporting staff with administrative tasks and guiding patients between departments. Their role aims to reduce waiting times, prevent delays, and improve patient comfort and confidence.
Vaccination
From October 2025, a pilot project allows flu vaccinations to be administered in selected pharmacies in three big cities of Czechia (Prague, Brno and Ostrava). The Ministry of Health aims to boost vaccination rates and strengthen pharmacies’ role in prevention. However, general practitioners have criticized the plan, arguing that pharmacists lack the necessary expertise and that the measure will not benefit patients or the healthcare system.
Digital tools and technology
Recognizing its importance for public health, the Ministry of Health, together with ÚZIS and the National Institute of Public Health (SZÚ), launched on 1 July a pilot of automated infectious disease reporting from primary care. Data are transmitted directly to the Infectious Disease Information System (ISIN), providing fast, accurate information while reducing administrative burden for doctors and regional health authorities. This digital tool enables quicker responses to epidemic threats and strengthens population health protection.
In recent years, Czechia has also introduced a fully digitalized central vaccination registry that collects real-time data from all healthcare providers, significantly reducing administrative burden. The system provides immediate overviews of vaccine distribution, capacity and coverage, with data openly accessible to professionals and the public.
From 2026, the app EZKarta will expand its functionality. It will include a “health index”, a type of alert guiding users on preventive check-ups and other health activities. If eligible for a free screening, the app will send mobile notifications. EZKarta already provides an overview of vaccinations, completed preventive check-ups, screening tests and links to other Ministry of Health web services, with additional features to be added over time.
References
https://mzd.gov.cz/tiskove-centrum-mz/prevon-2025
https://mzd.gov.cz/tiskove-centrum-mz/koordinovat-je-slusnost
https://www.nzip.cz/clanek/2428-screening-zavaznych-ocnich-vad-u-deti
https://www.zdravotnickydenik.cz/2025/07/demence-i-obezita-praktici-detsti-psychiatri-dohlednou-na-vic-pacientu
https://www.zakonyprolidi.cz/cs/2025-341
https://www.zdravotnickydenik.cz/2025/10/elektronizace-ezkarta-ezadanky-foltyn
The implementation of further mental health reforms, an important piece of the Strategic Framework for the Development of Health Care in the Czech Republic until 2030, is continuing amid system stresses and corresponding backlogs related to the COVID-19 pandemic and workforce shortages (Czechia is facing an acute shortage of child psychiatrists, both inpatient and outpatient).
The seven primary aims are:
- increase the quality of psychiatric care by systematic changes in the organisation of its provision;
- destigmatise the mentally ill and the field of psychiatry in general;
- increase user satisfaction with psychiatric care provided;
- increase effectiveness of psychiatric care through early diagnosis and identification of hidden psychiatric illnesses;
- increase success rates of full integration of mentally ill people into society (especially by improving conditions for employment, education and housing, etc.);
- improve connection of health, social and other follow-up services;
- humanise psychiatric care.
The specific procedures for achieving these goals are incorporated in three main strategic documents: the National Mental Health Action Plan 2020–2030, the National Action Plan for Alzheimer’s Disease and Related Diseases 2020–2030, and the National Suicide Prevention Action Plan 2020–2030, all of which are part Health 2030 as well. Programme implementation of the psychiatric care reform care began in 2017, with mental health centres offering new health and social services to care for those with serious mental illnesses in their own environments. Multidisciplinary teams representing professions from the health and social care systems (psychiatrists, clinical psychologists, general nurses and mental health nurses, and social workers, among others) connect patients with any relevant local authorities responsible for assessing housing allowances and allocating social housing, curators, guardians, local and state police, and other local services. The first mental health centres opened in July 2018 and by 2020 already cared for 3489 people (59% of them were treated for schizophrenia related diagnoses); the goal is to have 100 functioning centres by 2030. After some psychiatric hospitals were forced to discharge long-stay patients during the COVID-19 pandemic, mental health care centres immediately started providing them necessary support. As a part of destigmatising the mentally ill, guidance materials were created by a group of specialists and distributed at the regional level. Moreover, the NA ROVINU initiative was created as part of the project and promotes educational programmes for target groups, i.e., people with mental illnesses, their family members, health and social care personnel, public administration employees, and the communities around the emerging mental health centres.
Authors
References
Svačina, G., Svobodová, I., Protopopová, D., & Langins, M. (2021). Transforming primary health care during the pandemic. Community-based mental health services: a lifeline during COVID-19. Country vignette. WHO Europe, Copenhagen. https://www.who.int/czechia/publications/m/item/czechia-community-based-mental-health-services-a-lifeline-during-covid-19-(2021)
MZČR. (2019). Průvodce reformou psychiatrické péče [A guide to psychiatric care reform]. https://www.reformapsychiatrie.cz