The Slovak Republic is a landlocked country in central Europe with a population of over 5 million. The Czech Republic and Austria lie to the west, Poland to the north, Ukraine to the east and Hungary to the south. The largest city is the capital, Bratislava; the second largest city is Košice. Slovakia is a member of the European Union, the United Nations, the Organisation for Economic Cooperation and Development (OECD) and the World Trade Organization, among other international organisations. The majority of the inhabitants of Slovakia are ethnically Slovak (85.8%). Hungarians are the largest ethnic minority (9.5%). With a gross domestic product (GDP) of €63.3 billion in 2009, Slovakia is classified as a middle-income country. In that year total health expenditure represented 6.7% of GDP (Pažitný, 2008), 34% of which went on pharmaceuticals, the highest share among all OECD countries (World Health Organization, 2010).

Prevalence of mental disorders

Two epidemiological studies have recently been conducted to assess the prevalence of depressive and anxiety disorders in Slovakia – the EPID (Heretik et al, 2003) and EPIA (Novotný et al, 2006) surveys. According to the EPID survey, the 6-month prevalence rate of depression is 41% (13% major depression, 5% minor depression and 23% depressive symptoms only); and according to the EPIA survey, the 6-month prevalence of generalised anxiety disorder is 4%.

The overall rates for first lifetime contact with mental health out-patient services for all mental disorders has been reported to be 1724.4 per 100 000 inhabitants (NCZI, 2009). Almost 27% of treated mental disorders were classified as neurotic disorders; organic disorders were the second most commonly treated conditions in the out-patient setting (20.5%), followed by affective disorders (17.5%) and substance use disorders (12.7%) in 2008 (NCZI, 2009).

Policy and legislation

Slovakia has no laws specific to mental healthcare and there is no monitoring of the quality of care. Several independent bodies monitor human rights in general and some non-governmental organisations address the human rights of those with mental illness (Bražinová et al, 2008).

Slovakia ratified the main human rights instruments in 1992, shortly before the division of Czechoslovakia and the establishment of the Slovak Republic. Mental healthcare falls under the general system of healthcare and is regulated by general healthcare legislation, which reflects much of the international thinking about human rights.