Recent Trends in Mental Health Services in Italy: An Analysis of National and Local Data

1993 ◽  
Vol 38 (3) ◽  
pp. 195-202 ◽  
Author(s):  
Domenico De Salvia ◽  
Angelo Barbato
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Treatment ◽  
National Level ◽  
Community Services ◽  
Local Data ◽  
Case Register ◽  
Mental Hospitals ◽  
Mental Health Act

This paper reviews trends in Italian mental health services after the implementation of the 1978 Mental Health Act. Data available at the national level on public and private inpatient services, community mental health centres, residential and day care facilities are presented and discussed. Findings from two case-register areas, where comprehensive community services according to the Mental Health Act have been implemented, are discussed. Public mental hospitals are no longer used for psychiatric treatment, except for a small number of long stay patients. General hospital psychiatric units are the only setting in the public sector where psychiatric patients can be admitted. In private mental hospitals, the number of residents has decreased, while admissions have remained stable. However, community services are unevenly distributed and residential facilities are generally lacking. Little is known about quality of care provided, although data from some pilot studies are encouraging. Stable admission rates to forensic mental hospitals suggest that the criminalization of mentally ill has not increased. The effect of changing patterns of mental health care on suicide rates are discussed.

Human rights and the use of psychiatric medication

2014 ◽  
Vol 13 (4) ◽  
pp. 179-188 ◽  
Author(s):  
Lourdes Rodriguez del Barrio ◽  
Rosana Onocko Campos ◽  
Sabrina Stefanello ◽  
Deivisson Vianna Dantas dos Santos ◽  
Céline Cyr ◽  
...  
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Psychiatric Treatment ◽  
Community Services ◽  
Joint Analysis ◽  
Content Type ◽  
Formal Recognition

Purpose – Formal recognition of the human rights of people living with mental health problems has greatly progressed. We must ask ourselves, however, to what extent the formal recognition of these rights has transformed the culture of psychiatric care and improved their quality of life. Gaining Autonomy & Medication Management (GAM) is an approach that strives to empower service users and providers and promotes the exercise of users’ rights by transforming their relationship with the central component of psychiatric treatment in community services: psychopharmacology. The purpose of this paper is to show how GAM highlights the issues surrounding the establishment of a culture of rights. Design/methodology/approach – For this analysis qualitative data were collected in Brazil and in Quebec, Canada, through over 100 interviews done with people living with mental health issues and practitioners who participated in the different GAM implementation projects. Findings – Issues, challenges and obstacles facing the instauration of a human rights culture in mental health services are presented. The profound changes that the understanding and exercise of users’ rights bring to the lives of individuals are supported by excerpts illustrating recurring issues, situations and common experiences that appear in the various contexts of the two different countries. Research limitations/implications – This is not a parallel study taking place into two countries. The methodologies used were different, and as a consequence the comparative power can be limited. However, the results reveal striking similarities. Originality/value – There is scant research on human rights in mental health services in the community, and the issues surrounding the prescribing and follow-up of pharmacological treatment. The joint analysis of the researches in Brazil and in Canada, identified common challenges which are intertwined with the dominant approach of biomedical psychiatry.

Implementing a national case-management training program in Portugal

2011 ◽  
Vol 26 (S2) ◽  
pp. 555-555
Author(s):  
P. Mateus ◽  
M. Xavier ◽  
J. Caldas-Almeida
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Case Management ◽  
Training Program ◽  
National Level ◽  
Management Training ◽  
Role Playing ◽  
List Type ◽  
Program Content

IntroductionIn Portugal, a new National Mental Health Plan has been launched with the following objectives: equal access to care, decentralisation of mental health services and integration of mental health services in the general health services. In order to change the operational model for mental health teams, a case-management training program has been launched by the Ministry of Health.ObjectivesThis study aims to evaluate: a)the feasibility of implementing the program on a national level,b)the quality of the training program andc)the satisfaction of the trainees.MethodsThe study was carried out at 36 public mental health services in mainland Portugal. The professionals attended a case management course (SAMHSA procedures), in which they were trained by means of guidelines, demonstrative audios, scenarios and role-playing. The assessment was conducted with a questionnaire addressing logistics, program content, acquisition of skills, usefulness and overall satisfaction.Results135 professionals from the whole country have been involved. The trainees’ acquisition of competences was found rather satisfactory. Results of the training were impressive regarding satisfaction and motivation of the trainees (69% were highly satisfied). Dimensions such as organization (35% highly satisfied, 52% satisfied), program content (41% highly satisfied, 43% satisfied), practical skills gaining (35% highly satisfied, 58% satisfied) and usefulness (58% highly satisfied, 31% satisfied) were also very well rated.ConclusionsOf upmost relevance, it was possible to implement a case management training program at a national level, with no particular difficulties. The impact of courses on trainees was overall impressive.

Integrating Mental Health Services through Reimbursement Reform and Managed Mental Health Care

1997 ◽  
Vol 2 (2) ◽  
pp. 86-93 ◽  
Author(s):  
David Mechanic
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Financial Incentives ◽  
Systems Of Care ◽  
Public Mental Health ◽  
Community Services ◽  
Integration Of Services ◽  
The Usa ◽  
The Uk

People with serious and persistent mental illness require a range of community services typically provided by different specialized agencies. At the clinical level, assertive team case management is the strategy commonly used to achieve integration of services across specialized sectors. The USA also has used various financial and organizational approaches to reduce fragmentation and increase effectiveness, including development of stronger public mental health authorities, use of financial incentives to change professional and institutional behavior, requirements to allocate savings from hospital closures to community systems of care, and introduction of mental health managed care on a broad scale. These approaches have potential but also significant problems and there is often a large gap between theory and implementation. These US developments are discussed with attention to the implications for mental health services in the UK.

The future of specialist community teams in the care of those with severe mental illness

2007 ◽  
Vol 16 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Peter Tyrer
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Severe Mental Illness ◽  
Community Mental Health Services ◽  
Community Services ◽  
Crisis Resolution ◽  
Crisis Resolution Teams

SummaryAims – Specialist interventions in community psychiatry for severe mental illness are expanding and their place needs to be re-examined. Methods – Recent literature is reviewed to evaluate the advantages and disadvantages of specialist teams. Results – Good community mental health services reduce drop out from care, prevent suicide and unnatural deaths, and reduce admission to hospital. Most of these features have been also demonstrated by assertive community outreach and crisis resolution teams when good community services are not available. In well established community services assertive community teams do not reduce admission but both practitioners and patients prefer this service to other approaches and it leads to better engagement. Crisis resolution teams appear to be more successful than assertive community teams in preventing admission to hospital, although head- to-head comparisons have not yet been made. All specialist teams have the potential of fragmenting services and thereby reducing continuity of care. Conclusions – The assets of improved engagement and greater satisfaction with assertive, crisis resolution and home treatment teams are clear from recent evidence, but to improve integration of services they are probably best incorporated into community mental health services rather than standing alone.Declaration of Interest: The author has been the sole consultant in two assertive outreach teams since 1994 and might there- fore be expected to be in favour of this genre of service. He has received grants for evaluation of different services models from the Department of Health (UK) and the Medical Research Council (UK).

scholarly journals Why Do Approved Mental Health Professionals Think Detentions under the Mental Health Act Are Rising and What Do They Think Should Be Done about It?

2020 ◽  
Vol 50 (2) ◽  
pp. 616-633 ◽  
Author(s):  
Michael Bonnet ◽  
Nicola Moran
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Online Survey ◽  
Social Risk ◽  
Social Risk Factors ◽  
Mental Health Act ◽  
The Impact

Abstract The number of people detained under the 1983 Mental Health Act has risen significantly in recent years and has recently been the subject of an independent review. Most existing research into the rise in detentions has tended to prioritise the perspectives of psychiatrists and failed to consider the views of Approved Mental Health Professionals (AMHPs), usually social workers, who ultimately determine whether detention is appropriate. This mixed-methods study focused on AMHPs’ views on the reasons behind the rise in detentions and potential solutions. It included a national online survey of AMHPs (n = 160) and semi-structured interviews with six AMHPs within a Community Mental Health Team in England. AMHPs reported that demand for mental health services vastly exceeded supply and, due to inadequate resources, more people were being detained in hospital. AMHPs argued that greater investment in preventative mental health services and ‘low intensity’ support would help to mitigate the impact of social risk factors on mental health; and greater investment in crisis services, including non-medical alternatives to hospital, was required. Such investment at either end of the spectrum was expected to be more effective than changes to the law and lead to better outcomes for mental health service users.

scholarly journals Profile: Vanessa Cameron – 36 years at the Royal College of Psychiatrists

2016 ◽  
Vol 40 (6) ◽  
pp. 341-345
Author(s):  
Rob Poole ◽  
Catherine A. Robinson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
21St Century ◽  
Royal College ◽  
Chief Executive ◽  
Continuous Change ◽  
Mental Hospitals

On 16 December 2016, Vanessa Cameron retires as Chief Executive of the Royal College of Psychiatrists. She started working there in September 1980 and in 1984 she became Secretary of the College, the role that preceded chief executive. The College was formed in 1971, so Vanessa has been present for most of its lifetime. It has been a period of continuous change that has seen psychiatry leave the old mental hospitals, expand considerably in the late 1990s and early part of the 21st century, and come under huge pressure more recently. Although she has never worked within mental health services, Vanessa has been at the heart of British psychiatry for 36 years. She was awarded an MBE in the 2013 New Year's Honours list for services to psychiatry.

The WHO-EC partnership project on empowerment in mental health

2011 ◽  
Vol 26 (S2) ◽  
pp. 2101-2101
Author(s):  
A. Baumann
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
National Level ◽  
Health Problems ◽  
World Health ◽  
Full Potential ◽  
Regional Office ◽  
Country Level

People with mental health problems and their families have not been involved as equal partners in decision-making processes on mental health services, and they continue to be at risk of social exclusion and discrimination in all facets of life. In a mental health context, empowerment refers to the level of choice, influence and control that users of mental health services can exercise over events in their lives, and the key to empowerment is the removal of formal or informal barriers and the transformation of power relations between individuals, communities, services and governments. Despite all achievements that have been made over the past decade, there is still a strong need for empowerment of people with mental health problems and their families. The World Health Organization Regional Office for Europe and the European Commission started a three years lasting "Partnership Project on Empowerment in Mental Health" in 2008 which aims to support Member States in the European Region in creating societies in which people with mental health problems are enabled to develop and express their full potential as equal citizens. The WHO Statement on Empowerment in Mental Health has been published, about 100 examples of empowerment practice across Europe have been collected, and indicators for empowerment applicable at national level have been identified. The project outcomes and possibilities for their implementation at country level will be presented.

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