STIGMA IN MENTAL DISORDERS: WHAT IS PSYCHIATRY ABLE TO DO?

The problem of stigma in mental health in connected to the problem of human rights. Mental health professionals, psychiatrists included, display stigmatization of people with mental disorders mostly through social distance, even though they have “politically correct” opinions about their patients. Negative beliefs and attitudes in psychiatric profession should be opposed because of their important influence on public opinion, opinion of patients´ themselves and of their family members. The “disabling environment” formed through discriminative practices in all society levels can be improved through mental health policy documents and plans that involve clear human rights protection premises, resource allocation and development priorities in line with international standards. Slovenia invests at least 80% of mental health budget in psychiatric hospitals and social care institutions, which employ 90% of psychiatrists. Redirection of these resources to local level, together with reallocation of human resources, should improve attitudes of mental health workers towards people with mental problems, because of timely, effective and needs-led approach that enables recovery

SEVERE MENTAL ILLNESS – PATIENTS\u27 CHILDREN NEEDS

Care for families and children of people with severe mental illness is a professionally and politically neglected issue. The majority of countries provide only services for several needs of the patients’ families, i.e. treatment, custody and counselling. Management of stress and resolving of common problems are rarely addressed. Children of people with mental illness reflect and call professional attention to this issues. The deficiency of services is to be addressed by multidisciplinary team efforts. In the Slovenian organization of health services coordination could be provided by family physicians

STIGMA IN MENTAL DISORDERS: WHAT IS PSYCHIATRY ABLE TO DO?

The problem of stigma in mental health in connected to the problem of human rights. Mental health professionals, psychiatrists included, display stigmatization of people with mental disorders mostly through social distance, even though they have “politically correct” opinions about their patients. Negative beliefs and attitudes in psychiatric profession should be opposed because of their important influence on public opinion, opinion of patients´ themselves and of their family members. The “disabling environment” formed through discriminative practices in all society levels can be improved through mental health policy documents and plans that involve clear human rights protection premises, resource allocation and development priorities in line with international standards. Slovenia invests at least 80% of mental health budget in psychiatric hospitals and social care institutions, which employ 90% of psychiatrists. Redirection of these resources to local level, together with reallocation of human resources, should improve attitudes of mental health workers towards people with mental problems, because of timely, effective and needs-led approach that enables recovery

ANTIPSYCHOTICS SIDE EFFECTS\u27 INFLUENCE ON STIGMA OF MENTAL ILLNESS: FOCUS GROUP STUDY RESULTS

Background: Little research was done on the influence of antipsychotics’ side effects on stigma of mental illness. An overview of studies shows that people with mental illness state that because of medication side effects they feel discriminated in the field of employment, observe worsening of family relations and tend to skip or discontinue their regular medication. It is difficult to discriminate between stigmatizing effects of antipsychotics and other stigma related factors such as illness symptoms. Subjects and methods: A focus group of ten patients with schizophrenia or schizoaffective disorder with severe and remitting mental illness treated with antipsychotic medication was conducted to obtain their personal views on how side effects of antipsychotic drugs affect their everyday lives and contribute to the stigmatization because of mental illness. Results: The patients felt most stigmatized in areas of employment and occupation. They repeatedly skipped or discontinued regular medication due to side effects. Their families supported them throughout treatment and recovery despite problems associated with psychotropic medication. Conclusion: Medication induced stigma affects patients’ lives in substantial ways and therefore merits further research, part of which is the patients’ personal experience

ANTIPSYCHOTICS SIDE EFFECTS\u27 INFLUENCE ON STIGMA OF MENTAL ILLNESS: FOCUS GROUP STUDY RESULTS

Background: Little research was done on the influence of antipsychotics’ side effects on stigma of mental illness. An overview of studies shows that people with mental illness state that because of medication side effects they feel discriminated in the field of employment, observe worsening of family relations and tend to skip or discontinue their regular medication. It is difficult to discriminate between stigmatizing effects of antipsychotics and other stigma related factors such as illness symptoms. Subjects and methods: A focus group of ten patients with schizophrenia or schizoaffective disorder with severe and remitting mental illness treated with antipsychotic medication was conducted to obtain their personal views on how side effects of antipsychotic drugs affect their everyday lives and contribute to the stigmatization because of mental illness. Results: The patients felt most stigmatized in areas of employment and occupation. They repeatedly skipped or discontinued regular medication due to side effects. Their families supported them throughout treatment and recovery despite problems associated with psychotropic medication. Conclusion: Medication induced stigma affects patients’ lives in substantial ways and therefore merits further research, part of which is the patients’ personal experience

PRESCRIBING CHANGES IN ANXIOLYTICS AND ANTIDEPRESSANTS IN SLOVENIA

Background: The ratio of anxiolytics to antidepressants is an indicator of the quality of treatment of depression and anxiety in primary care. The objective of the study was to investigate the prescription of anxiolytics and antidepressants among Slovenian family physicians, including patient demographics and possible time-trends. Subjects and methods: An exploratory survey and register-based analysis of anxiolytic and antidepressant prescriptions in 2005 and 2008 was performed. Drugs included in the study were classified according to an Anatomical-Therapeutic-Chemical (ATC) drug classification system, and ATC data were used to calculate defined daily doses (DDD) per 1,000 practice population per day. Descriptive analysis of anxiolytic/antidepressant ratio by patients’ age, gender and region of residency was performed. Results: Total amount of prescribed antidepressant drugs increased by 45% during the observed 3-year period, while total prescribing of anxiolytics decreased by 14%, leading to the anxiolytics/antidepressants ratio diminishing from 1 to about 0.5. The highest reduction in the ratio was observed in the northeast region, characterised by high social deprivation and one of the highest suicide rates in Europe. The highest prescribing of anxiolytics and antidepressants was observed in the central region around the capital Ljubljana. Conclusions: The reduction of anxiolytic prescribing and increase in antidepressant prescribing indicates improvement in prescribing practice of Slovenian family physicians. There are big variations in prescribing among different Slovenian regions, which are attributable to the number of psychiatrists and access to psychiatric treatment

Mental Health Care

Mental health conceptualize a state of well-being, perceived self efficacy, competence, autonomy, intergenerational dependence and recognition of the ability to realize one's intellectual and emotional potential. Mental health care are services provided to individuals or communities by agents of the health services or professions to promote, maintain, monitor, or restore mental health. Students will become familiar with extensiveness of the problem, and levels of preventing it. It is illustrated by the case of Slovenia

Time Trends in Prescribing Habits of Anxiolytics and Antidepressants in Slovenian Family Practices (with Emphasis on Elderly Patients)

The aim of the study was to investigate prescription of anxiolytics and antidepressants among Slovenian family physicians regarding drug class with an emphasis on the elderly population and possible time-trends. Exploratory survey and register-based analysis of anxiolytic and antidepressant prescriptions of one hundred family physicians in Slovenia was performed in 2005 and 2008. Drugs included in the study were classified according to the Anatomical-Therapeutic- Chemical (ATC) drug classification system, and ATC data were used to calculate defined daily doses (DDD) per 1,000 practice population per day. The most often prescribed anxiolytics and antidepressants were identified and anxiolytic/ antidepressant ratio was estimation by patient age-group for the two studied years. Benzodiazepines showed highest share in the overall utilization of psychotropic drugs. The ratio between short- and long-acting benzodiazepines decreased by about one tenth during the observed period. Long-acting benzodiazepines were prescribed more often to the older patients. The decrease in anxiolytic/antidepressant ratio from 2005 to 2008 was the smallest in the elderly population. Further research is needed to ascertain the prescribers’ attitudes in order to devise strategies to further improve prescribing performance in elderly patients

Mental Health Care

Mental health conceptualize a state of well-being, perceived self efficacy, competence, autonomy, intergenerational dependence and recognition of the ability to realize one's intellectual and emotional potential. Mental health care are services provided to individuals or communities by agents of the health services or professions to promote, maintain, monitor, or restore mental health. Students will become familiar with extensiveness of the problem, and levels of preventing it. It is illustrated by the case of Slovenia