RESUMO
Eight community mental health care centres (initiated by the South-Eastern Europe Stability Pact) in Albania, Bosnia-Herzegovina, Croatia, Macedonia, Moldova, Montenegro and Romania were evaluated. Characteristics of patients, patient reported outcomes and patient views of care were assessed in 305 psychiatric patients. Patient characteristics varied across centres, with most patients having long term psychotic disorders. Treatment satisfaction and therapeutic relationships were rated favourably. Subjective quality of life mean scores were rather low, with higher satisfaction with health and dissatisfaction with the financial and employment situation. Being unemployed was the only factor associated with poor quality of life and lower treatment satisfaction. Most developing centres target patients with persistent psychotic disorders. Care appears highly valued by the patients. The findings encourage establishing more centres in the region and call for employment schemes for people with mental illnesses.
Assuntos
Centros Comunitários de Saúde Mental/organização & administração , Serviços Comunitários de Saúde Mental/organização & administração , Transtornos Mentais/terapia , Satisfação do Paciente , Qualidade de Vida , Adolescente , Adulto , Idoso , Centros Comunitários de Saúde Mental/estatística & dados numéricos , Estudos Transversais , Europa Oriental , Feminino , Humanos , Entrevistas como Assunto , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde/métodos , Relações Profissional-Paciente , Psicoterapia , Análise de Regressão , Fatores Socioeconômicos , Desemprego , Adulto JovemRESUMO
AIMS: To describe the mental health system in Albania. METHODS: Data were gathered in 2003 and in 2004 using a new WHO instrument, World Health Organization Assessment Instrument for Mental health Systems (WHO-AIMS), designed for collecting essential information on the mental health system of low and middle income countries. It consists of 6 domains, 28 facets and 156 items. RESULTS: The information collected through WHO AIMS covered the key aspects of mental health system in Albania: the mental health policy and the legislative framework, the network of mental health services and the characteristics of the users, the role of the primary health care, the human resources, the public education and the links with other governmental sectors, monitoring and research. CONCLUSIONS: The data collection through WHO AIMS represented a needed step for a better in-depth knowledge of the system and for implementing actions to strengthen the system. Examples of planned actions were the improvement of the mental health component in primary care, a clear shift of resources from mental hospitals to community facilities, an increase of the outpatient care and an expansion of the mental health information system.