Forging partnerships for mental health: The case of a prefecture in crisis ravaged Greece

Ntani

Giovazolias

et al. 2020

Int J Ment Health Syst

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Background: The mental healthcare treatment gap (mhcGAP) in adult populations has been substantiated across Europe. This study formed part of MentALLY, a research project funded by the European Commission, which aimed to gather qualitative empirical evidence to support the provision of European mental healthcare that provides effective treatment to all adults who need it. Methods: Seven focus groups were conducted with 49 health professionals (HPs), including psychologists, psychiatrists, social workers, general practitioners, and psychiatric nurses who worked in health services in Belgium, Cyprus, Greece, the Netherlands, Norway and Sweden. The focus group discussions centered on the barriers and facilitators to providing quality care to people with mild, medium, and severe mental health problems. Analyses included deductively and inductively driven coding procedures. Crosscountry consensus was obtained by summarizing findings in the form of a fact sheet which was shared for triangulation by all the MentALLY partners. Results: The results converged into two overarching themes: (1) Minding the treatment gap: the availability and accessibility of Mental Health Services (MHS). The mhcGAP gap identified is composed of different elements that constitute the barriers to care, including bridging divides in care provision, obstacles in facilitating access via referrals and creating a collaborative 'chain of care'. (2) Making therapeutic practice relevant by providing a broad-spectrum of integrated and comprehensive services that value person-centered care comprised of authenticity, flexibility and congruence. Conclusions: The mhcGAP is comprised of the following barriers: a lack of funding, insufficient capacity of human resources, inaccessibility to comprehensive services and a lack of availability of relevant treatments. The facilitators to the provision of MHC include using collaborative models of primary, secondary and prevention-oriented mental healthcare. Teamwork in providing care was considered to be a more effective and efficient use of resources. HPs believe that the use of e-mental health and emerging digital technologies can enhance care provision. Facilitating access to a relevant continuum of community-based care that is responsive coordinated and in line with people's needs throughout their lives is an essential aspect of optimal care provision.

Section: Discussionmentioning

confidence: 99%

Healthcare professionals’ perspectives on mental health service provision: a pilot focus group study in six European countries

Ntani

Giovazolias

et al. 2020

Int J Ment Health Syst

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“…It appears that the fiscal crisis and its effect on the social and economic life has impacted the "health chart" of the country. The crises have invaded people's lives like a violent storm and mental health experts feel that nobody was prepared to face its consequences (Triliva et al, 2013). More specifically, mental health experts appear to have experienced the crisis in the same way that the people that turn to them for help (Triliva and Georga, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…These consequences have taken a toll mainly on the vulnerable part of the population (the elderly, children, teenagers, immigrants, the unemployed, low-income employees as well as people with physical and mental health issues and disabilities). These conditions have brought on political, social and economic decline and ethical and psychological discomfort (Triliva et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Adolescents appear to be experiencing feelings of ideological and cultural confusion that herald impasses in shaping and fulfilling their identity, which, in turn, can be further complicated by the constant changes, turmoil and financial difficulties (Triliva et al, 2015). Given these circumstances, mental health professionals working in public mental health centres (MHCs) have been inundated with work and have also tried to find new ways of intervening (Triliva et al, 2013). Moreover, psychotherapeutic work has been affected in that psychologists and psychiatrists have found themselves identifying with people who seek services and have personally been influenced by austerity programmes (Triliva and Georga, 2014).…”

Section: Introductionmentioning

confidence: 99%

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The “constant tug-of-war” in mental health care in Greece

Kyriakidou

2018

MHRJ

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Purpose The purpose of this paper is to focus on how mental health professionals involved in the therapeutic treatment of children in public mental health facilities in Greece experience and talk about the impact of the socioeconomic crises on the psychotherapeutic process. Design/methodology/approach In all, 21 semi-structured interviews were conducted and phenomenologically informed thematic analysis was used in analysing the data. Findings The results coalesced into two all-encompassing thematic structures articulating the following: first, the socioeconomic crises have permeated society and therapeutic praxis like a torrential and chronic rain storm. This has resulted in a deluge in demand for therapeutic services within the public mental health sector; second, mental health professionals describe their positioning and work as “a constant tug-of-war” where they are inundated and often overwhelmed with work, find themselves identifying with service users and taking on several roles simultaneously, and being challenged to find solutions often in dire and complex situations. They describe how creativity and flexibility are in demand in their day-to-day interactions and if they are to intervene in place of a health and welfare system that is faltering. Doing therapeutic work under such circumstances appears to be both emotionally onerous and stimulating with regard to conceptualising new ways of intervening in such complex psychosocial situations. Research limitations/implications The study is limited in that only mental health professionals presented their experiences and service users were not included. The findings do highlight how severe austerity policies impact mental health services and peoples’ lives. Practical implications The study has implications for policy regarding the provision and organisation of mental health services in contexts where crises and economic turmoil prevail. Social implications The results associate severe austerity with major changes in family and community life. Originality/value The paper provides insights and implications on how mental health services are impacted by socioeconomic conditions.

“…Various forms of community-based mental health services have been developed including supported living facilities, community mental health centers and employment opportunities (Christodoulou et al, 2012 ). Nevertheless, health services in the country were profoundly impacted by the socioeconomic crisis of 2008–2018 by budget cuts and reductions to access (Triliva et al, 2013 ) and increases in referrals and demand for services (Kyriakidou & Triliva, 2018 ). A comprehensive framework for mental healthcare provision has not been established in Greece, and this is not an exception concerning mental health stigma and its effects.…”

Section: Introductionmentioning

confidence: 99%

Mental Health Professionals’ Attitudes Towards People with Severe Mental Illness: Are they Related to Professional Quality of Life?

Koutra

Mavroeides

Community Ment Health J

2021

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The present study examines whether attitudes of mental health professionals (MHPs) towards severe mental illness are associated with professional quality of life. The Attitudes towards Severe Mental Illness (ASMI), the Maslach Burnout Inventory (MBI), and the Professional Quality of Life Scale-5 (ProQOL-5) were completed by 287 MHPs in Greece (25.4% males, 74.6% females). The results indicate that MHPs hold predominantly positive attitudes towards people with severe mental illness. Nonetheless, MHPs' attitudes are deemed to be stereotypical according to ASMI concerning treatment duration, prospects of recovery, and whether patients are similar to other people. Higher scores in emotional exhaustion, depersonalization, compassion fatigue and ProQOL-5 burn out dimension were significantly associated with MHPs' unfavorable attitudes, whereas higher scores in compassion satisfaction and personal accomplishment were associated with MHPs' positive attitudes. Assessing compassion fatigue, compassion satisfaction and burnout levels could help identify the processes involved in the development or maintenance of MHPs' stigmatizing attitudes.