Peritogiannis Vaios, Manthopoulou Thiresia, Gogou Afroditi, Mavreas Venetsanos
Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece.
Department of Psychiatry, School of Medicine, University of Ioannina, Ioannina, Greece.
J Neurosci Rural Pract. 2017 Oct-Dec;8(4):556-561. doi: 10.4103/jnrp.jnrp_142_17.
Patients living in rural and remote areas may have limited access to mental healthcare due to lack of facilities and socioeconomic reasons, and this is the case of rural areas in Eastern Europe countries. In Greece, community mental health service delivery in rural areas has been implemented through the development of the Mobile Mental Health Units (MMHUs).
We present a 10-year account of the operation of the MMHU of the prefectures of Ioannina and Thesprotia (MMHU I-T) and report on the impact of the service on mental health delivery in the catchment area. The MMHU I-T is a multidisciplinary community mental health team which delivers services in rural and mountainous areas of Northwest Greece.
The MMHU I-T has become an integral part of the local primary care system and is well known to the population of the catchment area. By the end of 2016, the majority of patients (60%) were self-referred or family-referred, compared to 24% in the first 2 years. Currently, the number of active patients is 293 (mean age 63 years, 49.5% are older adults), and the mean caseload for each member of the team is 36.6. A significant proportion of patients (28%) receive care with regular domiciliary visits, and the provision of home-based care was correlated with the age of the patients. Within the first 2 years of operation of the MMHU I-T hospitalizations of treatment, engaged patients were reduced significantly by 30.4%, whereas the treatment engagement rates of patients with psychotic disorders were 67.2% in 5 years.
The MMHU I-T and other similar units in Greece are a successful paradigm of a low-cost service which promotes mental health in rural, remote, and deprived areas. This model of care may be informative for clinical practice and health policy given the ongoing recession and health budget cuts. It suggests that rural mental healthcare may be effectively delivered by integrating generic community mental health mobile teams into the primary care system.
由于缺乏设施和社会经济原因，生活在农村和偏远地区的患者获得心理保健服务的机会可能有限，东欧国家的农村地区就是这种情况。在希腊，通过设立流动心理健康单位（MMHU）来实施农村地区的社区心理健康服务。
我们介绍了约阿尼纳州和塞斯普罗蒂亚州MMHU（MMHU I-T）十年的运营情况，并报告了该服务对其服务区域内心理健康服务的影响。MMHU I-T是一个多学科社区心理健康团队，在希腊西北部的农村和山区提供服务。
MMHU I-T已成为当地初级保健系统不可或缺的一部分，并且在服务区域内广为人知。到2016年底，大多数患者（60%）是自我转诊或由家人转诊的，而在最初两年这一比例为24%。目前，活跃患者人数为293人（平均年龄63岁，49.5%为老年人），团队中每位成员的平均工作量为36.6。相当一部分患者（28%）通过定期上门访视接受护理，提供居家护理与患者年龄相关。在MMHU I-T运营的头两年内，接受治疗的患者住院率显著降低了30.4%，而患有精神障碍的患者在5年内的治疗参与率为67.2%。
MMHU I-T以及希腊的其他类似单位是低成本服务的成功范例，可促进农村、偏远和贫困地区的心理健康。鉴于当前的经济衰退和卫生预算削减，这种护理模式可能对临床实践和卫生政策具有参考价值。这表明，通过将通用社区心理健康流动团队纳入初级保健系统，可以有效地提供农村心理保健服务。
