14 research outputs found
The introduction and implementation of open dialogue in a day center in Athens, Greece: experiences and reflections of mental health professionals
IntroductionThe present study is part of a large-scale original action-research project aiming to assess the introduction and implementation of the Open Dialogue approach within the clinical practice of an established multidisciplinary team in a Day Centre in Athens, Greece. More specifically, it aimed to explore the experiences of professionals within the process of implementation both in relation to their clinical practice and their professional identity.MethodsData collection employed a focus group, which was set up to explore professional reflections of the implementation and research processes since the introduction of the model. Thematic Analysis of transcripts revealed two main themes that correspond to the impact of Open Dialogue on professionals’ clinical practice and on team dynamics, respectively.ResultsProfessionals identify several challenges in implementing OD, such as difficulties in linking theory to practice, containing uncertainty, and addressing cultural barriers to dialogical ways of working. Professionals further reflect on their own internal journey stemming from the implementation of Open Dialogue that has led them to greater openness and growth, personally and as a team.DiscussionThe role of mental health professionals is being acknowledged as being at the frontline of any meaningful psychiatric reform through the assimilation and promotion of humanistic paradigms aiming towards a change of culture in psychiatric care across different contexts. Despite variations in implementation across different contexts, the importance of consolidating and embracing Open Dialogue as a philosophical framework underpinning mental health care is being discussed
The association between bullying and early stages of suicidal ideation in late adolescents in Greece
<p>Abstract</p> <p>Background</p> <p>Bullying in schools has been associated with suicidal ideation but the confounding effect of psychiatric morbidity has not always been taken into account. Our main aim was to test the association between bullying behavior and early stages of suicidal ideation in a sample of Greek adolescents and to examine whether this is independent of the presence of psychiatric morbidity, including sub-threshold symptoms.</p> <p>Methods</p> <p>5614 pupils 16-18 years old and attending 25 senior high schools were screened in the first phase and a stratified random sample of 2431 were selected for a detailed interview at the second phase. Psychiatric morbidity and suicidal ideation were assessed with the revised Clinical Interview Schedule (CIS-R) while bullying was assessed with the revised Olweus bully/victim questionnaire.</p> <p>Results</p> <p>Victims of bullying behavior were more likely to express suicidal ideation. This association was particularly strong for those who were bullied on a weekly basis and it was independent of the presence of psychiatric morbidity (Odds Ratio: 7.78; 95% Confidence Interval: 3.05 - 19.90). In contrast, being a perpetrator ("bullying others") was not associated with this type of ideation after adjustment. These findings were similar in both boys and girls, although the population impact of victimization in the prevalence of suicidal ideation was potentially higher for boys.</p> <p>Conclusions</p> <p>The strong cross-sectional association between frequent victimization and suicidal ideation in late adolescence offers an opportunity for identifying pupils in the school setting that are in a higher risk for exhibiting suicidal ideation.</p
Les psychotherapies psychanalytiques breves dan le cadre de la sante publique
Ο στόχος αυτής της διατριβής είναι να μελετήσει τη σχέση των βραχειών ψυχαναλυτικών ψυχοθεραπειών και δημόσιας ψυχιατρικής περίθαλψης. Η μεθοδολογία που ακολουθείται είναι η κριτική περιγραφή των κύριων θεωρητικών μοντέλων στο χώρο της ψυχιατρικής (βιο-ιατρικό, ψυχαναλυτικό, κοινωνικό), των ορίων και αδυναμιών τους όταν κωδικοποιούνται σαν απλουστευμένες τεχνικές όπως επίσης και η περιγραφή των βραχειών ψυχοθεραπειών από ιστορική, επιστημολογική, τεχνική και κλινική άποψη. Διερευνάται η σχέση ψυχανάλυσης, ψυχοθεραπείας και η έννοια του περιορισμού του χρόνου στην ψυχοθεραπευτική διαδικασία, σε συσχέτιση με την ψυχική αλλαγή των ασθενών. Συμπερασματικά, οι βραχείες ψυχαναλυτικές ψυχοθεραπείες μπορούν να αποτελέσουν μια ενδιαφέρουσα κλινική και ψυχαναλυτική προσέγγιση στον πολύπλοκο χώρο του "παιχνιδιού" μεταξύ ασθενούς θεσμού, αποτελεσματικής έκβασης της ψυχοθεραπείας και απαρτιωμένου μοντέλου ψυχιατρικής φροντίδας στη δημόσια περίθαλψη
Insights into involuntary hospital admission procedures for psychiatric patients: A 3-year retrospective analysis of police records
The procedure of involuntary hospitalization has been an ongoing subject
of study. Its implementation requires the systematic co-ordination
between the Justice and Health Care systems around the globe. In the
case of Greece, the procedure under discussion is regulated by Law
2071/1992, which designates the Police as the agent that links the
aforementioned systems together. The present study aims to shed light
upon the procedure of involuntary hospitalizations, regarding the
preparatory stage and the Police involvement up to the individuals’
admission to the on-call hospital for a mental health assessment (MHA).
The entry data of two police stations in Athens was recorded by the
respective Duty Officer responsible for each case. The police records
were retrospectively inspected and information on socio-demographic,
clinical and parametric characteristics was extracted. The data
collection took place between March and July 2020 and included 324
cases, 80.3% of which referred to involuntary hospitalizations; 17.6%
of sample cases did not meet the criteria of the procedure, as opposed
to 1.9% of the cases in which the patients eventually ended up being
voluntarily admitted and afterwards hospitalized for treatment. There
was a statistically comparison of socio-demographic, clinical and
parametric variables in relation to the status of hospitalization groups
(involuntary, voluntary and no hospitalization). Additionally,
statistical comparisons were made between parametric and clinical
variables in relation to the type of prosecution order (written:
standard route, oral: emergency route). Acute mental health
deterioration accounted for around 45% of the total data and it has
been identified as the main factor for informing the Hearings Prosecutor
office mainly by the patient’s family and subsequently proceeding to the
issuance of an order (in either written or oral form) to the Police.
This enables the Police to escort the individuals and lead them to a
psychiatric unit for mental health assessment (MHA) and based on this,
for involuntary hospitalization if deemed necessary. In 87.9% of the
cases, the individual was transported by police vehicles over a time
span ranging from the very same day to 22 days. In total, the written
prosecution orders (63.6%) outnumbered the oral ones (36.7%). The
findings of the present study demonstrate that the Prosecution order
type varies significantly depending on the causes that instigated the
involuntary hospitalization procedure. The psychiatric decision whether
there should be hospitalization or outpatient therapy also significantly
varies depending on the diagnosis. Lastly, the results point out that
the need for improvement and further clarification of the aforementioned
Greek Law is absolutely essential
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
Depression in late adolescence: a cross-sectional study in senior high schools in Greece
Background: Depression is a common mental health problem in adolescents
worldwide. The aim of the present study was to investigate the
prevalence, comorbidity and sociodemographic and socioeconomic
associations of depression and depressive symptoms, as well as the
relevant health services use in a sample of adolescents in Greece.
Methods: Five thousand six hundred fourteen adolescents aged 16-18 years
old and attending 25 senior high schools were screened and a stratified
random sample of 2,427 were selected for a detailed interview.
Psychiatric morbidity was assessed with a fully structured psychiatric
interview, the revised Clinical Interview Schedule (CIS-R). The use of
substances, such as alcohol, nicotine and cannabis, and several
sociodemographic and socioeconomic variables have been also assessed.
Results: In our sample the prevalence rates were 5.67 % for the
depressive episode according to ICD-10 and 17.43 % for a broader
definition of depressive symptoms. 49.38 % of the adolescents with
depressive episode had at least one comorbid anxiety disorder [OR:
7.76 (5.52-10.92)]. Only 17.08 % of the adolescents with depression
have visited a doctor due to a psychological problem during the previous
year. Anxiety disorders, substance use, female gender, older age, having
one sibling, and divorce or separation of the parents were all
associated with depression. In addition, the presence of financial
difficulties in the family was significantly associated with an
increased prevalence of both depression and depressive symptoms.
Conclusions: Prevalence and comorbidity rates of depression among Greek
adolescents are substantial. Only a small minority of depressed
adolescents seek professional help. Significant associations with
financial difficulties are reported