Reform of the mental healthcare system in Greece, 1984–2006

Greece joined the European Community in 1981 and, 3 years later, the Commission of the European Communities provided financial and technical assistance under EEC Regulation 815/84 for the modernisation of the Greek mental healthcare system, with an emphasis on decentralisation and the development of community-based services, as well as the deinstitutionalisation of long-stay patients and improvement of conditions in public mental hospitals.

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Changing patterns of mental health care in Greece (1984–1996)

European Psychiatry ◽

10.1016/s0924-9338(99)00220-5 ◽

1999 ◽

Vol 14 (8) ◽

pp. 462-467 ◽

Cited By ~ 20

Author(s):

M.G. Madianos ◽

J. Tsiantis ◽

C. Zacharakis

Keyword(s):

Mental Health ◽

Technical Assistance ◽

Psychiatric Care ◽

Significant Shift ◽

Community Based ◽

Mental Hospitals ◽

Reform Programme ◽

Changing Patterns ◽

Community Based Services

SummaryGreece joined the European Community in 1981 and, three years later, the Commission of the European Communities provided financial and technical assistance under EEC Regulation 815/84 for the modernisation of the traditional psychiatric care system, with the emphasis on decentralisation of mental health services and the development of community-based services, as well as on deinstutionalization of long-stay patients and improvement of conditions in public mental hospitals. Over the last 11 years, the implementation of the EEC Reg. 815/84 programme contributed to a significant shift towards extramural care and rehabilitation. The role of the large mental hospitals has gradually been diminished and a large number of long-stay patients have been deinstitutionalised. It is commonly accepted that the EEC-funded psychiatric reform programme, despite inadequacies and constraints, had an impact on the changing mental health scene in Greece.

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Mental health reforms in the Czech Republic

BJPsych International ◽

10.1192/bji.2017.27 ◽

2018 ◽

Vol 16 (1) ◽

pp. 4-6 ◽

Cited By ~ 6

Author(s):

Ondrej Pec

Keyword(s):

Mental Health ◽

Czech Republic ◽

Health Reform ◽

Mental Healthcare ◽

Rehabilitation Services ◽

Community Based ◽

The Czech Republic ◽

Mental Health Reform ◽

Mental Health Reforms ◽

Community Based Services

This paper describes the history and current provision of mental healthcare in the Czech Republic. After the political changes in 1989, there was an expansion of out-patient care and several non-governmental organisations began to provide social rehabilitation services, but the main focus of care still rested on mental hospitals. In recent years, mental health reform has been in progress, which has involved expanding community-based services and psychiatric wards of general hospitals, simultaneously with educational and destigmatisation programmes.

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Should community-based services be publicly funded or contracted out?

Palliative & Supportive Care ◽

10.1017/s1478951512000454 ◽

2012 ◽

Vol 11 (3) ◽

pp. 267-272

Author(s):

Lynnette Nathalie Lyzwinski

Keyword(s):

Healthcare System ◽

Indirect Costs ◽

Policy Option ◽

Care Utilization ◽

Publicly Funded ◽

Community Based ◽

Rehabilitative Care ◽

Canada Health Act ◽

Private Financing ◽

Community Based Services

AbstractObjective:The introduction of Canada's Medicare in 1966 established precedence for a universally accessible and equitable healthcare system. Although Canada has been a leader in building the foundations of socialized medicine, it has stalled short of fulfilling a vision promulgated by its architects of a system that operates on a continuum of care. The aim of this review was to examine whether the expansion of publicly funded services under the Canada Health Act would be an economically and socially viable policy option.Method:A literature review of the direct and indirect social and economic costs associated with contracting out community-based services in the form of outpatient rehabilitative care, palliative care, and home care was conducted.Results:This article concludes that the private financing of community-based services increases healthcare costs in the long term through increased density and frequency of acute care utilization. It is associated with increased indirect costs in the form of caregiver burden and reduced labor market participation of informal caregivers. The expansion of publicly funded community-based services minimizes these direct health and indirect societal costs.Significance of results:The integration of publicly funded community-based services under the Canada Health Act would ensure that the principles of Medicare in the form of equity and accessibility would be enforced while maintaining an economically sustainable healthcare system.

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Health and Community-Based Services for Individuals with Neurological Conditions

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2017.207 ◽

2017 ◽

Vol 44 (6) ◽

pp. 670-675

Author(s):

Sarah E.P. Munce ◽

Kristen B. Pitzul ◽

Sara J.T. Guilcher ◽

Tarik Bereket ◽

Mae Kwan ◽

...

Keyword(s):

Online Survey ◽

Healthcare Professionals ◽

Healthcare Providers ◽

Mental Healthcare ◽

Community Based ◽

Term Care ◽

Neurological Patient ◽

Suburban Areas ◽

Neurological Conditions ◽

Community Based Services

AbstractBackground:The current study involves a national survey of healthcare providers who offer services for individuals with a variety of neurological conditions. It aims to describe the provision of health and community-based services as well as the admission criteria, waitlist practices, and referral sources of these services.Methods:An online survey was directed at administrators/managers from publicly funded hospital programs, long-term care homes, and community-based healthcare provider agencies that were believed to be providing information and/or services to patients with a variety of neurological conditions.Results:Approximately 60% (n=254) of respondents reported providing services in either urban/suburban areas or rural/remote areas only, whereas the remaining 40% (n=172) provided services regardless of patient location. A small proportion of respondents reported providing services for individuals with dystonia (28%), Tourette syndrome (17%), and Rett syndrome (13%). There was also a paucity of diverse healthcare professionals across all institutions, but particularly mental healthcare professionals in hospitals. Lastly, the majority of respondents reported numerous exclusion criteria with regard to service provision, including prevalent comorbid conditions.Conclusions:If the few services provided for these neurological patient populations exclude common comorbidities, it is likely that there will be no other place for these individuals to seek care.

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The architecture of the primary mental healthcare system for older people in India: what public policies tell us

International Journal of Mental Health Systems ◽

10.1186/s13033-021-00494-8 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Tom Kafczyk ◽

Kerstin Hämel

Keyword(s):

Mental Health ◽

Older People ◽

Old Age ◽

Healthcare System ◽

General Health ◽

Older Persons ◽

Mental Healthcare ◽

Community Based ◽

The Family ◽

Policy Fields

Abstract Background Old age mental healthcare is an issue that cuts across old age, general health, and mental healthcare policies. While strengthening the primary mental healthcare system in India is a common strategy across policy fields to improve the mental health of older persons, very little is known about the system’s planned architecture. This study explores public policy strategies for and approaches to the mental health of older persons, focusing on the primary healthcare (PHC) level and the role of the family. Methods A document analysis of 39 key public national policy documents (2007 – 2019) from three thematically grouped policy fields (mental health, old age, and general health) was conducted. Results Comprehensive community-based primary mental healthcare – focusing on vulnerable population groups including older persons – has been strengthened significantly since 2007. The promulgated approaches and strategies build on traditional community-based approaches to mental healthcare in India. They focus on (a) integrating community health workers into primary mental healthcare, (b) empowering the community to participate in healthcare planning, implementation, and monitoring, (c) supporting the family through a family-led approach to mental healthcare, and (d) integrating traditional Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy (AYUSH) services into primary mental healthcare. Conclusions While all policy fields address mental PHC, they do so in different ways, and approaches and strategies that promote an integrated perspective across policy fields are lacking. To realize the policies vision, strengthening PHC will be essential. Further research should evaluate strategies and approaches in light of social developments, such as eroding family norms and the poor state of the public health system in India, in order to assess their opportunities, challenges, and overall feasibility, with the benefits older people would experience taking centre stage in these inquiries.

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The Architecture of the Primary Mental Healthcare System for Older People in India – What Public Policies Tell Us

10.21203/rs.3.rs-415585/v1 ◽

2021 ◽

Author(s):

Tom Manuel Kafczyk ◽

Kerstin Haemel

Keyword(s):

Mental Health ◽

Older People ◽

Old Age ◽

Healthcare System ◽

General Health ◽

Older Persons ◽

Mental Healthcare ◽

Community Based ◽

The Family ◽

Policy Fields

Abstract Background: Old age mental healthcare is an issue that cuts across old age, general health, and mental healthcare policies. While strengthening the primary mental healthcare system in India is a common strategy across policy fields to improve the mental health of older persons, very little is known about the system’s planned architecture. This study explores public policy strategies for and approaches to the mental health of older persons, focusing on the primary healthcare (PHC) level and the role of the family.Methods: A document analysis of 39 key public national policy documents (2007-2019) from three thematically grouped policy fields (mental health, old age, and general health) was conducted.Results: Comprehensive community-based primary mental healthcare – focusing on vulnerable population groups including older persons – has been strengthened significantly since 2007. The promulgated approaches and strategies build on traditional community-based approaches to mental healthcare in India. They focus on (a) integrating community health workers into primary mental healthcare, (b) empowering the community to participate in healthcare planning, implementation, and monitoring, (c) supporting the family through a family-led approach to mental healthcare, and (d) integrating traditional Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy (AYUSH) services into primary mental healthcare.Conclusions: While all policy fields address mental PHC, they do so in different ways, and approaches and strategies that promote an integrated perspective across policy fields are lacking. Further research should evaluate strategies and approaches in light of social developments such as eroding family norms and the poor state of the public health system in India in order to assess their opportunities, challenges, and overall feasibility, with the benefits older people would experience taking center stage in these inquiries.

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Mental healthcare in Saint Lucia

BJPsych International ◽

10.1192/bji.2017.12 ◽

2018 ◽

Vol 15 (1) ◽

pp. 14-16 ◽

Cited By ~ 1

Author(s):

Karen A. Francis ◽

Andrew Molodynski ◽

Giselle Emmanuel

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Mental Healthcare ◽

Small Island ◽

Community Based ◽

Middle Income ◽

The Government ◽

Mental Wellness ◽

Community Based Services ◽

Significant Shortage

St Lucia is a small island in the eastern Caribbean with a population of approximately 200 000 people. Although St Lucia is formally ranked as a high middle-income country, there are pockets of deprivation and relatively low living standards. Mental health services in St Lucia have increased considerably and advanced over recent years because of a coalition between the government of the island and South East Asian partners. The National Mental Wellness Centre opened several years ago and has much improved facilities. There remains a significant shortage of community-based services, no mental health law, and a pervasive community stigma and apprehension regarding those with mental health problems.

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Greece

International Psychiatry ◽

10.1192/s1749367600005373 ◽

2008 ◽

Vol 5 (1) ◽

pp. 4-5

Author(s):

Anastasia Karastergeriou

Keyword(s):

Intellectual Disabilities ◽

National Health System ◽

Mental Healthcare ◽

Psychiatric Hospitals ◽

Community Services ◽

Community Based ◽

Psychiatric Units ◽

History Of ◽

Council Regulation ◽

Community Based Services

The history of mental healthcare offered to people with intellectual disabilities in Greece runs in parallel to that of people suffering from severe psychiatric disorders. Until the early 1980s, it was based on 9 overcrowded and understaffed state and 40 private psychiatric hospitals with a mixed population of patients with psychosis and of those with intellectual disabilities (Madianos et al, 1999). The psychiatric reforms began with Law 1397 in 1983, which introduced the National Health System, and, in the following year, European Council Regulation 815/84, through which financial aid was approved and a 5-year plan adopted. The main goal was the development of a network of community-based services in geographically sectorised areas, to replace the large psychiatric hospitals. Mental health centres, psychiatric units in general hospitals and many other community services were to be established, according to local requirement.

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