Psych

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5 pages, 197 KiB

Open AccessEditorial

Mobile Mental Health Units in Greece: Bridging Clinical Practice and Research in the Rural Context

by Vaios Peritogiannis and Maria Samakouri

Psych 2023, 5(3), 787-791; https://doi.org/10.3390/psych5030051 - 24 Jul 2023

Viewed by 911

Abstract

The present Special Issue of Psych, which has been now fully released, aimed to highlight the importance of the Mobile Mental Health Units (MMHUs) in delivering services in rural and remote areas in Greece, and to stress their role as an easily accessible [...] Read more.

The present Special Issue of Psych, which has been now fully released, aimed to highlight the importance of the Mobile Mental Health Units (MMHUs) in delivering services in rural and remote areas in Greece, and to stress their role as an easily accessible setting that provides a wide range of community-based psychosocial interventions, well beyond usual psychiatric care [...] Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

4 pages, 207 KiB

Open AccessEditorial

Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units

by Vaios Peritogiannis, Ioanna V. Papathanasiou and Orestis Giotakos

Psych 2022, 4(2), 277-280; https://doi.org/10.3390/psych4020024 - 16 May 2022

Cited by 4 | Viewed by 1943

Abstract

Almost a decade ago, an article published in the official journal of the Hellenic Psychiatric Association, concerning the state of Greek mental health reform, referred to the significant shortages of mental health staff and services in rural areas of the country [...] Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

5 pages, 492 KiB

Open AccessEditorial

Τhe Contribution of Mobile Mental Health Units to Community Psychiatric Care in Greece

by Maria Samakouri, Olympia Evagorou and Athena Frangouli-Sakellaropoulou

Psych 2022, 4(1), 100-104; https://doi.org/10.3390/psych4010009 - 12 Feb 2022

Cited by 6 | Viewed by 2575

Abstract

The implementation of Mobile Mental Health Units (MMHUs) was a decisive step in the psychiatric reform and the development of community psychiatric care in Greece [...] Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

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Research

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12 pages, 753 KiB

Open AccessArticle

Mobile Mental Health Units in Heraklion Crete 2013–2022: Progress, Difficulties and Future Challenges

by Anna Paschalidou, Maria Anastasaki, Avgi Zografaki, Christina Kalliopi Krasanaki, Maria Daskalaki, Vasilis Chatziorfanos, Anna Giakovidou, Maria Basta and Alexandros N. Vgontzas

Psych 2023, 5(1), 26-37; https://doi.org/10.3390/psych5010003 - 30 Dec 2022

Cited by 1 | Viewed by 1618

Abstract

Mobile mental health units (MMHUs) have been proposed as an effective model to serve the mental health needs of remote underserved areas. In 2013, the Department of Psychiatry, University of Crete, started a pilot MMHU to cover the needs of remote rural areas [...] Read more.

Mobile mental health units (MMHUs) have been proposed as an effective model to serve the mental health needs of remote underserved areas. In 2013, the Department of Psychiatry, University of Crete, started a pilot MMHU to cover the needs of remote rural areas of the Heraklion Prefecture. The main objectives were early detection, prevention and therapy of patients with severe psychiatric disorders, without access to regular psychiatric care. In addition to regular visits to primary care health centers, a community support network was established. During this 10-year period, the MMHU has evaluated 3343 patients and performed 19,935 visits. The most frequent diagnoses are depression and anxiety (52.7%) whereas psychosis and bipolar disorders are the third (12.7%) and fifth most frequent diagnoses (4.7%). Half of the patients with depression/anxiety were older than 65 years and one third were living alone. Furthermore, the first visit with the MMHU of severely mentally ill was about 15 years later from the self-reported onset of psychotic symptoms. We discuss how to improve our ability to detect and intervene earlier in patients with severe mental illness, and how to address effectively, both pharmacologically and psychosocially, the depression and loneliness of older individuals living in small remote communities. Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

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11 pages, 469 KiB

Open AccessArticle

The Interventions of a Mobile Mental Health Unit on the Refugee Crisis on a Greek Island

by Iliana Fylla, Eleonora Fousfouka, Maria Kostoula and Pinelopi Spentzouri

Psych 2022, 4(1), 49-59; https://doi.org/10.3390/psych4010004 - 3 Jan 2022

Cited by 5 | Viewed by 3709

Abstract

This present study concerns refugees and asylum seekers who have been referred to a Mobile Mental Health Unit (MMHU-Ch) in rural Greece on a Northeast Aegean Island during the refugee crisis in 2015. Our objective is the examination and recording of psychopathology characteristics’, [...] Read more.

This present study concerns refugees and asylum seekers who have been referred to a Mobile Mental Health Unit (MMHU-Ch) in rural Greece on a Northeast Aegean Island during the refugee crisis in 2015. Our objective is the examination and recording of psychopathology characteristics’, the presentation of the therapeutic interventions provided, and the difficulties. The sample is composed of 418 requests made by refugees, asylum seekers, adults, and children. The clinical and demographic data have been gathered from the MMHU-Ch’s charts. The study is retrospective, descriptive with quantitative and categorical variables. The data has been analyzed with the utilization of SPSS. The dominant diagnosis in children involves anxiety disorders, developmental disorders, and PTSD. One noteworthy finding is the high percentage of suicide behavior regardless of psychiatric diagnosis, which should be further examined. As far as interventions are concerned, the conclusions which have arisen are the gradually stronger commitment of the referents, but also the high percentage of requests that dropped out. Further examination of the interventions and their efficiency is recommended as well as probing the features of psychopathology in the long term with a view to clarifying the patronizing and aggravating factors. Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

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9 pages, 255 KiB

Open AccessArticle

Dietary Habits and Obesity in Patients with Psychotic Disorders in Rural Areas in Northwestern Greece

by Maria Bakola, Thiresia Manthopoulou, Konstantinos Bonotis and Vaios Peritogiannis

Psych 2022, 4(1), 1-9; https://doi.org/10.3390/psych4010001 - 29 Dec 2021

Cited by 3 | Viewed by 2518

Abstract

People suffering from psychotic disorders display high rates of physical morbidity and mortality in comparison to the general population. The present study explores the relation between the dietary habits, the prevalence of obesity and the occurrence of physical morbidity in patients who suffer [...] Read more.

People suffering from psychotic disorders display high rates of physical morbidity and mortality in comparison to the general population. The present study explores the relation between the dietary habits, the prevalence of obesity and the occurrence of physical morbidity in patients who suffer from psychotic disorders in rural regions of northwest Greece. Two scales were applied to evaluate the quality of life (Quality of Life Questionnaire II, Moorehead–Ardelt) and the dietary habits (Dietary Instrument for Nutrition Education (DINE) Questionnaire) of these patients. The study sample used in this study consisted of 55 patients who suffered from a psychotic disorder. Most (75%) were male, with a mean age of 51.5 years and an average duration of disease of 25.1 years. Of these, 38.2% (21 patients) were obese with a BMI < 30 Kg/m², 32.7% (16 patients) were overweight and 29.1% had a normal body weight. The majority of the sample, 80%, was treated with second-generation medications. With regards to their dietary habits, 94.5% (52/55) of the sample showed a low intake of fiber content, 67.3% (37/55) showed a high intake of saturated fats and 100% (55/55) a low intake of unsaturated fats. The rates of physical morbidity in the present sample were 21.8% with at least one disease and 14.5% with two diseases, whereas 5.5% met the criteria for metabolic syndrome (MS). The average BMI of the women was statistically significantly higher compared to the men. The majority of the sample (69.1%) exhibited acceptable levels of quality of life. No co-relations of quality of life with BMI were found. In addition, no co-relations of BMI with dietary habits were revealed. Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

15 pages, 261 KiB

Open AccessArticle

Albanian Migrants in Cyclades: Contact with Mental Health Services and Implications for Practice

by Stella Pantelidou, Sofia Manolesou, Antigoni Apostolopoulou, Katerina Giannakopoulou and Stelios Stylianidis

Psych 2021, 3(4), 916-930; https://doi.org/10.3390/psych3040057 - 17 Dec 2021

Cited by 2 | Viewed by 2905

Abstract

The purpose of this study was to examine the potential differences between Albanian migrants and Greeks in the islands of Paros and Antiparos with regard to seeking help from the local public mental health service, namely the Mobile Mental Health Unit of NE [...] Read more.

The purpose of this study was to examine the potential differences between Albanian migrants and Greeks in the islands of Paros and Antiparos with regard to seeking help from the local public mental health service, namely the Mobile Mental Health Unit of NE Cyclades Islands (EPAPSY-NGO). The study’s instruments include the Global Assessment of Functioning (GAF) and a questionnaire for recording psychosocial profile data and information concerning contact with the services. The results showed that significantly less Albanian migrants contacted the mental health services in the past in comparison to Greeks. When using the service, the Albanians were more likely to see a psychiatrist in the Unit, rather than a psychologist-psychotherapist, and they more often received prescriptions for medication. There was a significantly higher dropout rate among Albanian migrants. This study highlights the different aspects of access and use of mental health services among Albanian migrants compared with native residents. Further research should focus on the factors related to early dropouts and difficulties accessing mental health services in rural areas, in order to develop more focused and effective interventions and improve the quality of care provided. Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

12 pages, 237 KiB

Open AccessArticle

Decrease of Hospitalizations and Length of Hospital Stay in Patients with Schizophrenia Spectrum Disorders or Bipolar Disorder Treated in a Mobile Mental Health Service in Insular Greece

by Aikaterini Garbi, Ioannis Tiniakos, Zacharenia Mikelatou and Ioannis Drakatos

Psych 2021, 3(4), 780-791; https://doi.org/10.3390/psych3040049 - 4 Dec 2021

Cited by 8 | Viewed by 3046

Abstract

In recent years serious mental health issues, such as schizophrenia spectrum disorders and bipolar disorder, have been treated in the community by community-based mental health services. In the present study our goal was to estimate the modification in the number of hospitalizations and [...] Read more.

In recent years serious mental health issues, such as schizophrenia spectrum disorders and bipolar disorder, have been treated in the community by community-based mental health services. In the present study our goal was to estimate the modification in the number of hospitalizations and duration of admissions in either psychotic patients or patients with bipolar disorder, treated by a Mobile Mental Health Unit in the islands of Kefalonia, Zakynthos and Ithaca (MMHU-KZI). Data were collected from a total of 108 patients with schizophrenia spectrum disorders and bipolar disorder. For each patient comparison was made for the same time interval prior and after engagement to treatment with the MMHU-KZI and not for the total hospitalizations that patients had in their history. There was a statistically significant reduction (45.9%) in hospitalizations after treatment engagement with the MMHU-KZI, as the Wilcoxon signed ranks test indicated. Furthermore, a major decrease (54.5%) of hospitalization days was noted after treatment engagement with the unit. This pattern of mental health provision may be beneficial for the reduction of the number and duration of psychiatric hospitalizations. Despite the beneficial contribution of community-based mental health units, hospital based treatment should always be available, since severe relapses are better treated in inpatient setting. Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

Other

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11 pages, 578 KiB

Open AccessPerspective

The Contribution of Society of Social Psychiatry P. Sakellaropoulos to the Psychiatric Reform in Rural Greece

by Harilaos Papachristou, Iliana Lazogiorgou-Kousta, Vasilis Chronopoulos and Athena Fragouli-Sakellaropoulou

Psych 2023, 5(2), 497-507; https://doi.org/10.3390/psych5020033 - 6 Jun 2023

Cited by 1 | Viewed by 804

Abstract

The present paper aims to describe the structure, function, and goals of two of the oldest Mobile Mental Health Units in Greece, namely, the Mobile Mental Health Unit in Fokida (MMHU-F) and the Mobile Mental Health Unit in Thrace (Alexandroupolis, MMHU-T). Information about [...] Read more.

The present paper aims to describe the structure, function, and goals of two of the oldest Mobile Mental Health Units in Greece, namely, the Mobile Mental Health Unit in Fokida (MMHU-F) and the Mobile Mental Health Unit in Thrace (Alexandroupolis, MMHU-T). Information about their historical background, catchment areas, and current staffing, as well as the services provided by each MMHU is discussed. The focus of the paper is slightly biased towards the MMHU-F because it is the only available mental health service in the whole Fokida prefecture. The major goals of the MMHUs are the diagnosis, treatment, and prevention of relapse of severe mental illness within the community. Other important goals of the MMHUs are psychoeducation, psychological support for the family/caregivers, as well as vocational training and support for patients with severe mental illness. Statistical data depicting the demographic characteristics and diagnostic profiles of patients in each MMHU is also provided, and the differences between the two MMHUs are briefly discussed. Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

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8 pages, 227 KiB

Open AccessPerspective

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

by Vaios Peritogiannis and Fotini Tsoli

Psych 2021, 3(4), 792-799; https://doi.org/10.3390/psych3040050 - 5 Dec 2021

Cited by 5 | Viewed by 2446

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Community Psychiatry in Rural Greece: The Role of the Mobile Mental Health Units)

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