The Interventions of a Mobile Mental Health Unit on the Refugee Crisis on a Greek Island

This present study concerns refugees and asylum seekers who have been referred to a Mobile Mental Health Unit (MMHU-Ch) in rural Greece on a Northeast Aegean Island during the refugee crisis in 2015. Our objective is the examination and recording of psychopathology characteristics’, the presentation of the therapeutic interventions provided, and the difficulties. The sample is composed of 418 requests made by refugees, asylum seekers, adults, and children. The clinical and demographic data have been gathered from the MMHU-Ch’s charts. The study is retrospective, descriptive with quantitative and categorical variables. The data has been analyzed with the utilization of SPSS. The dominant diagnosis in children involves anxiety disorders, developmental disorders, and PTSD. One noteworthy finding is the high percentage of suicide behavior regardless of psychiatric diagnosis, which should be further examined. As far as interventions are concerned, the conclusions which have arisen are the gradually stronger commitment of the referents, but also the high percentage of requests that dropped out. Further examination of the interventions and their efficiency is recommended as well as probing the features of psychopathology in the long term with a view to clarifying the patronizing and aggravating factors.

Mobile Mental Health for Depression Assistance

Depression is a prevalent and severe medical illness that negatively affects how people feel, think, and act, with estimates pointing towards more than 300 million suffering from depression worldwide. Although effective treatments exist, about 80% of people in low and middle-income countries do not receive therapy. Therefore, technology has become a promising tool to assist in reducing disparities. This study aims to identify and map the available evidence on mobile health applied to depression and clarify key concepts. The authors analyzed clinical trials developed over the last five years. EBSCO and PubMed were searched, and a total of 14 conducted RCTs were selected and reviewed. Despite some limitations regarding dropout rates and several ethical and safety concerns, the mobile mental health future seems promising.

Mobile Mental Health

Several people with mental health problems do not receive suitable treatment and often avoid or delay seeking help due to concerns about being treated differently and other practical barriers (for example, services costs and unavailability). The mobile health concept has gained more enthusiasts worldwide exactly because it helps mitigate some of these issues. However, despite the emerging scientific evidence in the last decade that proves the efficacy and safety of these interventions, professionals have shown some doubts and worries about their implementation, especially in the mental health field. Thereby, this chapter provides a review on the subject, presenting several mobile applications for mental health problems and also the expectations and needs of health professionals and users for development and implementation of a mobile application.

Albanian Migrants in Cyclades: Contact with Mental Health Services and Implications for Practice

The purpose of this study was to examine the potential differences between Albanian migrants and Greeks in the islands of Paros and Antiparos with regard to seeking help from the local public mental health service, namely the Mobile Mental Health Unit of NE Cyclades Islands (EPAPSY-NGO). The study’s instruments include the Global Assessment of Functioning (GAF) and a questionnaire for recording psychosocial profile data and information concerning contact with the services. The results showed that significantly less Albanian migrants contacted the mental health services in the past in comparison to Greeks. When using the service, the Albanians were more likely to see a psychiatrist in the Unit, rather than a psychologist-psychotherapist, and they more often received prescriptions for medication. There was a significantly higher dropout rate among Albanian migrants. This study highlights the different aspects of access and use of mental health services among Albanian migrants compared with native residents. Further research should focus on the factors related to early dropouts and difficulties accessing mental health services in rural areas, in order to develop more focused and effective interventions and improve the quality of care provided.

Decrease of Hospitalizations and Length of Hospital Stay in Patients with Schizophrenia Spectrum Disorders or Bipolar Disorder Treated in a Mobile Mental Health Service in Insular Greece

In recent years serious mental health issues, such as schizophrenia spectrum disorders and bipolar disorder, have been treated in the community by community-based mental health services. In the present study our goal was to estimate the modification in the number of hospitalizations and duration of admissions in either psychotic patients or patients with bipolar disorder, treated by a Mobile Mental Health Unit in the islands of Kefalonia, Zakynthos and Ithaca (MMHU-KZI). Data were collected from a total of 108 patients with schizophrenia spectrum disorders and bipolar disorder. For each patient comparison was made for the same time interval prior and after engagement to treatment with the MMHU-KZI and not for the total hospitalizations that patients had in their history. There was a statistically significant reduction (45.9%) in hospitalizations after treatment engagement with the MMHU-KZI, as the Wilcoxon signed ranks test indicated. Furthermore, a major decrease (54.5%) of hospitalization days was noted after treatment engagement with the unit. This pattern of mental health provision may be beneficial for the reduction of the number and duration of psychiatric hospitalizations. Despite the beneficial contribution of community-based mental health units, hospital based treatment should always be available, since severe relapses are better treated in inpatient setting.

Adolescent Perspectives on How an Adjunctive Mobile App for Social Anxiety Treatment Impacts Treatment Engagement in Telehealth Group Therapy

Adjunctive mobile mental health apps to supplement mental health treatment have been growing in recent years given their ability to address treatment engagement barriers. However, few studies have explicitly examined how these mobile apps impact treatment engagement, and even fewer have investigated this topic through adolescents’ perspectives. To this end, we conducted semi-structured interviews with five adolescents who used an adjunctive mobile mental health app in combination with telehealth cognitive behavioral group therapy for social anxiety. Using a multidimensional framework of treatment engagement, we elicited their perspectives on how the app impacted their engagement in telehealth group therapy and gathered their suggestions for improving the app. Using a consensual qualitative research approach, we learned that adolescents felt the app increased their comfort with others in therapy and their expectations about the effectiveness of mental health apps. They also indicated that the app prepared them for in-session participation and facilitated out-of-session skills practice. Adolescents had valuable suggestions such as adding app features to facilitate social connectedness between group members and adding appointment reminders in the app. This preliminary study highlights implications for future adjunctive mobile mental health app developers and researchers to increase adolescents’ treatment engagement in mental health services.

A Systematic Review of the Effectiveness, Content, and Usage Patterns of Mobile Mental Health Interventions on Smartphone Platforms for Anxiety Symptoms

"This systematic review aims to examine the content, usage pattern and efficacy of mobile mental health interventions in reducing anxiety symptoms. A search of 10 electronic databases returned 44 408 studies in total and 27 studies met the inclusion criteria, including 4460 participants in total. The rate of attrition was 27% (SD = 22) among the participants who initiated the app use. The rate of significant reductions in measures of anxiety symptoms was 87% from within-subjects pretest to posttest assessments, yet this rate dropped to 46% when compared to a waitlist/control group. A vast majority of the studies used cognitive and/or behavioral interventions (N = 26, 96%), a few studies included professional support (N = 11, 41%), a structured form of delivering the interventions (N = 8, 30%) or tailored it to users’ needs (N = 6, 22%). Few studies reported the actual time spent on the app per week (N = 4, M = 63.76, SD = 62.17). The mobile mental health interventions were effective in reducing anxiety symptoms, yet this effectiveness eroded compared to control groups. There is a need to develop consistent ways of reporting the usage patterns and testing evidence-based interventions other than cognitive behavioral treatments."