Old age mental health services in Southern Balkans: Features, geospatial distribution, current needs, and future perspectives

Abstract

Background Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia. Methods After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored. Results A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries. Conclusions Regional disparities in resources and services for seniors’ mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.

North Macedonia interprofessional dementia care (NOMAD) – personalized care plans for people with dementia and caregiver psychoeducation delivered at home by interprofessional teams

“…The services are fragmented, and there is a lack of support system for families affected by dementia. These are challenging times for the healthcare system and social services regarding dementia management and there are gross differences among the care structure, types, and costs of dementia care for people with dementia across Europe and worldwide, but unlike many countries in South and Southeastern European, most of the countries from Northern Europe have formal care services (Alexopoulos et al, 2020). These disparities are expected to further deepen with the novel disease-modifying treatments and the inequalities among different countries regarding health outcomes, care, and quality of life of people with dementia will become more obvious, creating an even bigger gap than the one already existing (Jönsson et al, 2022(Jönsson et al, , 2023.…”