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National and international research results have highlighted the fact that workplace stress causes mental and somatic problems. The aim of the present paper is to define exposure to workplace-related risk factors, with special focus on psychosocial risk factors, and the way they interconnect with workplace conditions, relationships with superiors and colleagues, and moral, professional and financial appreciation.Cross-sectional research with the help of an anonymous online self-administered questionnaire was carried out among 261 higher education employees (67% women, 33% men, mean age 43.4 years) from 12 faculties of the University of Szeged, Hungary. Statistical analysis was performed using IBM SPSS 22.0.The primary workplace stress factors for university employees were strict deadlines (80.4%), frequent overwork (64.2%) and difficulty in meeting requirements (56.7%). Communication problems with colleagues and superiors were also highlighted (47.5%). Job strain was higher for women than for men. With regard to low financial, professional, and moral appreciation, employees were characterised by the existence of work requirements impossible to meet, as well as by low autonomy. Experience of anxiety and aggression came along with low financial and moral appreciation (p0.001).Our data suggests that employees at the university were subject to several psychosocial risk factors, and worked under considerable mental stress, leading to a higher prevalence of mental health problems. The results highlight the need for a health-focused policy-making in higher education to reduce health expenditure and increase efficiency at work.Rezultati nacionalnih in mednarodnih raziskav kažejo, da stres na delovnem mestu povzroča duševne in telesne težave. Cilj tega članka je opredeliti izpostavljenost dejavnikom tveganja, povezanim z delovnim mestom, posebej psihosocialnim dejavnikom, in njihovo medsebojno povezanost z razmerami na delovnem mestu, odnosi z nadrejenimi in sodelavci ter moralnim, poklicnim in finančnim zadovoljstvom.Izvedli smo presečno raziskavo s pomočjo anonimnega spletnega samoocenjevalnega vprašalnika, ki ga je izpolnilo 261 zaposlenih v visokošolskem izobraževanju (67,0 % žensk, 33,0 % moških; starost moških je bila 43,4 leta) iz 12 fakultet Univerze v Szegedu na Madžarskem. Statistično analizo smo opravili s programom IBM SPSS 22.0.Primarni dejavniki stresa na delovnem mestu pri zaposlenih na univerzi so bili strogi roki (80,4 %), pogosta preobremenjenost (64,2 %) in težave pri izpolnjevanju zahtev (56,7 %). Izpostavljene so bile tudi težave pri komunikaciji s sodelavci in nadrejenimi (47,5 %). Delovni napori so bili večji pri ženskah kot pri moških. V primeru nizkega finančnega, poklicnega in moralnega zadovoljstva je bilo za zaposlene značilno, da obstajajo delovne zahteve, ki jih je nemogoče izpolniti, in da imajo nizko stopnjo avtonomije. Z nizkim finančnim in moralnim zadovoljstvom je bil povezan občutek anksioznosti in agresije (p0,001).Naši podatki kažejo, da so se zaposleni na univerzi pri delu spopadali z več dejavniki psihosocialnega tveganja in da so bili pod precejšnjim duševnim pritiskom, kar je povezano z večjo pojavnostjo težav z duševnim zdravjem. Rezultati poudarjajo potrebo po oblikovanju politik v visokošolskem izobraževanju, ki bodo osredotočene na zdravje, da se zmanjšajo izdatki za zdravstvo in poveča delovna učinkovitost.

Objectives. Health-related quality of life (HRQoL) measures a patient’s subjective experience of his or her health status. We aimed to show how the presence of chronic diseases and satisfaction with family physicians (FPs) were associated with the HRQoL of a Roma population. Methods. A cross-sectional study was carried out in May 2011 on a representative sample of 650 Roma living in Prekmurje, Slovenia. The EQ-5D questionnaire was used for measuring the HRQoL of the Roma. Demographical data, 12 groups of diseases diagnosed in the last 12 months and satisfaction with FPs were included in the questionnaire. Results. The response rate was 88.3% (574), of which 56.4% were female, and the average age of the participants had a mean value of 40.2±12.7 years. The presence of cardiovascular problems with risk factors for them or presence of musculoskeletal disorders were strongly associated with the presence of pain (Cramer’s V = 0.40 and 0.46 respectively).There was a strong association between the presence of mental disorders and anxiety and depression (Cramer´s V = 0.58). The average satisfaction with the family physician was 3.9 (mean±1.10) on a five-point Likert scale. There was no significant association between HRQoL and satisfaction with the family physician. Conclusions. Roma with chronic mental health problems had the lowest HRQoL in the Roma population. More attention should be paid to this subgroup of Roma in family medicine, and interventions should be provided. High satisfaction with their FPs is not associated with the observed quality of life variables

Avtor opozarja na vsebinsko kompleksnost pojma mobing, pri čemer pa se v njegovo vsebino ne spušča, četudi je tesno in pomembno povezan s temeljno človekovo pravico do dostojanstva. Izhaja iz predpostavke, da mobing pomeni motnjo v komunikaciji med ljudmi in da je kot tak prej predmet socioloških in psiholoških znanstvenih razprav kot poglobljene pravne analize. Zato izpostavi zgolj eno opredelitev mobinga, z namenom, da bi seznanile bralca z njegovo osnovno vsebino. Pravno razpravo pa omeji na zakonsko terminologijo poimenovanja ravnanj, do katerih prihaja na delovnem mestu in ki se vsebinsko bolj ali manj ujemajo z vsebino mobinga. Avtor natančno analizira pojma nadlegovanja in trpinčenja, kot sta opredeljena v Zakonu o delovnih razmerjih, in v nadaljevanju skuša oceniti delovno zakonodajo v luči zagotovitve vzvodov za učinkovito pravno in sodno varstvo oseb, žrtev nadlegovanja ali trpinčenja na delovnem mestu. Nenazadnje avtor izpostavi pomen motenj v komunikaciji za posameznikovo duševno zdravje. Being a human means a constant interaction between people. We interact at home within family, in schools, with friends, with business partners, at work. Especially at work the communication has unique and important meaning, partly because we spend at work a major part of the day, partly because a sphere of work consists of unique and very special (close) relationships between workers or between them and their employers. Mobbing is a manifestation of a disturbance or anomaly in communication, in the sphere of work, with such intensity that victims of such behaviour cannot be, at least temporarily, part of a working team anymore. Mobbing influences a mental integrity of an individual.In legal sense mobbing is not a very useful term because with the phenomena as such sociological and psychological scientists primarily deal with it. The definition of mobbing might be too vague and therefore inappropriate for certain legal action of those being mobbed. In the Slovene labour legislation the term mobbing is not used. Instead of that the legislation defines two different ways of behaviour at work similar to mobbing, which form a legal ground for a legal and judicial protection. One is harassment, the other is bullying. Harassment is any undesired behaviour associated with any personal circumstance with the effect or intent of adversely affecting the dignity of a person or of creating an intimidating, hateful, degrading, shaming or insulting environment. On the other hand, bullying at the workplace is any repetitive or systematic, reprehensible or clearly negative and insulting action or behaviour aimed at individual workers at the workplace or in connection with work. Looking at both definitions some similarities and differences as well can be found. The fact is that the term bullying is closer to the content of mobbing defined by Lehman.One of the basic aims of this article is to encourage the awareness of the special nature of the employment relationship creating a fertile field for the communication being abused. A subordination of a worker is a given fact which offers to a superior a wide space for instructions to the worker or a control of his performance, which exceeds normal intensity and consequently forms harassment or bullying. As far as a legal position of the worker being mobbed is concerned, there has to be mentioned a specific statutory obligation of an employer. The latter is bound to provide such a working environment in which none of the workers is subjected to sexual and other harassments or bullying on the part of the employer,, superior or co-workers. To this end the employer must take appropriate steps to protect the workers from the sexual and other harassments or from bullying at the workplace. That means that an employer can be liable although he did not perform the act of harassment or bullying. In such cases a victim has a higher possibility to get a proper compensation. Mobbing is a collateral damage of a modern and intense working environment being part of an entire life. Therefore, preserving our mental health is one the most challenging efforts of every individual.

Sklop, zasnovan na podlagi sedmih avtorskih idej, predstavlja življenje in delo prof. dr. Andreja Marušiča, psihiatra in psihologa, ki je s svojim predanim angažmajem pomembno sooblikoval področje javnozdravstvene politike duševnega zdravja doma in v svetu. Ves čas svojega delovanja je posebno pozornost namenjal razvojnemu napredku suicidologije, saj ga je problematika samomorilnosti strokovno posebej zanimala. Zavzemal se je za celostno integracijo suicidologije kot vede, ki bi temeljila na splošno sprejeti in enopomenski nomenklaturi. Zakonsko ureditev področja duševnega zdravja je razumel kot na najvišjih ustavnopravnih, strokovnih in etičnih načelih temelječ sistem zaščite in pomoči uporabniku, torej osebi z duševno motnjo. Sklop se končuje z doslej še neobjavljenim avtorskim člankom na temo zdravja kot ene same celote, prepleta telesnega in duševnega. The section presents the life and work of prof. Andrej Marušič, a psychiatrist and psychologist, who has contributed significantly to the broadening of limits and to deepening of understanding of human psychology, mental health and suicidality as well as to the development of public mental health policy nationwide and worldwide. The section is based on seven ideas of prof. Marušič, each being presented with a quote from one of the seven songs from his own music record. It is concluded with the previously unpublished article One Health Only as the entity of somatic and mental wellbeing. First, the necessity of an integrated Suicidology is emphasized. Prof. Marušič believed that Suicidology needs to become integrated in the following ways: 1) bio-psycho-socially; 2) between geneticists and environmentalists; 3) across the life span (prospective research needs to be encouraged in order to achieve this goal); 4) between the developed and the developing world; 5) from science to practice; 6) from local research to policy making; 7) from pure cognitive aims on one side (e.g. understanding the nature of the serotonergic system during a suicidal behaviour) to the emotionally coloured on the other (e.g. to have our beloved, who previously attempted suicide, by our side for as long as possible). An integrated Suicidology would enable a single nomenclature as the basis of the research and professional activities in the frame of a suicide prevention. As prof. Marušič noted, a clear and user-friendly definition of suicidality and its various presentations brings many benefits: It provides an effective communication between clinicians dealing with people in crisis as it can also provide a guidance for management and an indication of prognosis. It is an aid for the research, allowing different researchers to study similar patients. From the public mental health perspective, it helps us compare suicide-related statistics across countries and regions, before and after preventive actions, for validly and reliably. The definition of a suicide could be formulated in a way that would distinguish this type of death from other (not necessarily fatal) suicide-related behaviours and non-suicide related deaths. It would be based on the following three components: a) intent - self-destructiveness (yes; no); b) behavior - act of self-destruction (yes; no); c) result - death (yes; no). For a completed suicide all three components need to be present. An intent and act in the absence of the third component will result in a suicide attempt. Accordingly, the intent in the absence of the second and the third component will represent the most dangerous form of a suicidal ideation. In a deliberate self-harm with or without a fatal outcome, we hardly speak about a suicidal intent. In euthanasia there is no suicidal act. However, the suicidal intent can be present. The latter will result in death without a self-inflicted behaviour. What remains are two options: the suicide-less state and the non-suicidal death. As far as a suicide prevention in the 21st Century is concerned, prof. Marušič sees it as a cooperative effort of activists from various levels of society: suicide attempt survivors (I), non-governmental organizations and volunteers (II), primary healthcare (III) and mental health professionals (IV). National (mental) health legislation should, first and foremost, be user-friendly and therefore should encompass the following: an active participation of the user of healthcare services (I), a (personal) treatment efficiency (II), a wide choice of treatment methods (III), an equality and absence of discrimination (IV), a local nature of work including a suitable regional arrangement of small hospitals (V), a security of the user and his or her close ones as well as (mental) health professionals and their co-workers (VI), an autonomous and empowered user who needs to be adequately informed (VII), an inclusion and cooperation of the family and the close ones (VIII), respect for the user (no patronizing!) (IX), a choice of the least restrictive treatment method (X), an encouragement of advocacy (XI) and constant re-evaluation of the capacity for an informed consent and an autonomous decision-making (XII). Contemporary technology enables us to add new dimensions to health care, e.g. the implementation of internet and communication technologies (ICT) as enrichment to the standard care in various sub-disciplines of medicine and related fields. Prof. Marušič supported and helped to develop the so-called e-Health in Slovenia. His project e-Depression is a perfect example of ICT’s efficient use in optimizing and improving the possibilities of information exchange, treatment progress monitoring and availability of professional consulting for people suffering from depression, with the goal of empowering the patients and their caregivers as well as reducing the overall financial burden of the treatment. Prof. Marušič was very well aware of the fact that suicide is a process and not merely a self-destructive act. He emphasized the notion of suicidality beyond suicide. With the help of his colleagues he developed the Suicide Ideation and Behavior Questionnaire (SIBQ) which contains five questions about suicide ideation, four questions about suicide behavior, one question about the individual’s wish to die and two questions about familiarity of suicide. Each level of the questionnaire takes into account recent life events and ongoing vulnerabilities. His vision for the Suicidology of 21st Century sees the field as integrated (I), continuous (II), global (III) as well as local (IV), with a wholistic nature (V), flexible (VI), and human-oriented (VII). Prof. Marušič never ran out of ideas for new approaches to studying and researching mental health. Among others, he planned to start a research project on identification of factors which would predict a suicide attempt in the year following a previous suicide attempt. There really is not much else to say than: “Thank you, Andrej, for being the inspiration you are.”

Po 51. členu ustave ima vsak med nami pravico do zdravstvenega varstva. Žal pa se ob tem prepogosto pozablja na zdravje kot neločljiv preplet človekovega telesnega in duševnega stanja ter v povezavi s tem tudi na vzporedno varstvo duševnega zdravja. In vendar je prav duševno počutje tisto, ki morda najbolj neposredno vpliva na kakovost bolnikovega življenja, ne glede na diagnozo. Glede na visoko stopnjo pojavnosti duševnozdravstvenih težav ob telesnih boleznih in ob upoštevanju negativnih vplivov motenj, kot je denimo depresija, na motivacijo, potek in učinkovitost telesnega zdravljenja pa problematike nikakor ne gre spregledati. Članek osredotočeno govori o skrbi za eno samo zdravje, z željo, da bi zdravstvena nega v tem duhu nekoč postala pravilo, ne zgolj dobrodošla izjema, v okviru standardne bolnišnične oskrbe. Nujni pogoj za to pa sta ustrezno razumevanje zdravja kot temeljne človekove pravice in zavedanje družbene odgovornosti pri zagotavljanju visoke stopnje zaščite te pravice. The well-known saying ‘good old times’ does not apply to our understanding of the relationship between somatic and mental health, as a sharply dichotomous view on both has been supported for a long time throughout human history. Nowadays, however, we are aware that both represent two dimensions of one health only. Without somatic wellbeing there can be no optimal psychological wellbeing and vice versa. And yet we are still missing a wholistic outlook on treatment and rehabilitation when it comes to standard hospital or outpatient assessment of somatic disorders. Yet, it is the dimension of mental wellbeing that is perhaps most closely associated with the patient’s quality of life regardless of the diagnosis. The more severe the somatic health problem(s), the more important it is to dedicate a sufficient attention to the patient’s mental state and overall psychological functioning. It is people suffering from a somatic disease who represent a particular risk group in terms of mental disorders such as clinical depression and anxiety. If comorbidity of the somatic and mental disorder is present, a somatic treatment might not be efficient or not efficient at all. By taking the high prevalence of mental health problems in case of the somatic disease into account and acknowledging the negative influence of disorders, such as depression, on the patient’s motivation as well as the process and effectiveness of the somatic treatment, the problem is certainly not to be overlooked or underestimated. In this article I address the care for one health only, with the wish that health care in this sense would some day become a rule not merely a welcome exception in the frame of standard hospital care in our country. General national hospital treatment standards, as defined by the Slovene Ministry of Health, include: continuous improvement of services for patients (I), respectful health care of patients and their active participation in treatment-related decision making (II), providing all necessary treatment-related information to patients (III), ensuring that health care is performed by personnel who are keeping track with progress and most recent findings concerning their profession (IV), and the prevention of professional mistakes whenever possible (V). The improvement of standard hospital care with adequate assessment of mental health directly influences all these criteria in a positive way. It is the hospital setting where ensuring a good psychological wellbeing of patients is of special importance and at the same time the hardest to achieve. However, quite a few options for a hospital-based mental health care and improvement are at disposal: individual therapeutic conversations (I), group psychotherapy meetings for those who are able to attend (II), psychoeducation (III), training of relaxation and breathing exercises (IV), reducing negative thinking patterns and promoting the positive ones (V), art therapy (i.e. music, writing, painting) (VI), aromatherapy (VII), massage (VIII), warm and aromatized baths (IX) and others. A substantial psychological distress of the patient’s family members and other close ones is not to be overlooked as well. Primary health care represents the sector where long-term monitoring of the patients from the part of a professional and a trusted relationship between the two parties is most common. That is why the implementation of mental health-related services into primary care is of special importance; even more if we aim to get to the point of an actual equal assessment of the somatic and mental health in clinical practice and general society. The World Health Organization (WHO) has already underlined numerous benefits of such integration: a destigmatization of a mental disorder (I), acknowledging the problem of comorbidity (II), an improved prevention and recognition of mental disorders in primary care as the most easily accessible segment of health care (III), an improved (physical and financial) access to mental health services for people with a mental disorder (IV), a lower level of chronicity and hospitalization as well as an improved social integration of people with a mental disorder (V) and a higher availability (on the basis of reduced burden and pressure) of health workers from secondary and tertiary health care level, that is specialists of specific professions (VI). When it comes to the principles of WHO, the so-called ‘pyramid of optimal structure of mental health care’ needs to be mentioned as well. It applies to the organization’s doctrine which emphasizes the inclusion of mental health services into primary, secondary and tertiary health care. It is based on the users’ self-care (I) as the basic form of health protection, which can be supported by informal community care (II), mental health services in primary health care (III), social mental health care services and psychiatric services in general hospitals (IV), and finally, hospital institutions and specialists’ services (V) at the very top of the pyramid. In 21st century the enrichment of a standard treatment of a somatic disease with adequate assessment of mental health should certainly become one of our absolute priorities when it comes to planning and designing public health care. After all, mental health is one of the most crucial – if not the most crucial - determinants of the patient’s quality of life. And heightening the latter should be the leitmotif of every health intervention. »As mentally healthy as possible« - despite a somatic disease, is therefore an advisable motto when treating somatic health problems of any kind.