Healthcare Community - Regional Initiatives - Eastern European

Geriatric Psychiatry in Romania – 
Romanian Association of Geriatric Psychiatry

Geriatric psychiatry becomes a basic discipline for all the socio-medical providers and a specialty for physicians and health workers who devote themselves to the care of the elderly (J. Wertheimer 1996). Old Age Psychiatry is recognized as a specialty only in a few Eastern European countries, (Czech Republic, Romania and Turkey). In Romania, Old Age Psychiatry has been a recognized sub-specialty of Psychiatry since 2001. The specialty of the elderly requires grounding in general psychiatry, general medicine and gerontology as well as training in the specific aspects of both psychiatric and medical conditions as they occur in older people. 

As in all countries in this part of the world, geriatric psychiatry is still not substantially represented. In Romania we have founded scientific organizations such as the Romanian Alzheimer Society (1996), Romanian Association of Geriatric Psychiatry (1999), Romanian Medical Society of Research of Cognitive Disorders and AD, that try to improve this situation organizing the training, both undergraduate and postgraduate courses for young physicians/psychiatrists in order to be able to provide better care of the elderly. Our goal is to provide the basic skills at a high scientific level in old age psychiatry, to develop and establish more young psychiatrists in our part of the world, and to be able to face to the problems raised by mental health in the elderly.

The number of professionals working in the field is still relatively low to meet the needs of care for the elderly with mental disorders. A post-graduate one year training course is organized in Bucharest for a diploma in psychogeriatrics for psychiatrists, geriatricians and medical residents. Additionally, the first course in geriatric psychiatry with international participation was organized by Romanian Association of Geriatric Psychiatry (ARG) in 2000, during the 28th Congress of European Association of Geriatric Psychiatry. ARG has also organized two courses on geriatric psychiatry for general practitioners and other professionals presented in 2001 and 2002. Part of educational programs are the itinerant courses organized by ARG together with other national psychiatry associations under IPA’s umbrella as an IPA EE Initiative, and the summer courses organized in Romania, for psychiatrists from all EE countries on geriatric psychiatry. 

The Romanian Association of Geriatric Psychiatry and Romanian Alzheimer Society organize national and European meetings (The 28th EAGP Congress in 2000 in Oradea and The European Alzheimer Conference in 2001 in Bucharest) and participate at the national and international scientific meetings and courses sponsored by WHO, WPA, EAGP, AEP Section on Old Age Psychiatry, and IPA. The Romanian Association of Geriatric Psychiatry also participates in the pilot studies organized by WHO on AD and suicide. We also are working to obtain a national program to establish geriatric psychiatry services, and organized other providers and services for the elderly to improve the care and assistance to the elderly with or without mental disorders. The Mental Health Law appeared in Romania only in August 2002. In Chapter 4, the types of specific mental health services existing in Romania are listed, along with the care standards for individuals with mental disorders.

Today in Romania, in the care of mentally ill people, we are attempting to shift the orientation of mental health services from the psychiatric hospitals toward community care services. We have started by reducing the number of beds, but without ensuring that care programs and services will be available to these patients in the community. A great number of long stay psychiatric wards were transferred to the social services. The elderly with chronic mental disorders, as well as those with dementia, are taken care of both in psychiatric long-stay hospitals and through social services that are inadequate to care for these patients. Most dementia patients are still in the care of their families, when available. There are social services for the elderly in nursing homes, but without professional staff qualified in social work or geriatric psychiatry. The cooperation between social and medical services is still difficult because they are separate organizations. Stigma remains, maybe more than in developed countries, a major obstacle in ensuring access to good care for the elderly. 

The role of NGOs in the system of community care for the elderly is increasing in many countries, but remains very limited. It is a pity, but we do not have either a clear picture of all services available for elderly care or epidemiological studies in this field. Despite the professionals’ endeavors in the teaching and educational program, there exist only a few psychogeriatric services and few special care services for dementia patients. The national program for elderly care the only established project for the time being and is lacking in solid financial support. In Romania as in all former communist countries there are economical problems and national fundraising is needed to support national psychogeriatric organizations and services.

Announcement for First Eastern Europe Summer Course on Geriatric Psychiatry

It gives to us a great pleasure to invite you to participate in the First Old Age Psychiatry Summer Course, scheduled to take place in Oradea, Romania, in 29 August – 4 September, 2004. This course is organized by IPA’s Eastern European Initiative and Romanian Association of Geriatric Psychiatry, for young psychiatrists from Eastern European countries. Now IPA and ARG are presenting an intensive 7-day course that will introduce the essentials of geriatric psychiatry. We hope that the course will enhance the young general psychiatrists’ professional effectiveness. Caring of the mentally ill elderly requires an understanding of biological changes in late life and specificity of elderly mental disorders, required to recognize the medical comorbidity in the elderly and the high prevalence of depression and cognitive and non-cognitive symptoms of dementia. We believe that elderly mental illnesses are underrecognized and undertreated. Thus, we hope that this course will achieve the goal to understand that elderly mental disorders are recognizable and understandable and may also be better treated.

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