On measures for the further development of the mental health service of the population

Resolution of the President of the Republic of Uzbekistan
In order to develop the mental health service of the population, early detection and diagnosis of mental disorders, improve the quality of treatment of persons suffering from mental disorders, introduce an effective management system, develop science, increase human resources in the field, strengthen the material and technical base of psychiatric institutions, as well as the organization of timely provision of psychiatric care to the population:

1. To approve the proposals of the Ministry of Health on the radical improvement of the mental health service of the population, providing for:

introduction of a unified vertical management system for the provision of specialized psychiatric and narcological care;

integration of the mental health service into primary care medical institutions;

full provision of medicines to persons suffering from mental disorders, in accordance with the need;

strengthening the mental health of the population, especially children and adolescents;

improvement of the personnel training system, decent stimulation and creation of additional conditions for the effective work of specialists;

further strengthening of the material and technical base of psychiatric institutions.

2. To agree with the proposal of the Ministry of Health on the transformation, starting from July 1, 2023, of the Republican Specialized Scientific and Practical Medical Center for Narcology into the Republican Specialized Scientific and Practical Medical Center for Mental Health (hereinafter referred to as the Center), while maintaining the current funding procedure.

Determine that:

a) The Center:

establishes the provision of specialized psychiatric, medical-psychological and narcological care, forms a high-tech material base and a scientific school in these areas;

coordinates and monitors the work in the direction of mental health at all levels of health care;

b) psychiatric and drug treatment hospitals and dispensaries in the regions are territorial organizational and methodological departments of the Center;

The Center, its territorial branches in the Republic of Karakalpakstan, regions and the city of Tashkent operate as the main clinical base for the corresponding departments of medical higher, professional and secondary specialized educational institutions.

3. Starting from August 1, 2023, to introduce the states:

medical psychologist – in district (city) multidisciplinary central polyclinics by reducing the staff of district (city) departments of the Center for Healthy Lifestyle Support and Increasing physical activity of the population;

suicidologist – in neuropsychiatric dispensaries that do not have inpatient beds, and in psychiatric hospitals that have
dispensaries in their composition;

a doctor of the emergency department, a psychiatrist on duty, a medical psychologist or a psychotherapist within the existing states – in neuropsychiatric dispensaries with inpatient beds, and in psychiatric hospitals.

4. Put into practice by the end of 2023 Action program The World Health Organization for the Provision of assistance for Mental Disorders in primary care institutions, which provides for:

taking measures for the early detection and treatment of mental disorders already in the primary level of medicine;

development of skills and increase of knowledge of doctors and other medical workers of primary care medical institutions on clinical assessment, treatment and supervision of persons suffering from mental disorders.

5. The Ministry of Preschool and School Education, together with the Ministry of Health, to organize special socio-emotional learning (SEL) in institutions of general secondary education within the framework of the existing disciplines of the school curriculum and extracurricular processes on the formation of students' skills of self-control and overcoming difficult life situations, prevention of depressive, anxiety states and suicides.

6. Establish the procedure according to which:

starting from September 1, 2023, expenses related to the training of medical workers in retraining courses in the areas of "psychiatry", "forensic psychiatry", "medical psychology" and "narcology" are carried out at the expense of the Fund for Support and Attraction of Gifted and Qualified medical Specialists to medical institutions;

since the 2023/2024 academic year, admission to clinical residency and master's degree programs in the specialties "psychiatry", "medical psychology" and "narcology" is carried out exclusively on the basis of a state grant within the general admission parameters, and admission indicators are formed based on the study of the actual need for these specialties.

The Ministry of Health should take measures to send at least 40 specialists in the field to reputable foreign medical institutions and centers in 2023-2024 for advanced training and internships at the expense of the Fund for Support and Attraction of Gifted and Qualified medical Specialists to medical institutions.

7. Starting from July 1, 2023, increase the amount of the allowance from 25 percent to 50 percent to the official salary of psychiatrists operating in district (city) multidisciplinary central polyclinics, as well as psychiatrists, medical psychologists, psychotherapists and suicidologists operating in psychiatric medical institutions.

8. To the Ministry of Economy and Finance:

jointly with the Ministry of Health, to allocate additional funds in the amount of 10 billion soums in 2023 to provide on a preferential basis medicines for persons suffering from mental disorders during outpatient treatment, from 2024 – to provide the necessary funds when forming the parameters of the state budget on the basis of reasonable calculations of the Ministry of Health;

expenses related to the activities specified in this resolution should be carried out in 2023 at the expense of funds provided for expenses for other health–related activities, from 2024 - to provide for the allocation of funds in the parameters of the state budget.

9. Approve:

The program of comprehensive measures for the development of the mental health service of the population in 2023-2024 according to Appendix No. 1;

The program for equipping psychiatric institutions with medical equipment in 2023-2024 according to Appendix No. 2;

Measures to strengthen the mental health of children and improve the children's neuropsychiatric service according to Appendix No. 3;

A standard list of diagnostic and neurorehabilitation equipment required for children's multidisciplinary medical centers of the Republic of Karakalpakstan, regions and the city of Tashkent and medical associations of districts (cities), according to Appendix No. 4.

10. To make additions to some decisions of the Government of the Republic of Uzbekistan according to Appendix No. 5.

11. The Ministry of Health, together with the ministries and departments concerned, within two months to submit proposals to the Cabinet of Ministers on amendments and additions to legislative acts arising from this resolution.

12. Assign to the Minister of Health Inoyatov A.Sh. personal responsibility for the effective organization of the execution of this resolution.

13. Control over the implementation of this resolution shall be entrusted to the Prime Minister of the Republic of Uzbekistan Aripov A.N. and First Deputy Adviser to the President of the Republic of Uzbekistan Tuichiev L.N.

         President

Of the Republic of Uzbekistan Sh .MIRZIYOYEV

Tashkent City,

June 19, 2023.