Heterogeneity of the Departments of Mental Health in the Veneto Region ten years after the National Plan 1994-96 for Mental Health. Which implication for clinical practice? Findings from the PICOS Project

Abstract

SUMMARYAims - This study aims to present data on structural and human resources of public mental health services located in the Veneto Region, Italy, and to discuss them in the light of implementation of the first National Target Plan for Mental Health (“Progetto Obiettivo 1994-1996”) ten years after its launch. Methods - The study was conducted in the context of the PICOS (Psychosis Incident Cohort Outcome Study) Project, a large first-presentation multisite study on patients with psychotic disorders attending community mental heath services in the Veneto Region. Human and structural resources were surveyed in 26 study sites using a structured interview administered by the PICOS local referents. Results - CMHCs and Day Centres were homogeneously distributed across the Region and their overall rates per resident population met the national standards; a wide variability in the distribution of Day Hospitals was found, with the overall rate per resident population very far from meeting the national standard; the overall rate for Residential Facilities beds was higher than the recommended national standard, showing however an high variability across sites. The overall rate of mental health professionals per resident population was only slightly below the national standard: this was mainly achieved thanks to non-profit organizations which supplement the public system with unspecialised professionals; however, a wide variability in the local rates per resident population was found, with the 50% of the sites showing rates far lower the national standard. Specific lack of trained professionals involved in the provision of psychosocial interventions was found in most sites. Conclusions - A marked variability in human and structural resources across community mental health services in the Veneto Region was found. Possible reasons for this heterogeneity were analysed and implications for mental health care provision were further discussed.Declaration of Interest: The study has been supported by the Regione del Veneto, Giunta Regionale, Ricerca Sanitaria Finalizzata 2004, Venezia, Italia (grant to Professor M. Ruggeri).

Influence of perceived organisational factors on job burnout: survey of community mental health staff

“…The burnout prevalence among Italian mental health staff is a cause for concern, as this condition can further deplete public mental health services' already scarce human resources. 29 The proportion of Italian mental health staff scoring above the MBI cut-off was similar to that found by Prosser et al 8 in London (24%), but somewhat lower than reported by other studies conducted in the UK. 36,11 Our results also confirmed the second hypothesis, since burnout has a different impact on the various professional categories, with severe burnout shown to be more frequent among social workers and psychiatrists.…”

“…All mental health staff employed in the PICOS catchment areas (approximately 3.7 million inhabitants) were eligible for the survey, which examined a wide range of job categories, such as psychiatrists, clinical psychologists, resident psychiatrists, hospital and community psychiatric nurses, occupational therapists, social workers, healthcare support workers, and secretarial staff. 29 The data were collected from January to March 2005. Twenty-two of the 28 collaborating PICOS sites (78.5%) agreed to participate and provided a list of their mental health staff.…”

Organizational Wellbeing among Workers in Mental Health Services: A Pilot Study

“…Many studies [ 1 - 5 , 7 , 11 - 15 , 18 , 19 ] suggest the importance of job satisfation and work engagement among the workers to prevent burnout and job-related distress and to promote organizational wellbeing. Considerating the findings of the present study, we suppose that high level of perceived job satisfation could be related to the “community centred model” in mental health care services.…”

“…The centrality of users and the humanization of care involve many abilieties of the workers, such as listening, continuity in caring, timeliness, good skills in communication, problem solving and crisis management. Furthermore, in Italy as well as in other European countries with a National Public Health System, mental health services are facing severe financial shortages and consequent shortfalls in the number of sector-employed professionals [ 8 - 11 ]. Even more, the quality of the performances depends also on the professional and personal qualities of workers, who often offset structural deficiencies and procedural difficulties with their efforts and highly skilled job.…”

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

“…Family interventions generally consist of non-specific informal support/educational sessions. Specialized individual psychotherapeutic interventions (including CBT) for patients and specialized psychoeducational or cognitive-oriented family interventions are usually not provided because of the lack of trained professionals [26,27]. …”