scholarly journals Treatment Engagement of Psychotic Patients with a Mobile Mental Health Unit in Rural Areas in Greece: A Five-Year Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Athina Tatsioni ◽  
Nefeli Menti ◽  
Aikaterini Grammeniati ◽  
Vassiliki Fotopoulou ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Low Income ◽  
Rural Areas ◽  
Psychotic Disorders ◽  
Low Income Countries ◽  
Community Mental Health Service ◽  
Health Unit ◽  
Mobile Mental Health ◽  
Mental Health Unit

Objectives. Treatment of psychotic disorders is impended by high rates of disengagement from mental health services and poor adherence to antipsychotic medication. This study examined the engagement rates of psychotic patients with a community mental health service during a 5-year period.Methods. The Mobile Mental Health Unit of Ioannina and Thesprotia (MMHU I-T) delivers services in remote, rural, mountainous areas using the resources of the primary care system. Clinical and demographic information for patients with a diagnosis of schizophrenia and related psychoses was obtained from the medical records of our unit.Results. A total of 74 psychotic patients initially engaged in treatment with our unit. In half of cases treatment was home-based. With the exclusion of patients who died or discharged, engagement rates were 67.2%. Statistical analysis was performed for 64 patients, and no differences were found between engaged and disengaged patients regarding clinical and demographic parameters. All engaged patients regularly refilled their antipsychotic prescriptions.Conclusion. Engagement rates in our study were comparable to previous research, involving urban settings and shorter follow-up duration. Community mental health teams may ensure treatment continuation for psychotic patients in deprived, remote areas. This is important for low-income countries, affected by economic crisis, such as Greece.

scholarly journals Mental Healthcare Delivery in Rural Greece: A 10-year Account of a Mobile Mental Health Unit

2017 ◽  
Vol 08 (04) ◽  
pp. 556-561 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Thiresia Manthopoulou ◽  
Afroditi Gogou ◽  
Venetsanos Mavreas
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Community Mental Health ◽  
Rural Areas ◽  
Catchment Area ◽  
Mental Healthcare ◽  
Community Mental Health Service ◽  
Primary Care System ◽  
Mobile Mental Health ◽  
Care System

ABSTRACTIntroduction: Patients living in rural and remote areas may have limited access to mental healthcare due to lack of facilities and socioeconomic reasons, and this is the case of rural areas in Eastern Europe countries. In Greece, community mental health service delivery in rural areas has been implemented through the development of the Mobile Mental Health Units (MMHUs). Methods: We present a 10-year account of the operation of the MMHU of the prefectures of Ioannina and Thesprotia (MMHU I-T) and report on the impact of the service on mental health delivery in the catchment area. The MMHU I-T is a multidisciplinary community mental health team which delivers services in rural and mountainous areas of Northwest Greece. Results: The MMHU I-T has become an integral part of the local primary care system and is well known to the population of the catchment area. By the end of 2016, the majority of patients (60%) were self-referred or family-referred, compared to 24% in the first 2 years. Currently, the number of active patients is 293 (mean age 63 years, 49.5% are older adults), and the mean caseload for each member of the team is 36.6. A significant proportion of patients (28%) receive care with regular domiciliary visits, and the provision of home-based care was correlated with the age of the patients. Within the first 2 years of operation of the MMHU I-T hospitalizations of treatment, engaged patients were reduced significantly by 30.4%, whereas the treatment engagement rates of patients with psychotic disorders were 67.2% in 5 years. Conclusions: The MMHU I-T and other similar units in Greece are a successful paradigm of a low-cost service which promotes mental health in rural, remote, and deprived areas. This model of care may be informative for clinical practice and health policy given the ongoing recession and health budget cuts. It suggests that rural mental healthcare may be effectively delivered by integrating generic community mental health mobile teams into the primary care system.

The contribution of a mobile mental health unit to the promotion of primary mental health in rural areas in Greece: A 2-year follow-up

2011 ◽  
Vol 26 (7) ◽  
pp. 425-427 ◽  
Author(s):  
V. Peritogiannis ◽  
C. Mantas ◽  
D. Alexiou ◽  
V. Fotopoulou ◽  
V. Mouka ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Rural Areas ◽  
Health Unit ◽  
Mobile Mental Health ◽  
Northwestern Greece ◽  
Mental Health Unit

AbstractDuring the 2 years of the mobile mental-health unit's operation in Northwestern Greece, the referrals increased rapidly with 29.4% of patients never having received mental-health care before, while hospitalizations and relapses reduced significantly, indicating that community-oriented programs can contribute greatly to successfully addressing the needs of patients in remote rural areas.

scholarly journals Three models of community mental health services In low-income countries

2011 ◽  
Vol 5 (1) ◽  
pp. 3 ◽  
Author(s):  
Alex Cohen ◽  
Julian Eaton ◽  
Birgit Radtke ◽  
Christina George ◽  
Bro Manuel ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Low Income ◽  
Community Mental Health Services ◽  
Low Income Countries

scholarly journals The Greek Hybrid Version of the Assertive Community Treatment Model: A Perspective View between Challenges and Limitations

Psych ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 792-799
Author(s):  
Vaios Peritogiannis ◽  
Fotini Tsoli
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Professionals ◽  
Assertive Community Treatment ◽  
Rural Areas ◽  
Community Treatment ◽  
Community Mental Health Service ◽  
Perspective View

The Assertive Community Treatment (ACT) model of care has been long considered to be effective in the management of patients with severe mental illness (SMI) in most Western countries. The implementation of the original ACT model may be particularly challenging in rural and remote communities with small and dispersed populations and lack of adequate mental health services. Rural programs may have to adapt the model and modify the ACT fidelity standards to accommodate these limitations, and this is the rationale for the introduction of more flexible, hybrid ACT models. In rural Greece, the so called Mobile Mental Health Units (MMHUs) are well-established community mental health services. For patients with SMI that have difficulties engaging with treatment services, the new hybrid ACT model has been recently launched. The objective of this manuscript is to present the recently launched hybrid ACT model in rural areas in Greece and to explore the challenges and limitations in its implementation from the experience of a team of mental health professionals with ACT experience. Referral criteria have not been strictly set, but the number of previous relapses and hospitalizations is taken under consideration, as well as the history of poor treatment adherence and disengagement from mental health services. The main limitation in the implementation of the hybrid ACT service is that it has been introduced in several areas in the absence of a pre-existing community mental health service. This may impact referrals and limit focus on the difficult cases of patients with SMI, thus making the evaluation of the model inapplicable.

scholarly journals The impact of unemployment on mental health examined in a community mental health unit during the recent financial crisis in Greece

Psychiatriki ◽  
2020 ◽  
Vol 30 (4) ◽  
pp. 281-290 ◽  
Author(s):  
G Konstantakopoulos ◽  
K. Pikouli ◽  
D Ploumpidis ◽  
E Bougonikolou ◽  
K Kouyanou ◽  
...  
Keyword(s):  
Mental Health ◽  
Financial Crisis ◽  
Community Mental Health ◽  
Health Unit ◽  
Recent Financial Crisis ◽  
The Impact ◽  
Mental Health Unit

Directing Geriatric Health Care: Some Practical Issues

1984 ◽  
Vol 6 (3-4) ◽  
pp. 7-8 ◽  
Author(s):  
Dennis Wiedman
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Human Behavior ◽  
Care Delivery ◽  
Culturally Appropriate ◽  
Health Unit ◽  
Geriatric Population ◽  
Advantages And Disadvantages ◽  
Mental Health Unit

In fifteen month's experience as Director of a geriatrics community mental health unit I have seen my anthropologist role changing from teacher and researcher to applied clinical anthropologist/gerontologist, from non-judgemental objective scientist to objective decision maker and modifier of human behavior. This article details some of the advantages and disadvantages of a Ph.D. in anthropology for such a clinical position. While particular applications of anthropological methods and theories can facilitate the management of culturally appropriate health care delivery to a geriatric population, other areas of training not usually taught to anthropologists could be of value in a medically responsible clinical position.

scholarly journals Rural vs urban residence and experience of discrimination among people with severe mental illnesses in Ethiopia

2019 ◽  
Author(s):  
Sarah Forthal ◽  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Medhin Selamu ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Low Income ◽  
Rural Areas ◽  
Negative Binomial ◽  
Mental Illnesses ◽  
Urban Setting ◽  
Low Income Countries ◽  
Urban Settings ◽  
Adjusted Risk

Abstract Background Few studies have addressed mental illness-related discrimination in low-income countries, where the mental health treatment gap is highest. We aimed to evaluate the experience of discrimination among persons with severe mental illnesses (SMI) in Ethiopia, a low-income, rapidly urbanizing African country, and hypothesised that experienced discrimination would be higher among those living in a rural compared to an urban setting. Methods The study was a cross-sectional survey of a community-ascertained sample of people with SMI who underwent confirmatory diagnostic interview. Experienced discrimination was measured using the Discrimination and Stigma Scale (DISC-12). Zero-inflated negative binomial regression was used to estimate the effect of place of residence (rural vs. urban) on discrimination, adjusted for potential confounders. Results Of the 300 study participants, 63.3% had experienced discrimination in the previous year, most commonly being avoided or shunned because of mental illness (38.5%). Urban residents were significantly more likely to have experienced unfair treatment from friends (χ2(1)=4.80; p=0.028), the police (χ2(1) =11.97; p=0.001), in keeping a job (χ2(1)=5.43; p=0.020), and in safety (χ2(1)=5.00; p=0.025), and had a significantly higher DISC-12 score than those living in rural areas (adjusted risk ratio: 1.66; 95% CI: 1.18, 2.33). Conclusions Persons with SMI living in urban settings report more experience of discrimination than their rural counterparts, which may reflect a downside of wider social opportunities in urban settings. Initiatives to expand access to mental health care should consider how social exclusion can be overcome in different settings.

Mental Health Professionals' Attire

1998 ◽  
Vol 32 (6) ◽  
pp. 880-883 ◽  
Author(s):  
Mani Rajagopalan ◽  
Mario Santilli ◽  
David Powell ◽  
Megan Murphy ◽  
Marice O'brien ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Mental Health Professionals ◽  
Rural Areas ◽  
Case Manager ◽  
Case Managers ◽  
Small Sample ◽  
Community Mental Health Service ◽  
Mental Health Team ◽  
Mental Health Patients

Objective: Our aim was to obtain mental health patients' views on psychiatrists' and case managers' attire Methods: Eighty-six patients treated at a community mental health service were surveyed. Various types of commonly worn attire were listed. Respondents were asked to choose what they thought was most appropriate for their psychiatrist and case manager to wear. Results: Over 50% of respondents felt that psychiatrist or case manager dress was not an important issue. However, those who felt that it was preferred less formal attire. Conclusions: Psychiatrists and case managers in a community mental health team could consider adopting less formal attire. This conclusion is limited by the small sample and may be relevant to rural areas only. Further research is needed in urban centres. Implications of these findings are discussed.

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