Evidence is scarce in terms of tracking the progress of implementation of mental healthcare plans and policies (MHPPs) in Europe, we aimed to map and analyze the content of MHPPs across the WHO European region. We collected data from the WHO Mental Health Atlas 2011, 2017 and 2020 to map the development of MHPPs in the region. We contacted 53 key informants from each country in the European region to triangulate the data from WHO Mental Health Atlases and to obtain access to the national mental health plans and policies. We analyzed the content of MHPPs against the four major objectives of the WHO Comprehensive Mental Health Action Plan, and we also focused on the specificity and measurability of their targets. The number and proportion of countries which have their own MHPPs has increased from 30 (52%) to 43 (91%) between 2011 and 2020. MHPPs are generally in line with the WHO policy, aiming to strengthen care in the community, expand mental health promotion and illness prevention activities, improve quality of care, increase intersectoral collaboration, build workforce and system capacity, and improve adherence to human rights. However, specific, and measurable targets as well as a description of concrete steps, responsibilities and funding sources are mostly missing. They often contain very little information systems, evidence and research, and mostly lack information on evaluating the implementation of MHPPs. Progress has been made in terms of the development of MHPPs in the WHO Europe. However, MHPPs are often lacking operationalization and appropriate data collection for evaluation. This is then reflected in missing evaluation plans, which in turn leads to lessons not being learned. To enhance the potential for knowledge generation and demonstration of impact, MHPPs should be more specific and contain measurable targets with allocated responsibilities and funding as well as evaluation plans.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
The Roma are Europe's largest ethnic minority group, and often face discrimination and social exclusion. Social strife and lack of access to healthcare are associated with increased symptoms of psychopathology. We aimed to review evidence on mental health outcomes and on access to mental healthcare among the Roma population in Europe. We systematically searched five databases (PsycINFO, Global Health, Social Policy and Practice, Web of Science and PubMed) and conducted a grey literature search in August 2020. We identified 133 studies, 26 of which were included for final analysis. We present the results using a narrative synthesis. The available literature indicates a relatively high prevalence of anxiety, depression and substance abuse among Roma, and females seem to be more affected than males. Roma children exhibit more externalizing and internalizing disorders when compared with non-Roma children. Mental health and perceived well-being among the Roma population are strongly linked to social determinants of health such as housing or economic income. Access to mental healthcare is limited for Roma people because of several barriers pertaining to language, lack of information regarding available services, and the insurance and economic status of Roma people. Roma people report mainly negative experiences with mental health services, including a lack of understanding from healthcare providers, and instances of racism and discrimination. There is a need for more research on mental health and access to healthcare in Roma people. Future studies should be participatory in order to provide guidelines for mental healthcare that addresses the needs of the Roma population.
- MeSH
- dítě MeSH
- dostupnost zdravotnických služeb MeSH
- duševní zdraví MeSH
- etnicita psychologie MeSH
- lidé MeSH
- menšiny MeSH
- Romové * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: Evidence suggests reduced survival rates following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in people with preexisting mental disorders, especially psychotic disorders, before the broad introduction of vaccines. It remains unknown whether this elevated mortality risk persisted at later phases of the pandemic and when accounting for the confounding effect of vaccination uptake and clinically recorded physical comorbidities. METHODS AND FINDINGS: We used data from Czech national health registers to identify first-ever serologically confirmed SARS-CoV-2 infections in 5 epochs related to different phases of the pandemic: 1st March 2020 to 30th September 2020, 1st October 2020 to 26th December 2020, 27th December 2020 to 31st March 2021, 1st April 2021 to 31st October 2021, and 1st November 2021 to 29th February 2022. In these people, we ascertained cases of mental disorders using 2 approaches: (1) per the International Classification of Diseases 10th Revision (ICD-10) diagnostic codes for substance use, psychotic, affective, and anxiety disorders; and (2) per ICD-10 diagnostic codes for the above mental disorders coupled with a prescription for anxiolytics/hypnotics/sedatives, antidepressants, antipsychotics, or stimulants per the Anatomical Therapeutic Chemical (ATC) classification codes. We matched individuals with preexisting mental disorders with counterparts who had no recorded mental disorders on age, sex, month and year of infection, vaccination status, and the Charlson Comorbidity Index (CCI). We assessed deaths with Coronavirus Disease 2019 (COVID-19) and from all-causes in the time period of 28 and 60 days following the infection using stratified Cox proportional hazards models, adjusting for matching variables and additional confounders. The number of individuals in matched-cohorts ranged from 1,328 in epoch 1 to 854,079 in epoch 5. The proportion of females ranged from 34.98% in people diagnosed with substance use disorders in epoch 3 to 71.16% in individuals diagnosed and treated with anxiety disorders in epoch 5. The mean age ranged from 40.97 years (standard deviation [SD] = 15.69 years) in individuals diagnosed with substance use disorders in epoch 5 to 56.04 years (SD = 18.37 years) in people diagnosed with psychotic disorders in epoch 2. People diagnosed with or diagnosed and treated for psychotic disorders had a consistently elevated risk of dying with COVID-19 in epochs 2, 3, 4, and 5, with adjusted hazard ratios (aHRs) ranging from 1.46 [95% confidence intervals (CIs), 1.18, 1.79] to 1.93 [95% CIs, 1.12, 3.32]. This patient group demonstrated also a consistently elevated risk of all-cause mortality in epochs 2, 3, 4, and 5 (aHR from 1.43 [95% CIs, 1.23, 1.66] to 1.99 [95% CIs, 1.25, 3.16]). The models could not be reliably fit for psychotic disorders in epoch 1. People diagnosed with substance use disorders had an increased risk of all-cause mortality 28 days postinfection in epoch 3, 4, and 5 (aHR from 1.30 [95% CIs, 1.14, 1.47] to 1.59 [95% CIs, 1.19, 2.12]) and 60 days postinfection in epoch 2, 3, 4, and 5 (aHR from 1.22 [95% CIs, 1.08, 1.38] to 1.52 [95% CIs, 1.16, 1.98]). Cases ascertained based on diagnosis of substance use disorders and treatment had increased risk of all-cause mortality in epoch 2, 3, 4, and 5 (aHR from 1.22 [95% CIs, 1.03, 1.43] to 1.91 [95% CIs, 1.25, 2.91]). The models could not be reliably fit for substance use disorders in epoch 1. In contrast to these, people diagnosed with anxiety disorders had a decreased risk of death with COVID-19 in epoch 2, 3, and 5 (aHR from 0.78 [95% CIs, 0.69, 0.88] to 0.89 [95% CIs, 0.81, 0.98]) and all-cause mortality in epoch 2, 3, 4, and 5 (aHR from 0.83 [95% CIs, 0.77, 0.90] to 0.88 [95% CIs, 0.83, 0.93]). People diagnosed and treated for affective disorders had a decreased risk of both death with COVID-19 and from all-causes in epoch 3 (aHR from 0.87 [95% CIs, 0.79, 0.96] to 0.90 [95% CIs, 0.83, 0.99]), but demonstrated broadly null effects in other epochs. Given the unavailability of data on a number of potentially influential confounders, particularly body mass index, tobacco smoking status, and socioeconomic status, part of the detected associations might be due to residual confounding. CONCLUSIONS: People with preexisting psychotic, and, less robustly, substance use disorders demonstrated a persistently elevated risk of death following SARS-CoV-2 infection throughout the pandemic. While it cannot be ruled out that part of the detected associations is due to residual confounding, this excess mortality cannot be fully explained by lower vaccination uptake and more clinically recorded physical comorbidities in these patient groups.
- MeSH
- Betacoronavirus MeSH
- COVID-19 * mortalita epidemiologie komplikace MeSH
- dospělí MeSH
- duševní poruchy * epidemiologie MeSH
- kohortové studie MeSH
- komorbidita MeSH
- koronavirové infekce mortalita epidemiologie komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- pandemie * MeSH
- příčina smrti MeSH
- registrace MeSH
- SARS-CoV-2 * MeSH
- senioři MeSH
- virová pneumonie mortalita epidemiologie komplikace MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Stigmatizace duševních onemocnění je v České republice stále rozšířená. Iniciativa NA ROVINU vznikla v rámci implementace reformy péče o duševní zdraví a zaměřuje se na vytvoření destigmatizačních vzdělávacích programů pro šest předdefinovaných cílových skupin: uživatelé služeb péče o duševní zdraví, jejich rodinní příslušníci, zdravotníci, poskytovatelé sociálních služeb, úřady veřejné správy a komunity, které jsou v těsné blízkosti nově vybudovaných komunitních center pro duševní zdraví. Pro vytvoření konkrétních programů byla provedena situační analýza. Ta zahrnovala prozkoumání potřeb u každé cílové skupiny, mapování současných a minulých destigmatizačních programů v České republice a přehled světové literatury. Na základě toho byly vytvořeny a následně pilotovány programy pro každou cílovou skupinu. Za účelem evaluace byla sbírána kvalitativní a kvantitativní data. Kvalitativní data ve formě skupinových diskusí ukázala, že programy jsou přijatelné a použitelné pro dané cílové skupiny. Také na základě shromážděných kvalitativních údajů byly do programů implementovány změny. Implementace programů probíhá i nadále.
Stigma related to mental health is still widespread in the Czech Republic. The ON THE LEVEL initiative was created as part of the ongoing implementation of the mental health care reform in the Czech Republic and focuses on creating destigmatizing educational programs for six predefined target groups: users of mental health services, their family members, health professionals, social service providers, public office employees and communities that are in close proximity to the newly built community mental health centers. A situational analysis was undertaken to create the specific programs. This included an examination of the needs of each target group, a mapping of current and past destigmatization programs in the Czech Republic, and an overview of world literature. Based on this, programs were created and subsequently piloted for each target group. At the same time, qualitative and quantitative data were collected for evaluation purposes. Qualitative data in the form of focus group observations showed that the programs are acceptable and applicable to the target groups. On the basis of collected qualitative data, necessary changes were made to the programs. Implementation of programs is still ongoing.
PURPOSE: To describe temporal trends in inpatient care use for adult mental disorders in Czechia from 1994 until 2015. METHODS: Data from the nationwide register of inpatient care use and yearly census data were used to calculate (a) yearly admissions rates, (b) median length of stay, and (c) standardized inpatient-years for adult mental disorders (ICD-10 codes F0-F6] or G30). Segmented regressions were used to analyze age- and sex-specific temporal trends. RESULTS: Admission rates were increasing in adults (average annual percent change = 0.51; 95% confidence interval = 0.16 to 0.86 for females and 1.01; 0.63 to 1.40 for males) and adolescents and emerging adults (3.27; 2.57 to 3.97 for females and 2.98; 2.08 to 3.88 for males), whereas in seniors, the trend was stable (1.22; -0.31 to 2.73 for females and 1.35; -0.30 to 2.98 for males). The median length of stay for studied mental disorders decreased across all age and sex strata except for a stable trend in male adolescents and emerging adults (-0.96; -2.02 to 0.10). Standardized inpatient-years were decreasing in adults of both sexes (-0.85; -1.42 to -0.28 for females and -0.87; -1.19 to -0.56 for males), increasing in female adolescents and emerging adults (0.95; 0.42 to 1.47), and stable in the remaining strata. CONCLUSION: Psychiatric hospital admissions were increasing or stable coupled with considerable reductions in median length of stay, suggesting that inpatient episodes for adult mental disorders have become more frequent and shorter over time. The overall psychiatric inpatient care use was decreasing or stable in adults and seniors, potentially implying a gradual shift away from hospital-based care.
- MeSH
- délka pobytu * statistika a číselné údaje MeSH
- dospělí MeSH
- duševní poruchy * terapie epidemiologie MeSH
- hospitalizace * statistika a číselné údaje trendy MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- pacienti hospitalizovaní * statistika a číselné údaje MeSH
- příjem pacientů statistika a číselné údaje trendy MeSH
- registrace * MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Mental health literacy (MHL) grows in importance as the prevalence of mental health conditions rises worldwide. There is a need for valid MHL measures especially among adolescents. The current study aims to develop and validate a Universal mental health literacy scale for adolescents (UMHL-A), a self report scale to assess MHL of children between ages 10 and 14 across all four components within Kutcher's framework for MHL. The development of the UMHL-A was initiated by a literature review and followed by item generation. Then, we tested the face and content validity of the scale via a delphi study, focus groups and cognitive interviews with the target group. Next with a convenience sample, we established the factor structure and construct validity of the scale using exploratory and confirmatory factor analyses. Lastly, we tested the scale convergent validity with other measures. The final form of the scale was refined on a representative sample of Czech asolescents. The UMHL-A scale comprises 17 items measuring four components of MHL. The scale has substantial methodological advantages in comparison to existing measures of MHL, especially considering its brevity and comprehensive coverage of MHL. Further studies are needed to test its application and validity globally.
- MeSH
- dítě MeSH
- duševní poruchy * psychologie MeSH
- duševní zdraví MeSH
- lidé MeSH
- mladiství MeSH
- psychometrie MeSH
- reprodukovatelnost výsledků MeSH
- zdravotní gramotnost * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
This study investigated the Czech adults' mental health following the COVID-19 pandemic and the potential influence of data collection methodology on prevalence estimates. Separately, it investigated changes in help-seeking and associated barriers. Data from representative surveys on Czech adults, conducted in November 2017 (n = 3,306), in May (n = 3,021) and November 2020 (n = 3,000), and in November and December 2022 (n = 7,311), were used. Current mental disorders were assessed by the Mini International Neuropsychiatric Interview, and the treatment gap was established in individuals scoring positively. In help-seeking individuals, encountering barriers was investigated. In 2017 and 2022, 20.02 % and 27.22 % of individuals had at least one mental disorder, respectively. The 2022 panel sampling and online and telephone interviewing estimates (34.29 % and 26.7 %) were substantially higher than those from household sampling and personal interviewing (19.9 %). Prevalence rates based on household sampling and personal interviewing were broadly consistent in 2017 and 2022. The treatment gap was around 80 % from 2017 to 2022. More than 50 % of individuals encountered structural barriers in help-seeking in 2022. This study showed that prevalence rates were still elevated in 2022, but suggests that data collection methodology influenced the estimates. Separately, the treatment gap remained consistently very high, and encountering structural barriers in help-seeking was common.
- MeSH
- COVID-19 * epidemiologie MeSH
- dospělí MeSH
- duševní poruchy * psychologie MeSH
- duševní zdraví MeSH
- lidé MeSH
- pandemie MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: We aimed to screen Ukrainian war refugees (UWR) in Czechia for depression and anxiety, and to assess their recognition of personal mental health problems and related help-seeking. METHODS: We conducted a cross-sectional study on a sample of UWR in Czechia. We used PHQ-8 and GAD-7 to screen for depression and anxiety, SELF-I to assess the recognition of respondents' own mental health problems, and a set of questions regarding mental health-related help-seeking. FINDINGS: Our sample consisted of 1,347 UWR. More than 41 % of respondents screened positively for moderate or severe depression and more than 23 % for moderate or severe anxiety. Self-recognition of mental health as well as help-seeking was very low among those who screened positively for moderate or severe depression or anxiety. INTERPRETATION: Even those UWR who report severe symptoms do not identify themselves as potentially having mental health issues and are not seeking help.
- MeSH
- deprese epidemiologie psychologie MeSH
- duševní zdraví * MeSH
- lidé MeSH
- průřezové studie MeSH
- uprchlíci * psychologie MeSH
- úzkost epidemiologie psychologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
AIM: The aim of the study was to evaluate fidelity in first episode psychosis (FEP) teams in Czechia and to gage the feasibility and utility of the process in a mental health system that is undergoing a transformation. METHODS: Fidelity assessment was conducted using The First Episode Psychosis Services Fidelity Scale (FEPS-FS). Fidelity assessment was based on a review of data abstracted from the health records of active clients, program documents, administrative data, and interviews with members of staff. The mean scores were compared across the teams. Feasibility and utility were assessed by program response to their fidelity results. RESULTS: Three FEP teams were involved in the fidelity assessment. Across the 35 items, the mean fidelity score ranged from 2.5 to 3.1. Across the FEP teams, the percentage of the 35 items rated as 4 or 5 (satisfactory or exemplary) ranged from 34.3% to 51.4%. CONCLUSIONS: This study provided an opportunity to implement FEPS-FS and assess fidelity in FEP teams in Czechia. The fidelity assessment also provided a baseline for measuring change.
- MeSH
- lidé MeSH
- pilotní projekty MeSH
- psychotické poruchy * diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
We describe the development and provision of a digital mental health intervention and trauma support platform for victims of political and social repression in Belarus. The Samopomoch platform provides secure and effective support tailored to the needs of such victims, and individuals are provided with access to the service via a modern, encrypted, and protected communication platform. The service involves personal health tracking (e-mental health self-screening), targeted and untargeted client communication (psychoeducation and self-help information), and psychological counselling sessions. The Samopomoch platform is also collecting evidence to show the effectiveness of the service and proposes a model for replication in similar settings. To our knowledge, this is the first immediate digital mental health-care response to a political crisis, and the high needs and increasing demand for this service within the targeted population indicate the necessity for its continuation and scaling-up. We urge policy makers to provide immediate responses for establishing digital mental health interventions and psychological trauma support.
