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The coronavirus disease 2019 (COVID-19) pandemic has affected the mental health of the entire population and poses unique challenges to the delivery of psychiatric services. To best respond, we must [...]

Problem In Latvia, the move towards community-based mental health-care services has been slow. Approach The hospital managers of the only psychiatric hospital in Riga decided to establish two community-based clinics that were financially and administratively integrated with the hospital. The clinics were established using a step-wise approach by redistributing resources, including psychiatrists, nurses and beds, from the hospital to the new clinics. In 2005, the Veldre clinic started outpatient consultations and day care admissions. In 2009, Pardaugava clinic opened as an outpatient clinic. In 2012, an open-door inpatient ward with 30 beds was transferred from the psychiatric hospital to Veldre. In 2013, Pardaugava clinic opened a day care clinic and an open-door inpatient ward, transferring 26 beds from the psychiatric hospital. Local setting Latvians have worse mental health indicators than those of the average population in Europe. Mental care has traditionally focused on inpatient care. Relevant changes The clinics are now providing most of the outpatient services and the number of inpatients treated at the hospital has declined from 5696 patients in 2004 to 4957 patients in 2018. Patients are treated in a more open and patient-centred environment. Lessons learnt The administrative and financial integration of the new community-based clinics within the existing structures of the hospital is a successful approach. Transferring resources to the clinics seems to have improved the quality of care without requiring additional funding apart from the initial investment costs. Involving the staff members during the planning phase reduced resistance to the project. [phrase omitted] [phrase omitted] Probleme En Lettonie, l'evolution vers des prestations de soins de sante mentale communautaires a progresse lentement. Approche Les dirigeants de l'unique hopital psychiatrique de Riga ont decide de fonder deux cliniques communautaires integrees financierement et administrativement a l'hopital. Leur creation a fait l'objet d'une approche graduelle de redistribution des ressources, notamment des psychiatres, infirmiers et lits, depuis l'hopital vers les nouvelles cliniques. En 2005, la clinique de Veldre a commence les consultations externes et les admissions pour des soins de jour. En 2009, la clinique externe de Pardaugava a debute ses activites. En 2012, une unite d'hospitalisation a regime ouvert comptant 30 lits a ete transferee de l'hopital psychiatrique vers Veldre. En 2013, la clinique de Pardaugava a inaugure un etablissement de jour et une unite d'hospitalisation a regime ouvert, recuperant 26 lits de l'hopital psychiatrique. Environnement local Les indicateurs de sante mentale en Lettonie sont inferieurs a la moyenne observee au sein de la population europeenne. Les soins de sante mentale etaient traditionnellement axes sur l'hospitalisation des patients. Changements significatifs Les cliniques assurent desormais la plupart des prestations externes et le nombre d'hospitalisations a diminue, passant de 5696 patients en 2004 a 4957 patients en 2018. Les patients sont pris en charge dans un environnement plus ouvert et mieux adapte a leurs besoins. Lecons tirees L'integration administrative et financiere des nouvelles cliniques communautaires au sein des structures hospitalieres existantes est une approche efficace. Le transfert des ressources vers les cliniques semble avoir ameliore la qualite des soins prodigues sans necessiter de fonds supplementaires, a l'exception de l'investissement initial. Enfin, impliquer les membres du personnel dans la phase de planification a permis de limiter la resistance au projet. [phrase omitted] Situacion El avance hacia los servicios de atencion de la salud mental comunitarios es muy lento en Letonia. Enfoque Los gerentes del unico hospital psiquiatrico de Riga decidieron establecer dos clinicas en la comunidad que se integraron financiera y administrativamente con el hospital. Las clinicas se establecieron mediante un enfoque gradual, al redistribuir los recursos, incluidos psiquiatras, enfermeros y camas, del hospital a las nuevas clinicas. En 2005, la clinica de Veldre inicio consultas a pacientes ambulatorios y admisiones para la atencion diurna. En 2009, la clinica Pardaugava se inauguro como una clinica para pacientes ambulatorios. En 2012, una sala para pacientes hospitalizados con 30 camas fue transferida del hospital psiquiatrico a Veldre. En 2013, la clinica Pardaugava abrio una clinica de atencion diurna y una sala para pacientes hospitalizados sin restricciones, en la que se transfirieron 26 camas del hospital psiquiatrico. Marco regional Los habitantes de Letonia tienen indicadores de salud mental peores que los de la poblacion media de Europa. Tradicionalmente, la atencion mental se ha centrado en la atencion a los pacientes hospitalizados. Cambios importantes En la actualidad, las clinicas prestan la mayor parte de los servicios a los pacientes ambulatorios y el numero de pacientes hospitalizados tratados en el hospital disminuyo de 5696 pacientes en 2004 a 4957 en 2018. Los pacientes son tratados en un ambiente mas accesible y centrado en el paciente. Lecciones aprendidas La integracion administrativa y financiera de las clinicas nuevas en la comunidad dentro de las estructuras que ya existen en el hospital es un enfoque exitoso. La transferencia de recursos a las clinicas parece haber mejorado la calidad de la atencion sin requerir el financiamiento adicional aparte de los costos de inversion inicial. La participacion de los miembros del personal durante la fase de planificacion redujo la complejidad del proyecto., Introduction The World Health Organization (WHO) promotes the development of community-based mental health-care services as part of a balanced care model. (1, 2) Nevertheless, policy-makers in many central and eastern [...]

In this paper, we examined the extent to which one's own religiosity, as well as that of her or his peers, has on alcohol and substance use among undergraduate students at a medium-sized public university in the southeastern United States. Findings indicate that though peer religiosity significantly affects substance use, one's own religiosity is not a significant predictor of substance use. Discussion of results, limitations of the study, and directions for future research are also discussed., In the United States, drinking and illicit substance use among college students is quite prevalent on college campuses (Giordano, Prosek, Daly, Holm, Ramsey, Abernathy, & Sender, 2013; Johnston, O'Malley, Bachman, [...]