The mental health care system in Ukraine is centralized and largely focuses on capacity for inpatient psychiatric treatment with 90% of funding allocated to inpatient psychiatric care at hospitals, much higher than countries who already have more decentralized care. Community-based mental health care options, including mental health provided at the primary health care level are currently limited or absent in the mental health system. Psychosocial support, as well as self-care and mental health promotion are also insufficiently developed. Covid-19 pandemic is serious challenge for health care system, especially for consultation liaison psychiatry.

Mental health monitoring and psychological support in University Clinic of Kharkiv National Medical University, Ukraine during COVID-19 epidemic.

HADS, SCL-90, HDRS, HARS

During COVID-19 epidemic, implemented combination of off-line and eye-to-eye methods of mental health monitoring and psychological counselling for patients and medical staff in University clinic of Kharkiv National Medical University. Model of early detection and management of mental disorders based on multidisciplinary teamwork principles, сombination of off-line and eye-to-eye methods of screening, monitoring and psychological counselling for patients and medical staff. The online format proved beneficial because many patients of University clinic have trust issues and preferred not to deal with psychiatric services locally when it comes to mental health problems and it was accessible on epidemic conditions. An important part of the outreach work by the project was to destigmatize mental health problems.

Combined model (off-line and eye-to-eye services) of mental health care is preferred compare to traditional approach in modern conditions.

Сognitive deficit significantly affects the quality of life of patients. Aims of research was detection of cognitive impairments of varying degrees in epilepsy, and as well as studying the results of complex treatment in conditions of University clinic, physical and psychological rehabilitation, cognitive training and VNS included.

We studied the features of clinical and psychopathological manifestations of cognitive impairments in patients suffering from epilepsy.

The study was attended by 100 patients (35 men and 65 women) who were inpatient care. The following psychodiagnostic techniques were used: the Toronto Cognitive Assessment TorCA, the test of 10 words of Luria, the MOCA test, the Münsterberg test, the quality of life scale, the Hamilton scale of depression and anxiety.

MCI was observed in 88 % patients, dementia in 12 % (50 % - mild dementia, in 24 % - moderate dementia and in 16% - severe dementia). We used non-pharmacological rehabilitation methods for correction of cognitive impairment in epileptic patients with MCI and mild dementia during 3 mounth.. Improving of cognitive function was observed in 48 % patients, stable level of cognitive function - in 36 %, progressing of cognitive imparment - in 16 % patiens with epilepsy.

The results of the conducted research indicate the need for further study of the features of cognitive disorders in pharmacologically treatment resistant epilepsy and implementation of training aimed at improving cognitive function and preventing the progression of cognitive impairment in complex treatment of those patients.