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Aim. The analysis of the extent, sociodemographic and clinical predictors, and consequences of disclosing mental health problems for people with psychotic disorders. Method. 147 individuals with a diagnosis of psychotic disorder (ICD-10 categories F20--F29) were examined with questionnaires to assess the extent and consequences of their disclosing of mental health problems to others, as well as their social functioning, depressive symptoms, and the global severity of psychopathological symptoms. Results. The majority of respondents talked openly about their mental health problems to their parents, spouses or life partners, as well as physicians and other non-psychiatric health care professionals, while a substantial minority (less than one-fifth) talked about these issues to casual acquaintances, neighbors, teachers and lecturers, co-workers, police officers and municipal guards, representatives of the court system, or public officials. Multiple regression analysis showed that the older the respondents were, the less willing they were to disclose their mental problems to others (β = --0.34; p <0.05). In contrast, the longer they were ill, the more inclined they were to disclose their mental health issues (β = 0.29; p <0.05). Disclosure of mental health problems had varying effects on the subjects' social relationships, with a significant proportion reporting no difference in the way they were treated by others, while others reported either deterioration or improvement in this area. Conclusions. The results of the study provide clinicians with practical guidance on supporting and assisting patients with psychotic disorders in the process of making informed decisions about "coming out". [ABSTRACT FROM AUTHOR]

Abstract Background Schizophrenia is a significantly disabling disease that affects all major areas of life. There is a lack of comprehensive synthesis of research findings on the full extent of psychosocial difficulties (PSDs) experienced by people living with schizophrenia. This paper provides a systematic review of the literature concerning PSDs and their associated factors in schizophrenia. PSDs were conceptualized in accordance with the International Classification of Functioning, Disability and Health (ICF) as disabilities, in particular impairments of mental functions, activity limitations and participation restrictions. Methods An electronic search using MEDLINE and PsychINFO plus a manual search of the literature was performed for qualitative and longitudinal studies published in English between 2005 and 2010 that examined PSDs in persons with schizophrenia. The ICF was used as a conceptual framework. Results A total of 104 papers were included. The most frequent PSDs addressed in the literature were not specific ones, directly linkable to the ICF categories of mental functions, activity limitations or participation restrictions, but broad areas of psychosocial functioning, such as psychopathological symptoms (53% of papers) or global disability and functioning (37%). Among mental functions, the most extensively studied were cognitive functions (27%) and emotional functions (27%). Within the domain of activities and participation, the most widely investigated were difficulties in relationships with others (31%) and employment (20%). Of the factors associated with the intensity or course of PSDs, the most commonly identified were treatment modalities (56%), psychopathological symptoms (26%), and socio-demographic variables (24%). Medication tended to improve the most relevant PSD, but at the same time was the only consistently reported determinant of onset of PSDs (emerging as unwanted side-effects). Conclusions The present review illustrates the remarkably broad scope and diversity of psychosocial areas affected in schizophrenia and shows how these areas are interconnected and how they interact with contextual factors. The need for a shift in focus of schizophrenia research is suggested – from an excessive reliance on global measures of psychopathology and disability for defining outcomes to the creation of profiles of specific PSDs that have a more direct bearing on the disabling experience and real-world functioning of patients and can serve to guide interventions and monitoring over time.

Aim. The aim of this publication is to analyze the organizational units of mental healthcare for adults based on the data on the services reported to the National Health Fund in 2010--2016. Method. The following organizational forms of care were analyzed: mental health outpatient clinics, general psychiatric wards, general day care psychiatric wards, community mental health teams, and psychiatric emergency rooms. These organizational units were analyzed in terms of their number, utilization and accessibility. In addition, a preliminary simulation of the expected Mental Health Centers was carried out. Results. In Poland, in 2010--2016, the number of mental health service providers under contracts with the National Health Fund increased by 5%. The most robust growth was observed for community mental health teams, whose number increased by 282%. However, this organizational form was used by a marginal (1.9%) percentage of patients. The highest rate of admission to general psychiatric wards was observed in districts where a general psychiatric ward and a mental health clinic were available with no day care psychiatric wards or community mental health teams. A small number of entities providing comprehensive care was in operation in 2016. The preliminary simulation has shown that in 2016 a total of 156 Mental Health Centers should have been in operation, assuming that each of them would have provided care for 200,000 inhabitants. Conclusions. It would be advisable to analyze the exact geographic distribution of units, human resources in individual organizational units, and to take financial outlays for mental healthcare in their various forms into consideration. [ABSTRACT FROM AUTHOR]

Aim. In Poland, there is no systematic epidemiological research on mental disorders of children and adolescents in the general population, as well as a register dedicated to mental disorders. The aim of the presented study is to analyze psychiatric services reported to the National Health Fund that were provided to children and adolescents in the years 2010--2016. Method. The starting point of this study was report entitled Maps of health needs in mental disorders published by the Ministry of Health. The analysis concerns all mental health services provided to children and adolescents in the years 2010--2016. The analysis covers seven largest, in terms of the number of patients, groups of mental disorders according to ICD-10 in children and adolescents. Results. In the years 2010--2016, both the number of psychiatric service users under the age of 18 years and the total number of healthcare services have increased in almost all of analyzed areas. Unusually high increase in the number of services provided in the ad hoc mode in A&E department was registered, with a very small share of services provided in home environment. In almost all analyzed groups of mental disorders, there was a greater number of boys, as well as residents of a town/city. Only in the group of neurotic disorders associated with stress and in the somatic form a slightly higher number of girls was noticed. Conclusions. In the years 2010--2016, an increase in the number of registered cases in the population of children and adolescents and the number of services in almost all of the analyzed areas was observed. High increase in services provided in the ad hoc mode in A&E department and a small share of services provided in the home environment indicates significant discrepancy between the needs and the availability of resources. [ABSTRACT FROM AUTHOR]

Aim. Analyzing the indices that allow to improve population health by, for example, improving the quality of healthcare services and increasing accessibility to these services is among the priorities of the World Health Organization (WHO). This is of particular importance in Poland, as the psychiatric care reform is being carried out in accordance with the National Mental Healthcare Program guidelines. The aim of the study is to analyze mental health services provided to adults and reported to the National Health Fund in 2010-2014. Methods. In the present study, we expanded the information included in the second part of the maps of health needs. In addition to the evaluation of services provided to adults in 2014, we presented an analysis of services in 2010-2014. According to these data, there was a continuous increase both in the number of individuals provided with services for psychiatric disorders and in the total number of provided services. There was an increase in the number of patients treated for mood disorders, neurotic disorders, stress-related and somatic disorders, as well as addictions. Results. The increase in the total number of services was mainly seen for outpatient types of care. The reasons why in 2014 there was a resurgence in psychiatric hospitalizations and in the hospitalization rate per 100 thousand adults remains unclear. Conclusions. Our results indicate the need for further support of the development of psychiatric care using multidirectional efforts within an integrated model for solving health problems. An overall analysis of services provided in psychiatric care requires access to information on services funded from non-public sources and expanding the reported information. [ABSTRACT FROM AUTHOR]

Aim. The purpose of this study was to evaluate the impact of anti-stigma training led by people who had previously experienced mental health crises (i.e., 'experts by experience') on various aspects of participants' attitudes towards the people with mental illness. Method. The three-hour workshops were attended by 185 people; the training was held in 17 groups, with 3-19 people in each (11 on average). Almost half of the participants (45.4%) were employees of the mental health care system. The participants were asked to fill out a set of questionnaires immediately before and after the training, which evaluated the following aspects of their attitudes: social distance, stigmatizing attributions, beliefs about self-determination/ability to attain important life goals by people with mental illness, and also beliefs about the social value of people with mental illness. The respondents were asked to complete the same set of questionnaires again online a month and six months after the training. The data were analyzed based on a piecewise latent trajectory model. Results. Out of the 185 people who participated in the workshops, 115 (62.2%) filled out the questionnaires a month after, and 87 (47.0%) six months after the training. The analyses showed an improvement in all four measures of attitudes expressed directly after the training. In three out of the four examined aspects of attitudes (intensity of social distance, stigmatizing attributions and beliefs about self-determination of people with mental illness) the positive impact of the training continued after six months. Conclusions. The results provide preliminary empirical evidence that the structured antistigma intervention under evaluation, using the elements of education and interpersonal contact can be an effective tool for improving social attitudes towards people with mental illness. [ABSTRACT FROM AUTHOR]

Background : There is a need to develop culturally adapted interventions that support the personal recovery and real-world functioning of people diagnosed with schizophrenia. Aims : This study reports on the development and evaluation of a culturally adapted, recovery-oriented, cognitive behavioural workshop for service users with schizophrenia. Method : The feasibility and acceptability were assessed, as were changes over time in personal recovery and psychosocial functioning (primary outcomes) along with psychopathology and health-related behaviours (secondary outcomes), using multi-level modelling. It was also assessed whether personal recovery predicts psychosocial functioning. Results : The workshop was feasible and was received favourably. Participants improved over time regarding confidence and hope, feeling less dominated by symptoms, psychosocial functioning, and psychopathology. Personal recovery predicted decreased psychosocial difficulties. Conclusions : The workshop is a promising intervention. It shows potential in terms of both improving personal recovery as well as real-life functioning of people diagnosed with schizophrenia. Further workshop evaluation in a randomized controlled study is required. [ABSTRACT FROM AUTHOR]