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- Costa, D, et al.
(författare)
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Factors associated with quality of services for marginalized groups with mental health problems in 14 European countries
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; , s. Art. no. 49-
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Tidskriftsartikel (refereegranskat)abstract
- Background:Different service characteristics are known to influence mental health care delivery. Much less isknown about the impact of contextual factors, such as the socioeconomic circumstances, on the provision of careto socially marginalized groups.The objectives of this work were to assess the organisational characteristics of services providing mental health carefor marginalized groups in 14 European capital cities and to explore the associations between organisationalquality, service features and country-level characteristics.Methods:617 services were assessed in two highly deprived areas in 14 European capital cities. A Quality Index ofService Organisation (QISO) was developed and applied across all sites. Service characteristics and country levelsocioeconomic indicators were tested and related with the Index using linear regressions and random interceptlinear models.Results:The mean (standard deviation) of the QISO score (minimum = 0; maximum = 15) varied from 8.63 (2.23) inIreland to 12.40 (2.07) in Hungary. The number of different programmes provided was the only service characteristicsignificantly correlated with the QISO (p < 0.05). The national Gross Domestic Product (GDP) was inverselyassociated with the QISO. Nearly 15% of the variance of the QISO was attributed to country-level variables, withGDP explaining 12% of this variance.Conclusions:Socioeconomic contextual factors, in particular the national GDP are likely to influence theorganisational quality of services providing mental health care for marginalized groups. Such factors should beconsidered in international comparative studies. Their significance for different types of services should be exploredin further research.Keywords:Mental health services, Quality index of service organization, Socially marginalized groups,Multi-level analysis
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- Welbel, M, et al.
(författare)
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Addiction treatment in deprived urban areas in EU countries: Accessibility of care for people from socially marginalized groups
- 2013
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Ingår i: Drugs. - : Informa UK Limited. - 0968-7637 .- 1465-3370. ; 20:1, s. 74-83
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study examines the accessibility of addiction treatment within services providing mental health care and support for people from socially marginalized groups in deprived urban areas across EU countries.Methods: Services providing mental health care and support in deprived areas of 14 EU capital cities were assessed with a questionnaire. We analysed the availability and accessibility of those services providing addiction treatment for people from six groups: the long-term unemployed, the homeless, street sex workers, asylum seekers and refugees, irregular migrants and people from travelling communities.Results: While 30% of all the assessed services provided addiction treatment, in 20% of services, addiction was a criterion for exclusion. Among services providing addiction treatment, 77% accepted self-referrals, 63% were open on weekends or in the evening, 60% did not charge any out-of-pocket fees, 35% provided access to interpreters, and 28% ran outreach activities. These results varied substantially among EU capitals.Conclusion: Access to addiction treatment for socially marginalized groups varies across Europe. Some of the models identified may constitute barriers to treatment. Developing care delivery models that facilitate access for vulnerable populations should be a priority for national and European policies.
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- Priebe, Stefan, et al.
(författare)
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Good practice in mental health care for socially marginalized groups in Europe : a qualitative study in 14 countries
- 2012
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; :12, s. 248-
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Tidskriftsartikel (refereegranskat)abstract
- Background:Socially marginalised groups tend to have higher rates of mental disorders than the general populationand can be difficult to engage in health care. Providing mental health care for these groups represents a particularchallenge, and evidence on good practice is required. Thisstudy explored the experiences and views of experts in 14European countries regarding mental health care for six socially marginalised groups: long-term unemployed; street sexworkers; homeless; refugees/asylum seekers; irregular migrants and members of the travelling communities.Methods:Two highly deprived areas were selected in the capital cities of 14 countries, and experts were interviewed foreach of the six marginalised groups. Semi-structured interviews with case vignettes were conducted to exploreexperiences of good practice and analysed using thematic analysis.Results:In a total of 154 interviews, four components of good practice were identified across all six groups: a) establishingoutreach programmes to identify and engage with individuals with mental disorders; b) facilitating access to services thatprovide different aspects of health care, including mental health care, and thus reducing the need for further referrals; c)strengthening the collaboration and co-ordination betweendifferent services; and d) disseminating information onservices both to marginalised groups and to practitioners in the area.Conclusions:Experts across Europe hold similar views on what constitutes good practice in mental health care formarginalised groups. Care may be improved through better service organisation, coordination and information.
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- Priebe, Stefan, et al.
(författare)
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Mental health-care provision for marginalized groups across Europe: findings from the PROMO study
- 2013
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 23:1, s. 97-103
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Tidskriftsartikel (refereegranskat)abstract
- Background: Providing mental health care to socially marginalized groups is a challenge. There is limited evidence on what form of mental health-care generic (i.e. not targeting a specific social group) and group-specific services provide to socially marginalized groups in Europe. Aim: To describe the characteristics of services providing mental health care for people with mental disorders from socially marginalized groups in European capitals. Methods: In two highly deprived areas in different European capital cities, services providing some form of mental health care for six marginalized groups, i.e. homeless, street sex workers, asylum seekers/refugees, irregular migrants, travelling communities and long-term unemployed, were identified and contacted. Data were obtained on service characteristics, staff and programmes. Results: In 8 capital cities, 516 out of 575 identified services were assessed (90%); 297 services were generic (18–79 per city) and 219 group-specific (13–50). All cities had group-specific services for the homeless, street sex workers and asylum seekers/refugees. Generic services provided more health-care programmes. Group-specific services provided more outreach programmes and social care. There was a substantial overlap in the programmes provided by the two types of services. Conclusions: In deprived areas of European capitals, a considerable number of services provide mental health care to socially marginalized groups. Access to these services often remains difficult. Group-specific services have been widely established, but their role overlaps with that of generic services. More research and conceptual clarity on the function of group-specific services are required.
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