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Improving the mental health of the population: towards a strategy on mental health for the European Union: green paper
- Author:
- EUROPE. Health and Consumer Protection Directorate-General
- Publisher:
- European Commission
- Publication year:
- 2005
- Pagination:
- 25p.
- Place of publication:
- Brussels
The Green paper aims to launch a public consultation on how better to tackle mental illness and promote mental wellbeing in the EU, in line with the mandate for action at Community level. If confirmed, the initiative should lead to the development of a Commission proposal for an EU-strategy on mental health in late 2006.
The sociocultural context of the European Early Promotion Project
- Authors:
- DRAGONAS Thalia, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.32-40.
- Publisher:
- Taylor and Francis
Describes the sociocultural settings and relevant health care services within which the European Early Promotion Project was conducted, in order to render the interpretation of study results more meaningful and justify cross-cultural differences. Greece, Cyprus and Serbia are characterised by lower social expenditure and welfare provision and higher poverty rates than the UK and, especially, Finland, the latter having achieved an advanced welfare provision system. Large differences also exist among participating countries in child mental health and primary care services. Finland and the UK have made the biggest advances in promotional work with families, while Greece, Cyprus and Serbia present, to smaller or larger degree, deficiencies in health service infrastructure and their ability to follow social, economic and scientific advances in the area of maternal and child wellbeing. Part of a special issue on the EEPP.
The European Early Promotion Project: description of the service and evaluation study
- Authors:
- PUURA Kaija, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.17-31.
- Publisher:
- Taylor and Francis
Describes an innovative cross-cultural method of working with families to promote the psychosocial wellbeing of children and prevent the development of psychological and social problems. Also presents a study designed to evaluate the effects of the service. Primary health care workers in 5 countries of northern, central and southern Europe were trained to conduct promotional interviews with all prospective mothers in their area one month before and one month after birth. They were also taught to work with mothers identified as in need of support as a parent, using a specific counselling model to try to prevent the onset of child mental health difficulties. Effects of the intervention on children's psychological development and family adaptation were evaluated at 2 years of age in comparison with matched groups not receiving the intervention, using a set of questionnaires, interviews and observation methods. The total sample at initial assessment was 824 families, of which 705 (85.65) were retained for outcome assessment. Part of a special issue on the European Early Promotion Project (EEPP).
Promoting children's mental health: the European Early Promotion Project
- Authors:
- DAVIS Hilton, TSIANTIS John
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.4-16.
- Publisher:
- Taylor and Francis
Introduces the special issue on the European Early Promotion Project (EEPP), a major project set up to address problems arising from the prevalence of psychosocial disorders in children by developing and evaluating a promotional and preventive service in a European context.
Socio-economic inequalities in suicide: a European comparative study
- Authors:
- LORANT Vincent, et al
- Journal article citation:
- British Journal of Psychiatry, 187(1), July 2005, pp.49-52.
- Publisher:
- Cambridge University Press
Social factors have been shown to be predictors of suicide. It is not known whether these factors vary between countries. The aim was to present a first European overview of socio-economic inequalities in suicide mortality among men and women. The authors used a prospective follow-up of censuses matched with vital statistics in ten European populations. Directly standardised rates of suicide were computed for each country. In men, a low level of educational attainment was a risk factor for suicide in eight out of ten countries. Suicide inequalities were smaller and less consistent in women. In most countries, the greater the socio-economic disadvantage, the higher is the risk of suicide. The population of Turin evidenced no socio-economic inequalities. Socio-economic inequalities in suicide are a generalised phenomenon in western Europe, but the pattern and magnitude of these inequalities vary between countries. These inequalities call for improved access to psychiatric care for lower socio-economic groups.
Child and family outcomes of the European Early Promotion Project
- Authors:
- DAVIS Hilton, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.63-81.
- Publisher:
- Taylor and Francis
This paper, part of a special issue on the European Early Promotion Project (EEPP), concerns outcomes for families involved in the Project and presents data collected when the children were between 6-8 and 24 months old. A total of 824 families were recruited from the 5 countries involved. At baseline, differences were found between country samples in extent and type of need (Finnish families having the lowest risk factor rates and Serbia the highest, for example), but recruitment was generally successful in including families from the whole range of need, excluding those with the severest physical and psychiatric problems. Although not randomised, intervention families (receiving the EEPP service) were reasonably matched with comparison families (receiving usual services) on most variables initially, except in Greece, where intervention families were somewhat more at risk. At 24 months, in spite of low intensity of service provision and methodological difficulties likely to reduce effects, there was evidence, particularly in Greece, of differences in outcome favouring the intervention group, who also showed significantly higher levels of satisfaction with the intervention received. It was concluded that the service merits further exploration to assist in understanding promotional and preventative processes.
Primary prevention of child mental health problems using primary health care professionals: cost comparisons
- Authors:
- KNAPP Martin, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.95-102.
- Publisher:
- Taylor and Francis
The importance of economic dimension in planning, delivery and evaluation of care and support for children and families is widely recognised. This paper reports a cost analysis of a primary prevention programme in 4 European centres using primary health care professionals trained to promote the psychosocial adaptation of children from birth. The cost of the intervention in training and supervision for each country was estimated, and the impact on service use and cost 2 months after the birth of the index child was measured. Total costs incurred by families at comparison sites where no such training was provided were also calculated and compared with total costs at intervention sites. Cost differences between countries were also explored. Differences in total costs between the groups were small and did not reach statistical significance. However, total costs varied substantially between countries. Training primary health care professionals in primary prevention of child mental health problems is found to be inexpensive and does not appear to affect total costs in the years immediately following. Given the outcome findings, the cost evaluation provides encouragement for wide establishment and examination of this preventative intervention. Part of a special issue on the European Early Promotion Project (EEPP).
Training for primary health care practitioners
- Authors:
- LAYIOU-LIGNOS, Effie, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.41-53.
- Publisher:
- Taylor and Francis
Describes in detail the training course for primary health care practitioners (PHCPs) designed for the needs of the European Early Promotion Project (EEPP), aiming to promote parent-infant interaction and ensure that resources are targeted to families in need of more support. The course is based on the principles of adult learning models and uses a partnership approach to the helping process, combining the Parent Adviser model, promotional interviewing from the EU/WHO project and the theory and skills of assessing and supporting early parent-infant interaction and the psychosocial development of infants. It provides a step-by-step exposition of how to train PHCPs, stressing the importance of the helper-parent relationship and ways of facilitating parent-child communication. It gives an analytic description of the course content and training methods. It describes in detail the supervision which followed the training and accompanied the PHCPs throughout the implementation phase, elaborating on the supervisory relationship and the alliance necessary for the supervision to be effective. It concludes with some remarks about training and supervision and their role in the project. Part of a special issue on the EEPP.
The effects of the European Early Promotion Project training on primary health care professionals
- Authors:
- PAPADOPOLOU Kalliroi, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.54-62.
- Publisher:
- Taylor and Francis
Explores the effects of the European Early Promotion Project (EEPP) training on primary health care professionals with regard to knowledge, self-efficacy and ability to identify need in families, and to their satisfaction with training received. A quasi-experimental group comparison design was developed in which an intervention and a comparison group were assessed twice: the intervention group before and after the special EEPP training and the comparison at the same time but without the training. Overall results show a tendency for the intervention group to improve in knowledge and perceived self-efficacy, and a significant improvement in their accuracy of need identification in families, compared with the comparison group. These results were more prominent in Greece, Serbia and the UK than in Finland and Cyprus, whereas training satisfaction was high in all sites. The results are discussed in terms of their implications for early intervention as well as for training primary health care professionals to conduct preventative and promotional work with families. Part of a special issue on the EEPP.
Factors affecting timely recognition and diagnosis of dementia across Europe: from awareness to stigma
- Authors:
- VERNOOIJ-DASSEN Myrra J. F. J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(4), April 2005, pp.377-386.
- Publisher:
- Wiley
Timely recognition and diagnosis of dementia is the pre-condition for improving dementia care, but diagnosis often occurs late in the disease process. The aim was to compare facilitators and obstacles to the timely recognition of dementia across eight European Union states, in order to implement established policies for earlier diagnosis. Twenty-three participants from different disciplines, purposively sampled for professional expertise in dementia research and innovative practice, attended two focus groups. Stigma in ageing and dementia, accompanied by a sense that there is little to offer until later on in the disease, underpinned the widespread reluctance of GPs to recognise dementia at an early stage and were major obstacles to the timely diagnosis of dementia across all eight countries. Dementia care services varied widely across Europe. Countries with the greatest development of dementia health care services were characterised by national guidelines, GPs fulfilling a gatekeeper function, multi-disciplinary memory clinics and innovative programmes that stimulated practice and new services. Dementia-related stigma was perceived as being less prominent in these countries. Overcome of delays in the timely diagnosis of dementia needs more than specialist services. They should address the processes associated with stigma, age and dementia, especially where these relate to physician practice and diagnostic disclosure. Stigma is perceived as variable across European States, with a promising finding that its impact is relatively small in countries with the widest range of dementia care services.