Neoliberalism and Mental Health: A Critical Theoretical Analysis

Abstract

Introduction: Stroke represents one of the most significant public health challenges in Georgia, characterized by high morbidity, disability, and mortality. The incidence of stroke in Georgia is on the rise. Post-stroke complications—such as impairments in mobility, speech, swallowing, cognition, and psychosocial functioning—require timely and comprehensive rehabilitation, which demands substantial financial and human resources. As a developing country, the introduction of state-funded post-stroke rehabilitation in Georgia constitutes a critical step forward. This program was launched in 2022; however, its scope, coverage, and effectiveness still require thorough evaluation. The aim of this study is to assess the accessibility of rehabilitation services for stroke survivors, identify existing barriers, and evaluate the outcomes of the program from the perspectives of both patients and healthcare professionals. Methods: A mixed-methods approach was employed for this study, including quantitative surveys with patients and in-depth interviews with neurologists who are directly involved in the rehabilitation process. Results: Data analysis revealed that funding for rehabilitation is a decisive factor in improving patients’ conditions. The majority of respondents reported clinical and functional improvement following the rehabilitation course. However, the study also identified several critical issues: 91% of the surveyed patients reside in Tbilisi, while approximately 75% of stroke cases occur in the regions. This points to a significant geographical disparity in service availability. According to official data, only 956 patients benefited from state-funded post-stroke rehabilitation between 2022 and 2025, whereas the annual need is estimated to be in the tens of thousands. Conclusion: The initiation of state funding for rehabilitation services marks a positive and necessary development. Nonetheless, the current program does not meet the large-scale needs existing across the country, particularly in rural areas. Limited accessibility, lack of infrastructure, shortage of specialists, and informational barriers remain key systemic challenges. Therefore, expanding services, revising the funding model, and improving public awareness are essential steps toward making rehabilitation timely, accessible, and comprehensive for all stroke survivors in Georgia.