51
|
Krupchanka D, Winkler P. State of mental healthcare systems in Eastern Europe: do we really understand what is going on? BJPsych Int 2018; 13:96-99. [PMID: 29093919 PMCID: PMC5619493 DOI: 10.1192/s2056474000001446] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The article examines the current state of mental healthcare systems in countries of Eastern Europe and derives implications for future research and service development. Analysis of available statistics from the World Health Organization’s Mental Health Atlas suggests the need for better-quality data collection. Nonetheless, there appear to be insufficient resources allocated to mental health, lack of involvement of service users in policy-making and, to a large extent, systems continue to rely on mental hospitals. Based on the data presented, a set of directions for future reforms was drafted.
Collapse
|
52
|
Winkler P, Janoušková M, Kožený J, Pasz J, Mladá K, Weissová A, Tušková E, Evans-Lacko S. Short video interventions to reduce mental health stigma: a multi-centre randomised controlled trial in nursing high schools. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1549-1557. [PMID: 29101447 DOI: 10.1007/s00127-017-1449-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/22/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND We aimed to assess whether short video interventions could reduce stigma among nursing students. METHODS A multi-centre, randomised controlled trial was conducted. Participating schools were randomly selected and randomly assigned to receive: (1) an informational leaflet, (2) a short video intervention or (3) a seminar involving direct contact with a service user. The Community Attitudes towards Mental Illness (CAMI) and Reported and Intended Behaviour Scale (RIBS) were selected as primary outcome measures. SPANOVA models were built and Cohen's d calculated to assess the overall effects in each of the trial arms. RESULTS Compared to the baseline, effect sizes immediately after the intervention were small in the flyer arm (CAMI: d = 0.25; RIBS: d = 0.07), medium in the seminar arm (CAMI: d = 0.61; RIBS: d = 0.58), and medium in the video arm (CAMI: d = 0.49 RIBS: d = 0.26; n = 237). Effect sizes at the follow-up were vanishing in the flyer arm (CAMI: d = 0.05; RIBS: d = 0.04), medium in the seminar arm (CAMI: d = 0.43; RIBS: d = 0.26; n = 254), and small in the video arm (CAMI: d = 0.22 RIBS: d = 0.21; n = 237). CONCLUSION Seminar had the strongest and relatively stable effect on students' attitudes and intended behaviour, but the effect of short video interventions was also considerable and stable over time. Since short effective video interventions are relatively cheap, conveniently accessible and easy to disseminate globally, we recommend them for further research and development.
Collapse
|
53
|
Winkler P, Krupchanka D, Roberts T, Kondratova L, Machů V, Höschl C, Sartorius N, Van Voren R, Aizberg O, Bitter I, Cerga-Pashoja A, Deljkovic A, Fanaj N, Germanavicius A, Hinkov H, Hovsepyan A, Ismayilov FN, Ivezic SS, Jarema M, Jordanova V, Kukić S, Makhashvili N, Šarotar BN, Plevachuk O, Smirnova D, Voinescu BI, Vrublevska J, Thornicroft G. A blind spot on the global mental health map: a scoping review of 25 years' development of mental health care for people with severe mental illnesses in central and eastern Europe. Lancet Psychiatry 2017; 4:634-642. [PMID: 28495549 DOI: 10.1016/s2215-0366(17)30135-9] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/14/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
Just over 25 years have passed since the major sociopolitical changes in central and eastern Europe; our aim was to map and analyse the development of mental health-care practice for people with severe mental illnesses in this region since then. A scoping review was complemented by an expert survey in 24 countries. Mental health-care practice in the region differs greatly across as well as within individual countries. National policies often exist but reforms remain mostly in the realm of aspiration. Services are predominantly based in psychiatric hospitals. Decision making on resource allocation is not transparent, and full economic evaluations of complex interventions and rigorous epidemiological studies are lacking. Stigma seems to be higher than in other European countries, but consideration of human rights and user involvement are increasing. The region has seen respectable development, which happened because of grassroots initiatives supported by international organisations, rather than by systematic implementation of government policies.
Collapse
|
54
|
Winkler P, Trausnitz A, Schroettner J, Apfolter A, Kapp K. EP-1533: Modulation complexity assessment in VMAT plans from different treatment planning systems. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31968-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
55
|
Haas S, Weigl M, Winkler P. Frühe Hilfen für Familien mit Migrationshintergrund. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
56
|
Zalsman G, Hawton K, Wasserman D, van Heeringen K, Arensman E, Sarchiapone M, Carli V, Höschl C, Winkler P, Balazs J, Purebl G, Kahn JP, Sáiz PA, Bobes J, Cozman D, Hegerl U, Rancāns E, Hadlaczky G, Van Audenhove C, Hermesh H, Sisask M, Peschayan AM, Kapusta N, Adomaitiene V, Steibliene V, Kosiewska I, Rozanov V, Courtet P, Zohar J. Evidence-based national suicide prevention taskforce in Europe: A consensus position paper. Eur Neuropsychopharmacol 2017; 27:418-421. [PMID: 28161247 DOI: 10.1016/j.euroneuro.2017.01.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 01/18/2017] [Indexed: 11/24/2022]
|
57
|
Krupchanka D, Kruk N, Sartorius N, Davey S, Winkler P, Murray J. Experience of stigma in the public life of relatives of people diagnosed with schizophrenia in the Republic of Belarus. Soc Psychiatry Psychiatr Epidemiol 2017; 52:493-501. [PMID: 28251244 DOI: 10.1007/s00127-017-1365-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 02/16/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Mental health-related stigma affects people with mental disorders and their families. We aimed to investigate the experience of stigma among relatives of patients with schizophrenia in Belarus and formulate recommendations for anti-stigma interventions. METHODS We conducted and thematically analysed 20 interviews with relatives of people diagnosed with schizophrenia. Experience of discrimination, strategies to cope with it, and requests for interventions were examined. RESULTS A number of themes related to the experience of stigma in the public life of relatives of people with schizophrenia were elicited in relation to: (1) mental health care (difficulties in contacting mental health professionals; in getting appropriate information; lack of alternatives to hospital treatment; absence of appropriate long-term care services); (2) employment of people living with schizophrenia and (3) contact with the police. Analysis of the strategies used to overcome difficulties revealed resignation and passive acceptance, self-reliance, and emotional containment during crises. Despite the passivity and scepticism in expressing needs, participants suggested a number of interventions that could reduce the burden of stigma. CONCLUSIONS With respect to the public domain of life, substantial stigma and discrimination perceived by families of people living with schizophrenia in Belarus is associated with structural issues of the country's mental health care system. To reduce the stigma-related burden, action must be taken to: (1) educate and support families and (2) deal with structural issues, by reorganising mental health services to better meet the needs of the families of people diagnosed with schizophrenia, and by including them in decision making at all levels.
Collapse
|
58
|
Janoušková M, Tušková E, Weissová A, Trančík P, Pasz J, Evans-Lacko S, Winkler P. Can video interventions be used to effectively destigmatize mental illness among young people? A systematic review. Eur Psychiatry 2017; 41:1-9. [PMID: 28049074 DOI: 10.1016/j.eurpsy.2016.09.008] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 09/20/2016] [Accepted: 09/28/2016] [Indexed: 12/30/2022] Open
Abstract
Video is considered to be an effective, easy to use tool employed in anti-stigma interventions among young people. Mass media has been shown to be effective for reducing stigma; however, there is insufficient evidence to determine the destigmatization effects of videos specifically. This article systematically reviews the effectiveness of video intervention in reducing stigma among young people between 13 and 25 years. We searched 13 electronic databases including randomized controlled trials, cluster randomized controlled trials, and controlled before and after studies. Of the 1426 abstracts identified, 23 studies (reported in 22 papers) met the inclusion criteria. Video interventions led to improvements in stigmatising attitudes. Video was found to be more effective than other interventions, such as classical face-to-face educational sessions or simulation of hallucinations. According to results of two studies, social contact delivered via video achieved similar destigmatization effect to that delivered via a live intervention. Although the quality of studies as well as the form of video interventions varied, the findings suggest that video is a promising destigmatization tool among young people; however, more studies in this area are needed. There was a lack of evidence for interventions outside of school environments, in low- and middle-income countries, and studies, which looked at long-term outcomes or measured impact on actual behaviour and implicit attitudes. The review generates recommendations for video interventions targeted at young people.
Collapse
|
59
|
Haas S, Weigl M, Unger T, Winkler P, Sagerschnig S, Anzenberger J, Juraszovich B, Gruber G. Can early childhood intervention networks support health equity? Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw173.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
60
|
Winkler P. Author's reply. Br J Psychiatry 2016; 209:350. [PMID: 27698219 DOI: 10.1192/bjp.209.4.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
61
|
Winkler P, Mladá K, Janoušková M, Weissová A, Tušková E, Csémy L, Evans-Lacko S. Attitudes towards the people with mental illness: comparison between Czech medical doctors and general population. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1265-73. [PMID: 27357820 DOI: 10.1007/s00127-016-1263-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 06/22/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE Stigma among health care professionals is detrimental to the life of those with mental health problems. In the region of post-communist Europe, the level of stigma among health care providers remains understudied. We aimed to compare attitudes towards people with mental illness between Czech medical doctors and the general population. METHODS The Community Attitudes towards Mentally Ill (CAMI) scale was used to measure stigmatizing attitudes among a nationally representative sample of (1) adults residing in the Czech Republic (n = 1810) and (2) Czech medical doctors (n = 1200). Descriptive statistics and multivariable linear regression were used to assess differences between both samples. RESULTS Compared to the general adult population in the Czech Republic, Czech medical doctors demonstrated less stigmatizing attitudes toward people with mental illness in 26 of the 27 CAMI items as well as in the total CAMI score. Medical doctors, however, were more likely to consider mental hospitals as an up-to-date method of treating people with mental illness. CONCLUSIONS Our findings demonstrate more favourable attitudes towards people with mental illness among Czech medical doctors when compared to the Czech general population. Stigma, however, is high among both these groups.
Collapse
|
62
|
Winkler P, Mladá K, Krupchanka D, Agius M, Ray MK, Höschl C. Long-term hospitalizations for schizophrenia in the Czech Republic 1998-2012. Schizophr Res 2016; 175:180-185. [PMID: 27094718 DOI: 10.1016/j.schres.2016.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 04/01/2016] [Accepted: 04/09/2016] [Indexed: 11/30/2022]
Abstract
Deinstitutionalization has not been pursued in the post-communist Europe until recently. The population of psychiatric patients institutionalized in the regional mental hospitals is, however, largely understudied. The aim of this study is to assess discharges of long-term inpatients with schizophrenia from Czech psychiatric hospitals and to analyse re-hospitalizations within this group. The nationwide register of all-cause inpatient hospitalizations was merged with the nationwide register of all-cause deaths on an individual level basis. Descriptive statistics, survival analysis and logistic regression were performed. 3601 patients with schizophrenia previously hospitalized for more than a year were discharged from Czech mental hospitals between 1998 and 2012. This included 260 patients hospitalized for >20years. Nearly one fifth (n=707) of the long-term patients died during the hospitalization; and discharges of 19.36% (n=697) were only administrative in their nature. Out of 2197 truly discharged patients, 14.88% (n=327) were re-hospitalized within 2weeks after the discharge. The highest odds of rehospitalization were associated with being discharged against medical advice (OR 5.27, CI: 3.77-7.35, p<0.001). These data are important for the ongoing mental health care reforms in the Czech Republic and other countries in the Central and Eastern Europe.
Collapse
|
63
|
Winkler P, Barrett B, McCrone P, Csémy L, Janous̆ková M, Höschl C. Deinstitutionalised patients, homelessness and imprisonment: systematic review. Br J Psychiatry 2016; 208:421-8. [PMID: 27143007 DOI: 10.1192/bjp.bp.114.161943] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 10/12/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Reports linking the deinstitutionalisation of psychiatric care with homelessness and imprisonment have been published widely. AIMS To identify cohort studies that followed up or traced back long-term psychiatric hospital residents who had been discharged as a consequence of deinstitutionalisation. METHOD A broad search strategy was used and 9435 titles and abstracts were screened, 416 full articles reviewed and 171 articles from cohort studies of deinstitutionalised patients were examined in detail. RESULTS Twenty-three studies of unique populations assessed homelessness and imprisonment among patients discharged from long-term care. Homelessness and imprisonment occurred sporadically; in the majority of studies no single case of homelessness or imprisonment was reported. CONCLUSIONS Our results contradict the findings of ecological studies which indicated a strong correlation between the decreasing number of psychiatric beds and an increasing number of people with mental health problems who were homeless or in prison.
Collapse
|
64
|
Winkler P, Horáček J, Weissová A, Šustr M, Brunovský M. Physical Comorbidities in Depression Co-Occurring with Anxiety: A Cross Sectional Study in the Czech Primary Care System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15728-38. [PMID: 26690458 PMCID: PMC4690951 DOI: 10.3390/ijerph121215015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/30/2015] [Accepted: 12/07/2015] [Indexed: 11/16/2022]
Abstract
Comorbidities associated with depression have been researched in a number of contexts. However, the epidemiological situation in clinical practice is understudied, especially in the post-Communist Central and Eastern Europe region. The aim of this study was to assess physical comorbidities in depression, and to identify whether there are increased odds of physical comorbidities associated with co-occurring depressive and anxiety disorders. Data on 4264 patients aged 18–98 were collected among medical doctors in the Czech Republic between 2010 and 2011. Descriptive statistics were calculated and multiple logistic regressions were performed to assess comorbidities among patients with depressive disorder. There were 51.29% of those who have a physical comorbidity, and 45.5% of those who have a comorbid anxiety disorders among patients treated with depression in Czech primary care. Results of logistic regressions show that odds of having pain, hypertension or diabetes mellitus are particularly elevated at those who have co-occurring depressive and anxiety disorder. Our findings demonstrate that comorbidities associated with depressive disorders are highly prevalent in primary health care practice, and that physical comorbidities are particularly frequent among those with co-occurring depressive and anxiety disorders.
Collapse
|
65
|
Haas S, Weigl M, Winkler P, Sagerschnig S, Knaller C, Gruber G. Early Childhood Networks - Strategy and implementation in Austria. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv173.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
66
|
Haas S, Weigl M, Winkler P, Sagerschnig S, Knaller C, Gruber G. Early Childhood Networks – Strategy and implementation in Austria. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
67
|
Winkler P, Mladá K, Csémy L, Nechanská B, Höschl C. Suicides following inpatient psychiatric hospitalization: A nationwide case control study. J Affect Disord 2015; 184:164-9. [PMID: 26093829 DOI: 10.1016/j.jad.2015.05.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 05/19/2015] [Accepted: 05/19/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Research shows the elevated risk of suicide associated with current or recent inpatient psychiatric hospitalization. However, it is unclear whether this applies in the area of post-communist Central and Eastern Europe where mental health care has not been deinstitutionalized yet. The present study aims to examine the rates of suicides among psychiatric patients during and shortly after discharge from inpatient hospitalization in the Czech Republic. METHODS All inpatient psychiatric hospitalizations and all suicides committed between 2008 and 2012 have been merged on an individual data basis. The time horizon between the admission and two months after the discharge from inpatient psychiatric facility was utilized and multiple logistic regression was performed to calculate the odds of committing suicide. RESULTS A total of 137,290 inpatients were hospitalized in Czech psychiatric facilities between 2008 and 2012, and 402 of the inpatients committed suicide during the hospitalization or within the 2 months after the discharge. Highly elevated risks of suicides were found to be associated with being a male, having a history of multiple hospitalizations, and having a diagnosis of affective, anxiety, or personality disorder. LIMITATIONS Limitations are related to the design of the study, and its reliance on routinely collected data. Also, it was not possible to assess the odds of suicide associated with inpatient psychiatric hospitalization against the odds of suicide in general population. CONCLUSIONS During psychiatric treatment and recovery, suicial behavior and idealiation is increased. In psychiatry, hospitalization may be a risky period for suicide behavior. Suicide rates during and soon after the psychiatric hospitalization identified in this study from Central and Eastern Europe are similar to the findings from Western Europe. Preventive strategies should be tailored accordingly.
Collapse
|
68
|
Sherif C, Al-Shameri A, Baltsavias G, Winkler P, Lunzer M, Kral M, Machegger L, Weymayr F, Emich S, Richling B. Computerized Angiographic Occlusion Rating for Ruptured Clipped Aneurysms is Superior to Subjective Estimation. J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
69
|
Al-Schameri AR, Baltsavias G, Winkler P, Lunzer M, Kral M, Machegger L, Weymayr F, Emich S, Sherif C, Richling B. Computerized Angiographic Occlusion Rating for Ruptured Clipped Aneurysms is Superior to Subjective Occlusion Rating. AJNR Am J Neuroradiol 2015; 36:1704-9. [PMID: 26228876 DOI: 10.3174/ajnr.a4399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/14/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The computerized occlusion rating to estimate angiographic occlusion of embolized aneurysms is superior to the subjective occlusion rating. In this study, we compared the 2 methods in the analysis of aneurysms clipped after subarachnoid hemorrhage. MATERIALS AND METHODS The pre- and postoperative angiographic images (DSA) of 95 selected patients were analyzed and stratified in 4 grades (grade 0 for 100%, grade I for <99%-90%, grade II for <89%-70%, grade III for <70% occlusion) by using the subjective (angiographic) occlusion rating and the computerized (angiographic) occlusion rating. For the subjective occlusion rating, the occlusion rate was estimated; for the computerized occlusion rating, the "occluded" and "nonoccluded" aneurysm areas were automatically calculated in square millimeters after outlining the ideal occlusion line. RESULTS With the subjective occlusion rating, 75 (78.9%), 12 (12.6%), 7 (7.4%), and 1 (1.1%) and with the computerized occlusion rating 45 (47.4%), 24 (25.3%), 20 (21.0%), and 6 (6.3%) patients had aneurysms stratified to grades 0, I, II and III, respectively. The interobserver variation was significant with the subjective occlusion rating but not with the computerized occlusion rating. The subjective occlusion rating overestimated aneurysm occlusion in 30 (31.6%) patients. Mean values were the following: subjective occlusion rating of 97.5 ± 6.3% and computerized occlusion rating of 93.5 ± 9.7%; P = < .001. No patient rebled, and 4 patients underwent retreatment during 36 ± 38.9 months; the predictive value (log-rank, Kaplan-Meier) of the subjective and computerized occlusion ratings with respect to retreatment was highly significant for both methods (subjective occlusion rating: χ(2), 29.65; P < .001; computerized occlusion rating: χ(2), 35.57, P < .001). CONCLUSIONS The 2 methods showed remarkable differences in the estimation of the angiographic occlusion rates of clipped aneurysms. The clearly lower interobserver variation of the computerized versus subjective occlusion rating may indicate a superiority of the computerized occlusion rating.
Collapse
|
70
|
Winkler P, Csémy L, Janoušková M, Mladá K, Bankovská Motlová L, Evans-Lacko S. Reported and Intended Behaviour Towards Those With Mental Health Problems in the Czech Republic and England. Eur Psychiatry 2015; 30:801-6. [DOI: 10.1016/j.eurpsy.2015.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 05/04/2015] [Accepted: 05/11/2015] [Indexed: 11/29/2022] Open
Abstract
AbstractThis is one of the first studies, which compares the level of stigmatizing behaviour in countries that used to be on the opposite sides of the Iron Curtain. The aim was to identify the prevalence of reported and intended stigmatizing behaviour towards those with mental health problems in the Czech Republic and to compare these findings with the findings from England. The 8-item Reported and Intended Behaviour Scale (RIBS) was used to assess stigmatising behaviour among a representative sample of the Czech population (n = 1797). Results were compared with the findings of an analogous survey from England (n = 1720), which also used the RIBS. The extent of reported behaviour (i.e., past and present experiences with those with mental health problems) was lower in the Czech Republic than in England. While 12.7% of Czechs reported that they lived, 12.9% that they worked, and 15.3% that they were acquainted with someone who had mental health problems, the respective numbers for England were 18.5%, 26.3% and 32.5% (P < 0.001 in each of these items). On the other hand, the extent of intended stigmatizing behaviour towards those with mental health problems is considerably higher in the Czech Republic. Out of maximum 20 points attached to possible responses to the RIBS items 5–8, Czechs had a lower total score (x = 11.0, SD = 4.0) compared to English respondents (x = 16.1, SD = 3.6), indicating lower willingness to accept a person with mental health problems (P < 0.001). The prevalence of stigmatizing behaviour in the Czech Republic is worrying. Both, further research and evidence based anti-stigma interventions, should be pursued in order to better understand and decrease stigmatizing behaviour in the Czech Republic and possibly across the post-communist countries in Central and Eastern Europe.
Collapse
|
71
|
Fountoulakis KN, Kawohl W, Theodorakis PN, Kerkhof AJFM, Navickas A, Höschl C, Lecic-Tosevski D, Sorel E, Rancans E, Palova E, Juckel G, Isacsson G, Jagodic HK, Botezat-Antonescu I, Warnke I, Rybakowski J, Azorin JM, Cookson J, Waddington J, Pregelj P, Demyttenaere K, Hranov LG, Stevovic LI, Pezawas L, Adida M, Figuera ML, Pompili M, Jakovljević M, Vichi M, Perugi G, Andreassen O, Vukovic O, Mavrogiorgou P, Varnik P, Bech P, Dome P, Winkler P, Salokangas RKR, From T, Danileviciute V, Gonda X, Rihmer Z, Benhalima JF, Grady A, Leadholm AKK, Soendergaard S, Nordt C, Lopez-Ibor J, Lopez-Ibor J. Relationship of suicide rates to economic variables in Europe: 2000-2011. Br J Psychiatry 2014; 205:486-96. [PMID: 25359926 DOI: 10.1192/bjp.bp.114.147454] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND It is unclear whether there is a direct link between economic crises and changes in suicide rates. AIMS The Lopez-Ibor Foundation launched an initiative to study the possible impact of the economic crisis on European suicide rates. METHOD Data was gathered and analysed from 29 European countries and included the number of deaths by suicide in men and women, the unemployment rate, the gross domestic product (GDP) per capita, the annual economic growth rate and inflation. RESULTS There was a strong correlation between suicide rates and all economic indices except GPD per capita in men but only a correlation with unemployment in women. However, the increase in suicide rates occurred several months before the economic crisis emerged. CONCLUSIONS Overall, this study confirms a general relationship between the economic environment and suicide rates; however, it does not support there being a clear causal relationship between the current economic crisis and an increase in the suicide rate.
Collapse
|
72
|
Dzúrová D, Winkler P, Drbohlav D. Immigrants' access to health insurance: no equality without awareness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7144-53. [PMID: 25026082 PMCID: PMC4113865 DOI: 10.3390/ijerph110707144] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/10/2014] [Accepted: 06/25/2014] [Indexed: 11/16/2022]
Abstract
The Czech government has identified commercial health insurance as one of the major problems for migrants’ access to health care. Non-EU immigrants are eligible for public health insurance only if they have employee status or permanent residency. The present study examined migrants’ access to the public health insurance system in Czechia. A cross-sectional survey of 909 immigrants from Ukraine and Vietnam was conducted in March and May 2013, and binary logistic regression was applied in data analysis. Among immigrants entitled to Czech public health insurance due to permanent residency/asylum, 30% were out of the public health insurance system, and of those entitled by their employment status, 50% were out of the system. Migrants with a poor knowledge of the Czech language are more likely to remain excluded from the system of public health insurance. Instead, they either remain in the commercial health insurance system or they simultaneously pay for both commercial and public health insurance, which is highly disadvantageous. Since there are no reasonable grounds to stay outside the public health insurance, it is concluded that it is lack of awareness that keeps eligible immigrants from entering the system. It is suggested that no equal access to health care exists without sufficient awareness about health care system.
Collapse
|
73
|
Herberhold T, Pieper T, Kudernatsch M, Pascher B, Hartlieb T, Weber K, Eitel H, Getzinger T, Holthausen H, Winkler P, Blümcke I, Staudt M. Enhancing diagnostic accuracy in presurgical evaluation: invasive recordings with a combination of subdural grids plus depth electrodes. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
74
|
Winkler P, Csémy L. Self-Experimentations with Psychedelics Among Mental Health Professionals: LSD in the Former Czechoslovakia. J Psychoactive Drugs 2014; 46:11-9. [DOI: 10.1080/02791072.2013.873158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
75
|
Winkler P, Jakse G, Lodron G, Uray M, Mayer H, Flitsch R, Kapp K. PD-0549: Volumetric changes in head&neck radiotherapy are not the most significant predictors for dose distribution shifts. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30655-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|