Souliotis Kyriakos, Agapidaki Eirini, Tzavara Chara, Economou Marina
Faculty of Social and Political Sciences, Department of Social and Education Policy, University of Peloponnese, Damaskinou & Kolokotroni Str., 20100 Corinth, Greece.
Health Policy Institute, Athens, Greece.
Int J Ment Health Syst. 2017 Oct 23;11:65. doi: 10.1186/s13033-017-0172-0. eCollection 2017.
Although the need for integration of mental health services into primary care is well established little has been done. The outbreak of the recession found the Greek mental health system in transition. As a response to the crisis, governments implemented horizontal budget cuts instead of health reforms. This resulted in an unfavorable situation for mental health which was set once again on the sidelines of the health policy agenda. Previous studies suggest that the most prevalent disorders in the years of financial crisis in Greece are depression and anxiety while a general increase of the psychiatric morbidity is observed does not follow the population' needs.
The present descriptive study was carried out between March and June of 2015. A convenience sample of 174 psychiatrists and psychiatry residents who met the inclusion criteria were finally selected to participate. Data were collected by using a 40-items questionnaire consisted of three sections: (a) nine questions about demographics, (b) nine questions pertaining to general aspects of administrative regulations related to primary care, (c) 22 questions about psychiatrists attitudes and perceptions towards their role in primary care. Quantitative variables are expressed as mean values, while qualitative variables as absolute and relative frequencies.
The vast majority of participants perceives the public primary care services and mental health services in their community as inadequate and considers psychiatrists' participation in primary care as important in order to improve the detection and management rates of people demonstrating mental health symptoms. They also believe that: (a) primary care practitioners' usually fail to detect the mental health conditions of patients; (b) their participation in primary care will decrease the social stigmatization for mental health conditions; (c) patients receiving pharmaceutical treatment for mental health problems by GPs and other primary care professionals usually fail to comply.
Respondents in the present study are receptive to participate in primary care. They believe that their inclusion to primary care will result to decreased social stigmatization for mental health problems, increased patient' access and improved detection and management rates for common mental health conditions.
尽管将心理健康服务纳入初级保健的必要性已得到充分认可，但相关工作进展甚微。经济衰退爆发时，希腊的心理健康系统正处于转型期。作为对危机的应对措施，政府实施了横向预算削减，而非进行卫生改革。这导致心理健康状况陷入不利局面，再次被置于卫生政策议程的边缘。此前的研究表明，希腊金融危机期间最普遍的疾病是抑郁症和焦虑症，同时观察到精神疾病发病率的普遍上升并未满足民众需求。
本描述性研究于2015年3月至6月进行。最终选取了174名符合纳入标准的精神科医生和精神科住院医师作为便利样本参与研究。通过一份由三个部分组成的40项问卷收集数据：（a）九个关于人口统计学的问题，（b）九个与初级保健行政规定一般方面相关的问题，（c）22个关于精神科医生对其在初级保健中角色的态度和看法的问题。定量变量以平均值表示，而定性变量以绝对和相对频率表示。
绝大多数参与者认为其社区的公共初级保健服务和心理健康服务不足，并认为精神科医生参与初级保健对于提高有心理健康症状者的检出率和管理率很重要。他们还认为：（a）初级保健从业者通常未能察觉患者的心理健康状况；（b）他们参与初级保健将减少对心理健康状况的社会污名化；（c）接受全科医生和其他初级保健专业人员药物治疗的心理健康问题患者通常不遵医嘱。
本研究中的受访者愿意参与初级保健。他们认为将他们纳入初级保健将导致对心理健康问题的社会污名化减少、患者获得服务的机会增加以及常见心理健康状况的检出率和管理率提高。
