scholarly journals Community Mental Health Services in Italy

10.17816/cp76 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 86-92
Author(s):  
Gaia Sampogna ◽  
Valeria Del Vecchio ◽  
Corrado De Rosa ◽  
Vincenzo Giallonardo ◽  
Mario Luciano ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Treatment Options ◽  
Community Mental Health Services ◽  
Psychiatric Hospitals ◽  
Residential Facilities ◽  
Community Based ◽  
Italian Model

In 1978, in Italy, approval of Basaglias reform law marked a shift from an asylum-based to a community-based mental health system. The main aim of the reform was to treat patients in the community and no longer in psychiatric hospitals. Following the Italian model, similar reforms of mental health care have been approved worldwide. The community-based model aims to promote integration and human rights for people with mental disorders on the basis of their freedom to choose treatment options. By 2000, all psychiatric hospitals had been closed and all patients discharged. Mental health care is organized through the Department of Mental Health, which is the umbrella organization responsible for specialist mental health care in the community; this includes psychiatric wards located in general hospitals, residential facilities, mental health centres, and day-hospital and day-care units. Approval of Law 180 led to a practical and ideological shift in the provision of care to patients with mental disorders. In particular, the reform highlighted the need to treat patients in the same way as any other patient, and mental health care moved from a custodialistic to a therapeutic model. Progressive consolidation of the community-based system of mental health care in Italy has been observed in the past 40 years. However, some reasons for concern still exist, including low staffing levels, potential use of community residential facilities as long-stay residential services, and a heterogeneity in the availability of resources for mental health throughout the country.

Regionalised Tertiary Psychiatric Residential Facilities

2008 ◽  
Vol 17 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Alain Lesage ◽  
David Groden ◽  
Elliot M. Goldner ◽  
Daniel Gelinas ◽  
Leslie M. Arnold
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Psychiatric Hospitals ◽  
Residential Facilities ◽  
Full Time ◽  
Community Based ◽  
Staffing Levels ◽  
Care Facilities

SummaryAims– Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely – with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call.Methods– This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing.Results– In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments withhostel wardssince the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia,Community Care Units(CCUs) have been applying this concept. In the Canadian province of British Columbia (BC),Tertiary Psychiatric Residential Facilities (TPRFs)have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital.Conclusions– This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary Psychiatric Care Facilities have the potential to act as hubs of expertise not only for treatment, rehabilitation, community integration and ser-vice co-ordination for the severely mentally ill, but also for research and training.Declaration of Interest: None.

scholarly journals Improving access to integrated mental health services in community-based settings in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Cardoso
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
General Hospital ◽  
General Health ◽  
Psychiatric Hospitals ◽  
Health Departments ◽  
Community Based ◽  
Number Of Patients

Abstract Background Scientific evidence has proven greater effectiveness of community-based mental health care offering a diversity of services. Among the main barriers to mental health treatment are difficulties in the access and poor integration with general health services. Description of the problem The current Portuguese National Mental Health Plan promoted the transition from psychiatric hospital-based care to care provided by a network of services in the community with the inpatient unit in the local general hospital. In this presentation we will describe the main aspects of the mental health reform and some figures illustrating the functioning of one of the new mental health departments. Results Since 2006 three large psychiatric hospitals were closed and mental health departments are now in place according to the new model. One example, the HFF department of psychiatry, has developed an innovative comprehensive and integrated model based in the general hospital and the community, ensuring a close coordination with primary care teams and all other relevant stakeholders in the community, offering diverse answers to patients’ needs, and preventing drop-outs. Between 2000 and 2011, the number of admissions went from 486 to 451, first admissions from 40% to 36%, and the average number of patients treated in day hospital from 12 to 24. Liaison psychiatry consultations (2713 to 3684), community teams’ visits (10,201 to 14,756), and home visits (236 to 980) have increased significantly, while rehabilitation programs were developed in two day centers in the community. Conclusions The Portuguese model of mental health care, based on the principles of accessibility and equity, community involvement, recovery and human rights, and continuity of care, has promoted greater accessibility, higher quality of care, and less stigma. An important integration of mental health and general health services has taken place allowing for a close collaboration between services.

scholarly journals Decriminalization in action: lessons from the Los Angeles model

CNS Spectrums ◽  
2019 ◽  
Vol 25 (5) ◽  
pp. 561-565 ◽  
Author(s):  
Kristen Ochoa ◽  
Oona Appel ◽  
Viet Nguyen ◽  
Elizabeth Kim
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Los Angeles ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Diversion Programs ◽  
Community Based ◽  
Fundamental Goal

Los Angeles County’s Office of Diversion and Reentry (ODR) has removed over 3800 people from the largest jail system in the country. Across various diversion programs, ODR’s fundamental goal is to provide permanent, lifetime care for each diverted person. This article describes ODR’s various diversion programs, and elucidates the types of elaborate clinical and court-related interventions that are necessary to remove persons with serious mental disorders from jail custody. As Los Angeles continues to build the necessary community-based continuum of mental health care, ODR’s model proves that thoughtfully removing persons with serious mental disorders from jail is possible and necessary for the health of both patients and community.

scholarly journals Qatar Community Mental Health Care: Achievements and Challenges

10.17816/cp78 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 76-80
Author(s):  
Mohamed Ali Ahmed ◽  
Suhaila Ali Ghuloum
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Best Practice ◽  
Community Mental Health Services ◽  
Historical Background ◽  
Community Based

Guided by international best practice and evidence-based medicine, the Qatar mental health service has undergone a major transformation in the last two decades, replacing the institution-based service with an accessible multidisciplinary community-based service. In this paper, we provide a brief historical background to mental health services in Qatar, and the progress and development towards community-based mental health-care provision. We also explore the challenges facing this new model of care in Qatar including social and cultural sensitivities, and the various solutions adopted to overcome these challenges. We outline the comprehensive plans envisaged to further develop Qatar community mental health services, including the provision of accessible, integrated and multimodal mental health care within primary care settings.

scholarly journals Utilization of Inpatient Mental Health Care in the Rhineland During the COVID-19 Pandemic

2021 ◽  
Vol 9 ◽  
Author(s):  
Jürgen Zielasek ◽  
Jürgen Vrinssen ◽  
Euphrosyne Gouzoulis-Mayfrank
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Health Care Utilization ◽  
Mental Health Care ◽  
Hospital Admissions ◽  
Psychiatric Hospitals ◽  
Care Utilization ◽  
Inpatient Mental Health ◽  
Mental Health Care Utilization

Background: During the Coronavirus-19 (COVID-19) pandemic, considerable changes occurred in the utilization of mental health care.Objectives: We conducted an analysis of the changes of inpatient and day patient mental health care utilization in an association of psychiatric hospitals during the COVID-19 pandemic.Materials and Methods: We used the statistics database of the association of nine psychiatric hospitals of the Rhineland Regional Council (Landschaftsverband Rheinland, LVR). We compared the case numbers of spring 2019 and spring 2020 and analyzed alterations in the diagnostic spectrum. Finally, we analyzed the age, gender, and diagnoses of patients tested positive for COVID-19.Results: A total of 25,612 inpatient psychiatric hospital admissions were assessed. Case rates decreased by 25% during the COVID-19 pandemic. Changes varied between diagnostic groups, and there were even increases in case numbers for certain diagnoses. Women and patients of higher ages were overrepresented among psychiatric inpatients with COVID-19.Conclusions: The COVID-19 pandemic resulted in considerable reductions in the total number of mental health-care admissions and in changes in the diagnostic spectrum. The results may be explainable by deferrals of elective hospital admissions during the acute phase of the pandemic and by destabilizing effects of the pandemic and social distancing on people with mental disorders.

scholarly journals Community Mental Health Care in Serbia: Development and Perspectives

10.17816/cp77 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 81-85
Author(s):  
Dusica Lecic-Tosevski ◽  
Maja Milosavljevic
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Health Centre ◽  
Psychiatric Hospitals ◽  
Primary Health Care System ◽  
Community Mental Health Care

Community mental health care was developed in Serbia in 1982 at the Belgrade Institute of mental health. Treatment was provided through the primary health care system, with each health centre having its own mental health care team. However, in the process of psychiatric reform and deinstitutionalization, dedicated community centres had to be established, in accordance with the National Strategy for the Development of Mental Health Care. The first community-based mental health centre opened in the southern area of Serbia in 2005 and subsequently, other centres were established. The centres are organized independently of psychiatric hospitals and are located in local, self-government units, providing psychosocial treatment and the continuation of mental health care. In relation to the ongoing reform of psychiatry in the country, there are positive and negative issues. There are 41.41 beds per 100,000 of the population in psychiatric hospitals and 18.33 beds per 100,000 of the population in the psychiatric departments of general hospitals. Day hospitals, established throughout the country, provide patients with good quality care. Mental health care professionals are educated to a high standard and integrative, person-centred treatment is applied in most services. However, the level of stigma directed towards those with mental illness is still high and constitutes a barrier to treatment. Well-developed screening and early detection programmes to identify persons requiring mental health care are lacking, as are the records of patients with mental disorders. The future goal is to further reduce the number of beds in psychiatric hospitals, establish new community mental health care services throughout the country and ensure the prevention of mental disorders, as well as mental health promotion.

Religious advisors’ role in mental health care in the European Study of the Epidemiology of Mental Disorders survey

2009 ◽  
Vol 45 (10) ◽  
pp. 989-998 ◽  
Author(s):  
Viviane Kovess-Masfety ◽  
◽  
Anne Dezetter ◽  
Ron de Graaf ◽  
Joseph Maria Haro ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
European Study

The importance of peer support in the recovery process of persons with mental disorders

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Stimac Grbic ◽  
I Pavic Simetin ◽  
A Istvanovic
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Peer Support ◽  
Community Intervention ◽  
Recovery Process ◽  
Therapeutic Interventions ◽  
Hospital Treatment ◽  
Personal Recovery

Abstract Issue Care for people with severe mental disorders requires approach that is focused on a person's strengths, not his weaknesses, and is a shift from a deficit model that is often associated with mental illness. Care users and their family members play an important role in this approach. Description of the Problem Mental disorders are the leading group of diseases in Croatia, according to the number of days of hospital treatment. The number of hospitalizations is high, and the rate of hospitalization for depression has tripled in the last twenty years. Such indicators highlight the need for reorientation of mental health care, from hospital-based to community-based, by organizing mobile community intervention teams. Results In Croatia, psychosocial peer teams were established by the NGO Ludruga, financed by local government, to provide peer support to persons with mental disorders. The main activities are: development of a personal recovery plan, home visits and providing psychological support to persons with mental disorders, organizing support groups and education of peer workers. The teams consist of a peer worker, social worker, psychologist, and operate under the supervision of a psychiatrist. The teams have been operating for five years, have had over a hundred users so far and are a significant help to the healthcare system in preventing rehospitalizations. Lessons The goal of therapeutic interventions in mental health care should be recovery. Recovery involves empowering a person to take responsibility for themselves and their health. Peer workers play an important role in the recovery process, providing hope for recovery. Their role must also be recognized by the health system. Key messages People with mental disorders and their families should be co-creators of care and recovery-oriented interventions. Only by comprehensive interventions, tackling all determinants of health, therapeutic goal can be achieved.

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