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

Peritogiannis, Vaios; Papathanasiou, Ioanna V.; Giotakos, Orestis

doi:10.3390/psych4020024

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…Those community-based services are interdisciplinary teams that deliver services in these areas according to the principles of social and community psychiatry (Peritogiannis, 2019). Although they consider all referrals, they prioritize patients with SMI (Peritogiannis & Mavreas, 2014).…”

Section: Mmhus In Rural Greecementioning

confidence: 99%

Vaccination rates against COVID-19 in patients with severe mental illness attending community mental health services in rural Greece

Peritogiannis¹,

Drakatos²,

Gioti³

et al. 2022

Int J Soc Psychiatry

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Background: Patients with severe mental illness (SMI) may be at increased risk for COVID-19-related severe morbidity and mortality. There is limited research on the vaccination rates against COVID-19 in patients with SMI. Aims: The objective of the present study is to explore vaccination rates and co-relations in patients with SMI, attending community mental health services, namely the Mobile Mental Health Units (MMHUs) in rural Greece. Method: All treatment engaged patients with SMI (schizophrenia-spectrum or bipolar disorder) with two MMHUs (MMHU of Kefalonia, Zakynthos and Ithaca, [MMHU KZI] and MMHU of the prefectures of Ioannina and Thesprotia [MMHU I-T]) in rural Greece were enrolled prospectively over a six-month period. The MMHU I-T had adopted a more proactive approach to patients’ vaccination, by informing patients and caregivers for its benefits. Results: Data were analyzed for 197 patients with SMI. The overall vaccination rate was 68.5% and did not differ from the respective rates in the general population. There were no differences in vaccination rates among patients attending the two MMHUs, nor among patients with different diagnoses (schizophrenia spectrum disorders or bipolar disorder). Vaccination was not associated with gender, educational level, history of alcohol and substance abuse, illness duration, or number of previous hospitalizations, whereas the effect size of age was moderate. In more than half non-vaccinated patients the refusal to get vaccinated was associated with fears and concerns as well as false beliefs that are encountered in the general population. Conclusion: In the present sample of treatment-engaged rural patients vaccination rates against COVID-19 appear to be satisfactory. There were no differences in vaccination rates with regard to the interventions that were applied to enhance vaccination. It seems that other forms of intervention should be applied to reluctant patients to modify their attitudes toward vaccination.

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Section: Mmhus In Rural Greecementioning

confidence: 99%

Vaccination rates against COVID-19 in patients with severe mental illness attending community mental health services in rural Greece

Peritogiannis¹,

Drakatos²,

Gioti³

et al. 2022

Int J Soc Psychiatry

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“…In rural and remote areas in Greece, mental healthcare in the community is primarily provided by locally based Mobile Mental Health Units (MMHUs) [ 33 , 34 ]. These interdisciplinary teams offer a wide range of evidence-based community interventions for patients with mental disorders, with a focus on severely ill patients, including those with a schizophrenia-spectrum disorder [ 35 ].…”

Section: Methodsmentioning

confidence: 99%

Use of Long-Acting Injectable Antipsychotics in a Clinical Sample of Community-Dwelling Patients with Schizophrenia-Spectrum Disorders in Rural Greece

Peritogiannis¹,

Tsoli²,

Gioti³

et al. 2023

JCM

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Data on the use of long-acting injectable antipsychotics (LAIs) in rural community mental healthcare settings are scarce. This study aimed to investigate the prescription patterns of LAIs in a clinical sample of patients with schizophrenia-spectrum disorders in rural Greece. All patients with schizophrenia-spectrum disorders who regularly attend the Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia (MMHU I-T) in northwestern Greece were included in the study. The sample consists of 87 patients (59 males and 28 females) with a mean age of 54.4 years and a mean illness duration of 28 years. Most patients (72.4%) received antipsychotic monotherapy, and nearly 30% received an LAI formulation, mostly a second-generation LAI (20 of 26 patients, 76.9%). The treatment regimen comprised benzodiazepines in one-third of the patients and antidepressants in one-quarter. There was no statistically significant association between treatment regimen and the clinical and demographic variables studied, except for biological sex (female). The percentage of patients treated with LAIs in this study was almost three times higher than the rate previously reported in Greece and is higher than the rates reported in other countries. Patients with schizophrenia-spectrum disorders in rural Greece may have adequate access to innovative treatment with second-generation LAIs. Further research is needed to demonstrate the cost-effectiveness of LAI treatment in rural communities and to elucidate the factors associated with such treatment.

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“…To address these barriers in mental healthcare delivery in rural areas, the Greek state has launched a number of generic community mental health teams over the last decades, the so-called Mobile Mental Health Units (MMHUs) with the aim of delivering services in remote and underserved areas of the mainland and the numerous Greek islands (Peritogiannis, 2019; Peritogiannis, Papathanasiou & Giotakos, 2022; Samakouri et al, 2022). The MMHUs have been successfully integrated within the primary healthcare system and treat all referred patients, although they prioritize patients with severe mental disorders (Peritogiannis, Fragouli-Sakellaropoulou, Stavrogiannopoulos, Filla et al, 2022; Peritogiannis & Mavreas, 2014).…”

Section: Introductionmentioning

confidence: 99%

First-contact patients with a community mental health service in rural Greece: A 3-year prospective study of treatment attendance and its co-relations

Grammeniati,

Mantziou,

Peritogiannis

2024

Int J Soc Psychiatry

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Background: Treatment continuation is essential for the optimal management of patients with mental disorders in the community, but treatment and outcome are often undermined by the high rates of service disengagement and treatment non-adherence across all psychiatric diagnoses. The phenomenon may be even more relevant in rural settings. Aims: The aim of the present study was to explore attendance to treatment in first-contact patients in a community-based treatment setting in rural Greece and to explore the associations of treatment attendance with demographic and clinical factors. Method: Data were collected prospectively over a 3-year period, with 1-year follow-up interval. All first-contact cases with the Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia (MMHU I-T), Northwest Greece were considered, but only clinical cases were processed. Results: The sample size consisted of 446 patients, with a mean age 65.4 ± 18.8 years. The rate of 12-month attendance to mental health treatment was 13.5% (60 out of 446 patients). Treatment attendance was found to be correlated with younger age, the diagnosis of schizophrenia-spectrum disorder, and patients’ referral by other psychiatric services. First examination over the year 2019 had been significantly inversely associated with treatment engagement. Conclusion: Rates of subsequent attendance after initial assessment in a rural community mental healthcare setting were rather low in the present study. Several variables that have been previously associated with service engagement were found to be related in this study too, whereas other were not. Research on treatment engagement in rural treatment settings should be ongoing to reveal all associated factors.

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

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 [...]

Cited by 6 publications

References 32 publications

Vaccination rates against COVID-19 in patients with severe mental illness attending community mental health services in rural Greece

Vaccination rates against COVID-19 in patients with severe mental illness attending community mental health services in rural Greece

Use of Long-Acting Injectable Antipsychotics in a Clinical Sample of Community-Dwelling Patients with Schizophrenia-Spectrum Disorders in Rural Greece

First-contact patients with a community mental health service in rural Greece: A 3-year prospective study of treatment attendance and its co-relations

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