Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece.
Postgraduate Program in Social Psychiatry, Democritus University of Thrace, Alexandroupolis, Greece.
Int J Soc Psychiatry. 2022 Mar;68(2):324-333. doi: 10.1177/0020764020985896. Epub 2021 Jan 21.
Mental healthcare service delivery in rural and remote areas in Greece is challenging due to socioeconomic and geographical reasons, and distant facilities. To address the needs of the underserved areas, the Greek state has launched a number of Mobile Mental Health Units (MMHUs).
The objective of the present study was to explore the differences among two MMHUs, one being run by a university general hospital (MMHU UHA) and the other being run by a nongovernmental organization (MMHU I-T).
The two MMHUs deliver services in rural areas of northeast and northwest Greece, respectively. Both MMHUs use the infrastructures of the primary healthcare system and have the potential for domiciliary visits.
Medical and nursing staff is much more in the MMHU UHA, whereas MMHU I-T has more psychologists, social workers and health visitors. Patients attended the MMHU I-T were significantly older than the patients attended the MMHU UHA (mean age 64.5 vs. 55.3 years) and the percentage of the elderly patients in treatment with the MMHU I-T (56.5%) is significantly higher than the corresponding percentage of the MMHU UHA (20%). The proportion of patients that received home-based care by the two MMHUs was almost identical. The percentage of patients with schizophrenia spectrum disorders that attended the MMHU UHA was significantly higher. Patients with affective disorders, anxiety disorders and organic brain disorders that attended the MMHU I-T were significantly more.
Despite the similarities among the MMHUs in rural Greece, this study recorded some important differences. The differences in staffing may be accounted for by the availability of resources. The differences in the patients' population may be explained by the fact that the MMHU UHA was designed from its beginning to treat patients with severe mental illnesses, mainly psychoses, and it accepts loss of referrals within the general hospital's network of psychiatric services. The MMHU I-T is an independent, locally based service that may be better perceived as an expansion of the primary care system. The results of the study could inform service practice and mental health policy.
由于社会经济和地理原因以及设施偏远，希腊农村和偏远地区的精神卫生保健服务提供具有挑战性。为了满足服务不足地区的需求，希腊国家已经启动了多个流动精神卫生单位（MMHU）。
本研究的目的是探讨两个 MMHU 之间的差异，一个由大学综合医院（MMHU UHA）运营，另一个由非政府组织（MMHU I-T）运营。
这两个 MMHU 分别在希腊东北部和西北部的农村地区提供服务。两个 MMHU 都利用初级保健系统的基础设施，并有可能进行家访。
MMHU UHA 的医疗和护理人员要多得多，而 MMHU I-T 则有更多的心理学家、社会工作者和健康访视员。在 MMHU I-T 就诊的患者明显比在 MMHU UHA 就诊的患者年龄大（平均年龄 64.5 岁比 55.3 岁），在 MMHU I-T 接受治疗的老年患者比例（56.5%）明显高于 MMHU UHA（20%）。两个 MMHU 提供家庭护理的患者比例几乎相同。在 MMHU UHA 就诊的精神分裂症谱系障碍患者比例明显更高。在 MMHU I-T 就诊的情感障碍、焦虑障碍和器质性脑障碍患者明显更多。
尽管希腊农村的 MMHU 之间存在相似之处，但本研究记录了一些重要差异。人员配备方面的差异可能是由于资源的可用性造成的。患者人群的差异可以解释为 MMHU UHA 从一开始就设计用于治疗严重精神疾病患者，主要是精神病患者，并接受综合医院网络内精神病服务的转诊损失。MMHU I-T 是一个独立的、基于本地的服务，可能被视为初级保健系统的扩展而被更好地接受。研究结果可以为服务实践和精神卫生政策提供信息。
