Lifelong learning and recovery: an account from the perspective of the EMILIA project.

The paper is based upon the accounts of mental health service users, who all suffered from severe long-term mental illness. The training intervention: “Empowering people in recovery” was developed during the Emilia project (see below). The training process in recovery at Middlesex University, London, an Emilia demonstration site, was accredited, took place over twelve weeks, four hours every session. At the Institute of Psychiatry and Neurology, Warsaw, the other Emilia demonstration site, there were twelve hours of taught training programme over three days in one week. The second phase was also twelve hours but at once a week intervals. The Emilia project also developed a “personal development plan” module for the training; both London and Warsaw demonstration sites assisted their mental health service users in using it. Many students taking part in this training found it to be a very positive experience. These results need replication and further work to identify what were the preconditions for making it such a worthwhile experience and how this could be replicated on a wider basis

Factors related to social support in neurological and mental disorders

Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness) and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality

Team-based occupational stress reduction: a European overview from the perspective of the OSCAR Project.

Work-related stress is a significant impediment to job satisfaction and healthy psycho-social functioning. It can alter the behaviour of the person involved and impair the quality of their life. In the European Union (EU), over the last decade, work-related stress has been consistently identified as one of the major workplace concerns--a challenge not only to the health of working people but also to the healthiness of their organizations. The study reported below attempted to address the issue of work-related stress through whole team training programmes, on a background of largely ineffective stress reduction training programmes offered to individuals within the workplace. This EU 'framework 5 Quality of Life' project focused instead on tackling the organizational level through training of mental health teams in five countries. The findings have significant implications to the conceptual, methodological and everyday organizational practice levels of tackling this central issue to the health of the workplace

Demographic and situational variations in levels of burnout in European mental health services: a comparative study.

This paper reviews the demographic and situational variations in levels of occupational burnout, as measured by the Maslach Burnout Inventory, among community and inpatient staff in six European mental health services, located in Aarhus and Storstrom in Denmark, Cambridge in the UK, Bodo in Norway, Tampere in Finland and Warsaw in Poland. The overall study design was a time series with baseline and follow-up at six and 12 months. A total of 414 members of staff were assessed in the six settings: 205 in inpatient facilities and 209 in the community. To calculate the influence of sociodemographic factors in relation to levels of burnout, a factor analysis was carried out. Each factor was analysed twice. There were no statistically significant differences regarding emotional exhaustion. Depersonalisation (DP) was higher in inpatient settings (1.73, standard error (SE) 0.04) than in community locations (1.62, SE 0.04). The lowest scores for DP for inpatient settings were observed in Aarhus (1.59, SE 0.08) and in Storstrom (1.65, SE 0.08). Regarding personal accomplishment (PA) the statistically significant differences were observed between Warsaw, which scored high in PA (39.92, SE 3.63), and Storstrom (76.36, SE 4.60), which scored low. Staff who had previously experienced relevant prior training on occupational stress reduction scored significantly lower in emotional exhaustion (EE) (3.75, SE 0.13) than those with no prior exposure to relevant training (4.07, SE 0.07). The study also indicated that men in the study scored significantly higher on DP (1.75, SE 0.05) than did women (1.60, SE 0.03). This may be explicable in terms of men being exposed to higher levels of violence than women

Team-based occupational stress reduction: a European overview from the perspective of the OSCAR project

Work-related stress is a significant impediment to job satisfaction and healthy psycho-social functioning. It can alter the behaviour of the person involved and impair the quality of their life. In the European Union (EU), over the last decade, work-related stress has been consistently identified as one of the major workplace concerns—a challenge not only to the health of working people but also to the healthiness of their organizations. The study reported below attempted to address the issue of work-related stress through whole team training programmes, on a background of largely ineffective stress reduction training programmes offered to individuals within the workplace. This EU 'framework 5 Quality of Life' project focused instead on tackling the organizational level through training of mental health teams in five countries. The findings have significant implications to the conceptual, methodological and everyday organizational practice levels of tackling this central issue to the health of the workplace

Psychosocial difficulties from the perspective of persons with neuropsychiatric disorders

Purpose: the objective of this study is to determine whether persons with neuropsychiatric disorders experience a common set of psychosocial difficulties using qualitative data from focus groups and individual interviews.Method: the study was performed in five European countries (Finland, Italy, Germany, Poland and Spain) using the focus groups and individual interviews with persons with nine neuropsychiatric disorders (dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke and substance dependence). Digitally recorded sessions were analysed using a step-by-step qualitative and quantitative methodology resulting in the compilation of a common set of psychosocial difficulties using the International Classification of Functioning, Disability and Health (ICF) as a framework.Results: sixty-seven persons participated in the study. Most persons with neuropsychiatric disorders experience difficulties in emotional functions, sleeping, carrying out daily routine, working and interpersonal relationships in common. Sixteen out of 33 psychosocial difficulties made up the common set. This set includes mental functions, pain and issues addressing activities and participation and provides first evidence for the hypothesis of horizontal epidemiology of psychosocial difficulties in neuropsychiatric disorders.Conclusions: this study provides information about psychosocial difficulties that should be covered in the treatment and rehabilitation of persons with neuropsychiatric disorders regardless of clinical diagnoses. Implications for Rehabilitation Emotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity. Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders. The effects of medication and social environment on patient's daily life should be considered in all the neuropsychiatric conditions<br/

Determinants of psychosocial difficulties experienced by persons with brain disorders: towards a ‘horizontal epidemiology’ approach

Objective: To test the hypothesis of ‘horizontal epidemiology’, i.e. that psychosocial difficulties (PSDs), such as sleep disturbances, emotional instability and difficulties in personal interactions, and their environmental determinants are experienced in common across neurological and psychiatric disorders, together called brain disorders.Study Design: A multi-method study involving systematic literature reviews, content analysis of patient-reported outcomes and outcome instruments, clinical input and a qualitative study was carried out to generate a pool of PSD and environmental determinants relevant for nine different brain disorders, namely epilepsy, migraine, multiple sclerosis, Parkinson’s disease, stroke, dementia, depression, schizophrenia and substance dependency. Information from these sources was harmonized and compiled, and after feedback from external experts, a data collection protocol including PSD and determinants common across these nine disorders was developed. This protocol was implemented as an interview in a cross-sectional study including a convenience sample of persons with one of the nine brain disorders. PSDs endorsed by at least 25% of patients with a brain disorder were considered associated with the disorder. PSD were considered common across disorders if associated to 5 out of the 9 brain disorders and if among the 5 both neurological and psychiatric conditions were represented.Setting: The data collection protocol with 64 PSDs and 20 determinants was used to collect data from a convenience sample of 722 persons in four specialized health care facilities in Europe.Results: 57 of the PSDs and 16 of the determinants included in the protocol were found to be experienced across brain disorders.Conclusion: This is the first evidence that supports the hypothesis of horizontal epidemiology in brain disorders. This result challenges the brain disorder-specific or vertical approach in which clinical and epidemiological research about psychosocial difficulties experienced in daily life is commonly carried in neurology and psychiatry and the way in which the corresponding health care delivery is practiced in many countries of the world.<br/