140 research outputs found
Mental health supported accommodation services in England and in Italy: a comparison
No full textPURPOSE: England and Italy are considered pioneers in the development of community mental health services. Both have implemented supported accommodation services for those with more complex needs, which can be broadly categorized into three main types with similar specification. The aim of this study was to compare the characteristics of these services and their users in England and Italy. METHODS: Data from two cross-sectional surveys of supported accommodation services undertaken across England and in Verona, Italy (England-619 service users from 87 services; Verona-167 service users from 25 services) were compared. RESULTS: Service users in the two samples had similar socio-demographic and clinical characteristics; most were male, unmarried and unemployed, with a primary diagnosis of schizophrenia or other psychosis and over 15 years contact with mental health services. Supported accommodation occupancy was high in both samples. The actual length of stay was greater than the expected length of stay for all three service types but overall turnover was similar between countries (p = 0.070). Across services, total needs and quality of life were higher for Italian compared to English service users (p < 0.001 for both) but, unmet needs were lower amongst English service users (p < 0.001). Around 40% in both samples moved to more independent accommodation successfully within 30 months. CONCLUSIONS: England and Italy have similar mental health supported accommodation pathways to assist those with more complex needs to gain skills for community living, but individuals tend to require longer than expected at each stage
P03-77 - Development of a European measure of best practice for people with long term mental illness in institutional care (DEMoBinc)
No full textThis session will describe the aims and progress of the DEMoBinc study and its potential impact across Europe. The project has led to the development of a toolkit (the Quality Indicator for Rehabilitative Care - QuIRC) for assessing the living conditions, care and human rights of people with longer term mental health problems in European psychiatric and social care institutions. The study has been funded for 36 months by the European Commission and started in March 2007. It involves 11 centres across 10 countries: UK; Germany; Spain; Czech Republic; Bulgaria; Italy; Netherlands; Poland; Greece; Portugal.The QuIRC assesses the provision of seven domains of care considered most important for recovery (built environment; therapeutic environment; treatments and interventions; self-management and autonomy; social inclusion; human rights; Recovery-orientated practice). A web-based version is under development that will provide performance reports for local and national care standard review. The QuIRC ratings have been compared against unit costs to give an assessment of the unit's value for money, and against service users’ quality of life, autonomy, experiences of care and markers of recovery to test whether it can deliver a proxy-measure of the unit's promotion of individuals’ human rights and recovery.Chair: Dr Helen KillaspySpeakers:Dr Helen Killaspy & Tatiana Taylor: “An overview of the DEMoBinc project and development of QuIRC”Sarah White: “Results of the QuIRC reliability testing, factor analysis and service user assessment”Dr Patryk Piotrowski: “The Delphi Exercise in Poland”Dr Thomas Kallert: “Development and use of QuIRC in Germany”</jats:p
Supported employment for people with severe mental illness: a pilot study of an Italian social enterprise with a special ingredient
No full textBACKGROUND: People with mental disorders are far more likely to be unemployed than the general population. Two internationally recognized, evidence-based models of interventions for employment for people with severe mental health problems are Individual Placement Support and the Clubhouse. In Italy, a common model is the 'social enterprise' (SE), which is a programme run by non-profit organisations that help individuals with disabilities to be employed. Despite SEs spread and relevance in Italy, there are no studies about Italian samples. This paper reports on a pilot evaluation of psychosocial and work outcomes of a SE based in Verona, Italy. The study aims to investigate if people with SMI involved in SE job placements may achieve personal recovery and better outcomes over time, and in comparison with a comparable group of users. METHODS: This is a pilot descriptive study with three components. A longitudinal design that comprised a functioning description of 33 SE members with a psychiatric disability in two time-points (when they joined the SE-on average 5 years before the study recruitment, and at the study recruitment-year 2018); and a repeated collection of job details of the 33 members in three time points: 2 years before the recruitment,-year 2016; 1 year before the recruitment - year 2017; and at the recruitment-year 2018. An assessment at the recruitment time-year 2018, of SE users' satisfaction with the job placement, symptoms, functioning, and quality of life (QoL). A cross-sectional study that compared the 33 SE members at the recruitment time-year 2018, with a matched group of people with the following criteria: living in local supported accommodations, being unemployed and not SE members. The two groups were compared on ratings of psychopathology, functioning, and QoL. Descriptive analyses were done. RESULTS: At the recruitment time - year 2018, all SE participants showed a significant better functioning (p < 0.001) than when they joined the SE-when they had been employed for an average of 5 years. In comparison to the matched group, SE members had significantly better functioning (p = 0.001), psychopathology (p = 0.007), and QoL (p = 0.034). According to their SE membership status, participants comprised trainees (21.2%) and employee members (78.8%). Trainees compared to employees had lower autonomies, functioning, QoL and more severe psychopathology. Over the two years prior to study recruitment, trainees showed stable poor autonomies, while employee members showed a variation from average autonomies in the 2 years before the recruitment time - year 2016, to good ones at the recruitment time - year 2018. Over the two years, all SE members set increasing numbers of objectives in all three domains. All SE participants reported high levels of satisfaction with all aspects of the job placement. CONCLUSIONS: SE that provides tailored support to assist people to gain employment skills may be an effective component in helping recovery from SMI
Exploring gender impact on collaborative care planning: insights from a community mental health service study in Italy
No full textIntroduction: Personal recovery is associated with socio-demographic and clinical factors, and gender seems to influence the recovery process. This study aimed to investigate: i) differences in the recovery goals of men and women users of a community mental health service in Italy; ii) any differences by gender in recovery over six months using the Mental Health Recovery Star (MHRS). Methods: Service users and staff completed the MHRS together at recruitment and six months later to agree the recovery goals they wished to focus on. Socio-demographic and clinical characteristics and ratings of symptoms (BPRS), needs (CAN), functioning (FPS), and functional autonomy (MPR) were collected at recruitment and six months follow-up. Comparisons between men and women were made using t-tests. Results: Ten women and 15 men completed the MHRS with 19 mental health professionals. Other than gender, men and women had similar socio-demographic, and clinical characteristics at recruitment. Women tended to choose recovery goals that focused on relationships whereas men tended to focus on work related goals. At follow-up, both men and women showed improvement in their recovery (MHRS) and women were less likely to focus on relationship related goals, perhaps because some had found romantic partners. There were also gains for both men and women in engagement with work related activities. Ratings of functional autonomy (MPR) improved for both men and women, and men also showed improvement in symptoms (BPRS) and functioning (FPS). Conclusions: Our findings suggest that collaborative care planning tools such as the MHRS can assist in identifying individualized recovery goals for men and women with severe mental health problems as part of their rehabilitation
Transitions in mental health care: The European Psychiatric Association contribution to reform in Bulgaria
No full textBackground: The Bulgarian Ministry of Health invited the European Psychiatric Association (EPA) to evaluate Bulgarian mental health care service provision in 2018. Bulgarian mental health services face very significant challenges including a legacy of historic underfunding, internal conflicts, poor planning, and the emigration of very high numbers of younger skilled staff that had followed accession to the European Union. There were significant disputes between stakeholders regarding the way forward and had been at least two unsuccessful previous external agency interventions that had attempted to find solutions. /
Method: This EPA position paper describes in detail the EPA mission to Bulgaria including methodology, findings, recommendations, and finally the positive actions and changes that are now underway as a result of the EPA report and intervention aimed at contributing towards improving Bulgarian mental health services. /
Results: After meetings with multiple stakeholders in the Bulgarian mental health system and analysis of data on service delivery, workforce, funding and configuration the EPA Panel agreed a list of twenty recommendations for change. /
Conclusions: The EPA mission, with the collaboration of multiple stakeholders in Bulgaria, was successful in stimulating high level government action to improve mental health services. Despite longstanding differences, it was possible to involve the stakeholders in constructive dialogue. The importance of “speaking with one voice” was a key lesson learned
Improving the quality of global mental health care requires universal agreement on minimum national investment
No full textMeeting the needs of women in mental health rehabilitation services
No full textA service evaluation investigated the gender sensitivity of a London mental health rehabilitation service, including interventions to increase participation in women-only groups and activities. Method: A total of 40 female service users and 13 staff teams from 13 inpatient and community-based rehabilitation projects completed questionnaires regarding the service's gender sensitivity. Results: Most projects provided women-only space and the majority of female service users had a female keyworker, but there was limited provision and uptake of women-only groups and activities. Conclusion: A focus on collaboration with female service users to identify and establish, where lacking, groups and activities that appeal to women service users is needed to increase meaningful occupation
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