Mental Health Care Reforms in Europe: Rehabilitation and Social Inclusion of People With Mental Illness in Russia

Jenkins, Rachel; McDaid, David; Nikiforov, Alexey; Potasheva, Angelina; Watkins, Jonathan; Lancashire, Stuart; Samyshkin, Yevgeniy; Huxley, Peter; Atun, Rifat

doi:10.1176/ps.2010.61.3.222

Cited by 8 publications

(6 citation statements)

References 5 publications

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“…If there has been any reduction in bed capacities, it might have been less motivated by initiatives to establish decentralized community based care but rather by a lack of funding [42]. The need for social and occupational rehabilitation after the political change still receives little consideration [43].…”

Section: Discussionmentioning

confidence: 99%

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

et al. 2012

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BackgroundGeneral psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context.Methodology/Principal FindingsGeneral psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989–1999, 1999–2009 and the whole period of 1989–2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from −11% in Croatia to −51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989–2009, trends in the prison population ranged from a decrease of −58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations.Conclusions/SignificanceAfter the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as a general rule for most of the countries.

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Section: Discussionmentioning

confidence: 99%

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

et al. 2012

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“…The principal exception to this was Moldova which did not experience any meaningful economic recovery during the study period (Abbott et al, 2010) and, interestingly, also did not show a significant decrease in levels of high psychological distress. It should also be recognised that major risk factors for poor mental health remain, with high levels of poverty, widening socio-economic inequalities, and limited health care coverage -particularly for mental health services (Jenkins et al, 2010;McDaid et al, 2006;Balabanova et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Despite uncertainty over the direction of causality, the findings do indicate the need to break the cycle of poverty, social exclusion and poor mental health in the region. This requires reductions in levels of poverty and social marginalisation at the population level, but also the scaling up of community-level interventions to increase the care and social and economic opportunities for people living with mental disorders (Lund et al, 2011;Jenkins et al, 2005Jenkins et al, , 2010McDaid et al, 2006;UNDP, 2011).…”

Section: Discussionmentioning

confidence: 99%

Changes in the levels of psychological distress in eight countries of the former Soviet Union

Roberts

Abbott

2012

Journal of Public Mental Health

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Purpose -The purpose of this paper is to compare levels of psychological distress in 2001 and 2010 in eight countries of the former Soviet Union and to explore how these changes vary for different population groups.Design/methodology/approach -Data were collected using two related studies from 2001 (n ¼ 14,242) and 2010 (n ¼ 15,081). Both studies consisted of nationally representative cross-sectional household surveys in Armenia,

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“…However, mental health services and systems remain limited, and greater attention is also required on risk-factors for poor mental health such as social exclusion and widening socioeconomic inequalities (Bobak, et al, 2006;Brainerd, 2001;Jenkins, et al, 2005;Jenkins, et al, 2010;McDaid, et al, 2006;Roberts, et al, 2012;Tomov, et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Psychological Distress and Problem Drinking

2015

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We examine the influence of harmful alcohol use on mental health using a flexible two-step instrumental variables approach and household survey data from nine countries of the former Soviet Union. Using alcohol advertisements to instrument for alcohol, we show that problem drinking has a large detrimental effect on psychological distress, with problem drinkers exhibiting a 42% increase in the number of mental health problems reported and a 15% higher chance of reporting very poor mental health. Ignoring endogeneity leads to an underestimation of the damaging effect of excessive drinking. Findings suggest that more effective alcohol polices and treatment services in the former Soviet Union may have added benefits in terms of reducing poor mental health.

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Mental Health Care Reforms in Europe: Rehabilitation and Social Inclusion of People With Mental Illness in Russia

Cited by 8 publications

References 5 publications

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

Changes in the levels of psychological distress in eight countries of the former Soviet Union

Psychological Distress and Problem Drinking

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