For more than 30 years, all the most severe patients have been transported to the Resuscitation and Intensive Care Unit of the Republican Vilnius Psychiatric Hospital (RVPL). No other hospital in the entire Eastern Lithuania region accepts them because they do not have psychiatrists available around the clock and cannot provide targeted psychiatric treatment. Therefore, every day all beds in the RVPL resuscitation unit are occupied by patients with severe psychoses, consciousness disorders, seizures, and other serious conditions, according to the hospital’s press release.
About 500 patients receive urgent specialized care annually. More than half of them are working-age people, aged 18–65.
“Currently, only RVPL doctors can provide urgent care to people with mental disorders because resuscitation units in regional hospitals are being closed, and at Santaros Clinics or the Republican Vilnius University Hospital, such patients are usually treated for no more than one or two days. Every week, patients who need not only urgent care but also immediate psychiatric treatment are transferred to us from these institutions. A painful recent incident involved a patient who had long consumed alcohol and, after treatment in two resuscitation units, was brought to us so suppressed that his respiratory function was impaired,” regrets RVPL director Prof. Dr. Arūnas Germanavičius.
He is convinced that such situations will only increase if the Ministry of Health, as planned, closes the RVPL Resuscitation and Intensive Care Unit from this September.
Does not recognize conditions caused by mental disorders
“After just a few months, patients may be left without professional targeted urgent care. We constantly see people who received resuscitation services in other hospitals, but no one recognized that the condition, e.g., consciousness disorder, was caused by a mental disorder. Meanwhile, in the RVPL Resuscitation and Intensive Care Unit, care is provided around the clock not only by anesthesiologists – resuscitators, intensive care doctors, but also psychiatrists, surgeons, radiologists, and internal medicine doctors,” says Jolita Čiuderė, head of the RVPL Resuscitation and Intensive Care Unit.
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Moreover, it is the only healthcare institution in Lithuania that applies the most advanced electroconvulsive therapy with modern equipment, involving an anesthesiologist-resuscitator, psychiatrist, and consulting specialists from other fields.
The most modern equipment is used to treat all catatonia states, schizophrenia spectrum disorders, treatment-resistant depression, severe mania, and severe psychosis. This method is also applied when there is a high risk of suicide, when the effect of antidepressants is insufficient and they start working only after two weeks of use or cause undesirable side effects. Since the hospital has suitable conditions for intensive monitoring of patients’ conditions and consulting specialists from other fields if necessary, the procedure is also performed on older patients when there are comorbid somatic diseases in severe mental conditions and the possibility of prescribing psychotropic drugs is limited.
Using electroconvulsive therapy for severe depression, when drugs and psychotherapy are ineffective, as well as in the presence of suicidal thoughts or psychosis, up to 80% of patients experience significant improvement. This treatment method is very safe and is applied worldwide, especially in Scandinavian countries.
