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Due to occupational exposure to potentially traumatic events, health care workers (HCWs) may be at risk of developing posttraumatic stress (PTS) symptoms or probable posttraumatic stress disorder (PTSD). This study examined probable PTSD, coping, and resilience among national HCWs working in Greece. A total of 17.9% of the sample of participants (N = 112) met the screening criteria for probable PTSD. Logistic regression models were constructed to assess if trauma coping self-efficacy (CSE) and resilience predicted probable PTSD, and the results indicated that lower trauma CSE significantly predicted probable PTSD in unadjusted models (OR = 0.89, 95% CI, 0.82, 0.96, p < 0.01) and adjusted models (OR = 0.90, 95% CI, 0.83, 0.97, p < 0.01). Our study findings suggest that organizations that employ HCWs may support their workers through ongoing screening, assessment, and training that enhances coping self-efficacy.

Background To date, cultural clinical research has primarily focused on differences between ethnic groups when investigating causal beliefs about mental disorders. While individual as well as contextual factors are considered important for gaining a better understanding of cultural influences, research on causal beliefs about post-traumatic stress disorder (PTSD) and cultural correlates in laypersons is scarce. Objective This study aimed at gaining a better understanding of the association between causal beliefs about PTSD and cultural aspects, as well as other contextual and individual correlates of causal beliefs. Method We conducted a cross-sectional, vignette-based online survey with 737 laypersons from Mexico, Ecuador, Germany, Greece, and Russia. Participants completed the revised Illness Perception Questionnaire (IPQ-R) and reported several cultural and sociodemographic (e.g. country of residence, gender, personal values) as well as mental health–related variables (e.g. PTSD symptoms, previous seeking of help). Latent class analysis (LCA) was performed to identify subgroups of individuals expressing similar causal beliefs for PTSD. Multinomial logistic regression was used to analyse covariates of class membership. Results LCA resulted in a three-class solution of casual beliefs: a traumatic event–focused class (41.1%); an intrapersonal causes class (40.1%); and a multiple causes class (18.0%). Multinomial logistic regression analysis revealed country of residence, gender, personal value of security, PTSD symptoms, and mental health literacy as significant covariates of class membership. Conclusions Integrating a more diverse concept of culture into cultural clinical research can be a valuable addition to group comparisons based on nationality or ethnicity. Cultural clinical research needs to move towards a more integrated approach that accounts for the complexity of culture. Including additional contextual and sociodemographic factors can help to reach a more accurate understanding of the cultural influences on the development of causal beliefs and mental health.

Abstract Background Mental healthcare is an important component in societies’ response to mental health problems. Although the World Health Organization highlights availability, accessibility, acceptability and quality of healthcare as important cornerstones, many Europeans lack access to mental healthcare of high quality. Qualitative studies exploring mental healthcare from the perspective of people with lived experiences would add to previous research and knowledge by enabling in-depth understanding of mental healthcare users, which may be of significance for the development of mental healthcare. Therefore, the aim of the current study was to describe experiences of mental healthcare among adult Europeans with mental health problems. Method In total, 50 participants with experiences of various mental health problems were recruited for separate focus group interviews in each country. They had experiences from both the private and public sectors, and with in- and outpatient mental healthcare. The focus group interviews (N = 7) were audio recorded, transcribed verbatim and analysed through thematic analysis. The analysis yielded five themes and 13 subthemes. Results The theme Seeking and trying to find help contained three subthemes describing personal thresholds for seeking professional help, not knowing where to get help, and the importance of receiving help promptly. The theme Awaiting assessment and treatment contained two subthemes including feelings of being prioritized or not and feelings of being abandoned during the often-lengthy referral process. The theme Treatment: a plan with individual parts contained three subthemes consisting of demands for tailored treatment plans in combination with medications and human resources and agreement on treatment. The theme Continuous and respectful care relationship contained two subthemes describing the importance of continuous care relationships characterised by empathy and respect. The theme Suggestions for improvements contained three subthemes highlighting an urge to facilitate care contacts and to increase awareness of mental health problems and a wish to be seen as an individual with potential. Conclusion Facilitating contacts with mental healthcare, a steady contact during the referral process, tailored treatment and empathy and respect are important aspects in efforts to improve mental healthcare. Recommendations included development of collaborative practices between stakeholders in order to increase general societal awareness of mental health problems.

Abstract Background The mental healthcare treatment gap (mhcGAP) in adult populations has been substantiated across Europe. This study formed part of MentALLY, a research project funded by the European Commission, which aimed to gather qualitative empirical evidence to support the provision of European mental healthcare that provides effective treatment to all adults who need it. Methods Seven focus groups were conducted with 49 health professionals (HPs), including psychologists, psychiatrists, social workers, general practitioners, and psychiatric nurses who worked in health services in Belgium, Cyprus, Greece, the Netherlands, Norway and Sweden. The focus group discussions centered on the barriers and facilitators to providing quality care to people with mild, medium, and severe mental health problems. Analyses included deductively and inductively driven coding procedures. Cross-country consensus was obtained by summarizing findings in the form of a fact sheet which was shared for triangulation by all the MentALLY partners. Results The results converged into two overarching themes: (1) Minding the treatment gap: the availability and accessibility of Mental Health Services (MHS). The mhcGAP gap identified is composed of different elements that constitute the barriers to care, including bridging divides in care provision, obstacles in facilitating access via referrals and creating a collaborative ‘chain of care’. (2) Making therapeutic practice relevant by providing a broad-spectrum of integrated and comprehensive services that value person-centered care comprised of authenticity, flexibility and congruence. Conclusions The mhcGAP is comprised of the following barriers: a lack of funding, insufficient capacity of human resources, inaccessibility to comprehensive services and a lack of availability of relevant treatments. The facilitators to the provision of MHC include using collaborative models of primary, secondary and prevention-oriented mental healthcare. Teamwork in providing care was considered to be a more effective and efficient use of resources. HPs believe that the use of e-mental health and emerging digital technologies can enhance care provision. Facilitating access to a relevant continuum of community-based care that is responsive coordinated and in line with people’s needs throughout their lives is an essential aspect of optimal care provision.

In recent years, researchers and policymakers have emphasised the importance of understanding the complex relationships between Water, Energy, Food and Ecosystems (WEFE). The primary reason for capturing these complexities is to understand how decisions made in the water, food and energy sectors can affect one another. Crucially, biodiversity and ecosystem services (E) play a mediating role in these relationships by making material and non-material contributions to all other sectors (W, E, F). The Nexus approach has been widely used for capturing these interdependencies and identifying opportunities for increasing efficiency, reducing trade-offs and building synergies for sustainable resource use across the WEFE nodes. One challenge in using this framework is the need to harmonise the technical and managerial dimensions of the WEFE interlinkages with the perceptions and priorities of local populations directly involved in the use and management of resources. This paper presents a methodological framework that seeks to integrate the perspectives of experts, practitioners and local stakeholders on the WEFE Nexus through the combined application of the Delphi and Focus Group methods. In this paper, the municipality of Apokoronas in Crete, Greece has served as the case in point. The combined framework allowed us to explore the Nexus understanding at the local level and was instrumental in the identification of initiatives for more integrated resource management. The triangulation of results captured the differences in priorities between practitioners and the local community at large, but also, more specifically, it pointed to discrepancies within groups and across WEFE sectors. The outcomes of this paper demonstrate that awareness and learning play a central role in Nexus actions to overcome conflicts and perceived inequalities, and to internalise solutions. The inclusion of the ecosystems node in the traditional WEF Nexus encouraged participants to contemplate the pivotal role of ecosystems in supporting the rest of the WEF sectors.

A multitude of crises have ravaged Greece during the past six years. The ensuing austerity policies, imposed as antidotes, appear to have impacted people's lives gravely. The collapse of a failing social and political system led to the establishment of social solidarity initiatives. One of these initiatives is the Somateio Allilovoithias Ofeileton Rethymnou (SAOR-Network for the Mutual Assistance of Rethymno's Debtors). SAOR offers comradeship by activating citizens to build collective strength and to resist foreclosures actively. In this paper, we present the results of a qualitative study focusing on the lives of the people who are members of the network and are involved in deterring foreclosures. Eleven interviews and a focus group discussion provided by coalition members were analyzed using phenomenologically informed thematic analysis. Three superordinate themes were identified: 1) Living on the precipice: Shocked, hoodwinked and debt-ridden; 2) Mutual anger against the ‘betrayers' and the need for resistance; and 3) The national bankruptcy and unending deliberations regarding country's and the coalition's fate. These themes comprise a story entitled: The neoliberal myth of austerity: Indebted personhood in a bankrupt nation. Indebted citizens described the emotional collapse, the alienation, the feelings of solidarity they experienced and their anger toward politicians.

This paper describes and discusses the results of an intervention aiming to sensitize children to the social and emotional processes involved in racism. The intervention was applied and evaluated in 10 Greek elementary schools. The goals and the intervention methods of the program modules are briefly outlined and the results of the program evaluation are elaborated and discussed. Two-hundred students participated in the program and 180 took part in the pre-and-post-testing which assessed their ability to identify emotions associated with prejudice, discrimination and stereotypical thinking; to understand similarities and differences between people; and to develop perspective taking and empathic skills in relation to diverse others. Results indicate gains in all three areas of assessment although the increased ability to identify similarities between people can also be attributed to age/grade effects. The implications of the findings are discussed with regard to antiracism intervention methods and evaluation strategies.