Estonian ministry on Natl Audit Office's criticism: More money is needed

TALLINN - The Ministry of Social Affairs on Friday responded to the National Audit Office's criticism that the state is not fulfilling its obligations concerning the availability of care for people with mental health disorders by stating that additional funding and closer cooperation with municipalities and service providers are needed to improve the availability of special care services.

The ministry said in its response that even with the current budget, significant changes have been achieved in the sector over the last 20 years -- new services have been created, and with the help of foreign funds, nearly 2,200 modern special care service spots have been established to replace large, dilapidated care home buildings, which allow people to live longer in their own homes and communities.

"There are shortcomings in special care services, and we understand that the situation is not easy for those who need the service or for their loved ones," said Maarjo Mändmaa, secretary general of the Ministry of Social Affairs.

Mändmaa added that with the growing number of people in need of special care, the services have been underfunded.

"In the last six years, we have submitted additional funding requests for the sector every year, but only nine percent of them have been approved," Mändmaa noted. "It is clear that increasing funding is unavoidable to improve the availability of services."

"At the same time, quite a lot can be done without extra funding. For example, we plan to shorten the deadlines for accepting or declining a service spot so that people can receive help and the service spot they need more quickly. Unfortunately, it often happens that a person may take a couple of months to decide and later give up the spot, while hundreds of people remain waiting in line," the secretary general explained.

In recent years, one important goal has been the development of community-based and more flexible services to support the daily living and independence of people with special needs in their homes and everyday environments. As a result of amendments to the Social Welfare Act that came into effect this year, those in need can access day- and week-care services, allowing them to continue living at home while providing their relatives with up to 23 days per month of relief and necessary support. Since the beginning of the year, 202 people have been directed to this service.

In addition, the state continues, as in previous years, to establish new facilities. Over the past 20 years, nearly 1,700 modern specialized care service spots have been established to replace large, worn-out buildings, and almost 500 new community living service spots have been added. Between 2026 and 2029, another 324 service spots are to be reorganized.

The Estonian Social Insurance Board and the Ministry of Social Affairs do not perform their statutory obligation to ensure special care services to people with mental disorders, the National Audit Office says in its latest audit report.

Although the share of the budget for special care in the operating expenditure of the government sector has remained stable, it has not ensured accessibility as the number of people in need of assistance is increasing. The government and the Riigikogu have been aware of the problems for years but have failed to take decisions that would bring about changes, the report says.

In its overview, the National Audit Office looked for an answer to the question of whether the special care services organized by the state are accessible.

"The short answer is no," said Rauno Vinni, the audit manager of the National Audit Office.