Transcript National Mental Health Programme - Pedro Mateus

National Mental
Health Programme
EEA Grants Portugal
Mental Health Programme
Pedro Mateus
Summary
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Context
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Programme development
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Mental Health in Portugal
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National Mental Health Plan
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Programme Areas for Mental Health
Indicators - Portugal
Unesco 2011
Real GDP per capita (2013)
14.300 €
Eurostat 2013
Gross domestic expenditure as a percentage of GDP
1.50
Unesco 2011
Unesco 2011
Gross domestic expenditure by field of science
Social Sciences: 12.9%
Medical Sciences: 11.3%
Programme Development
Key points
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Link national priorities with EEA Grants framework.
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Strengthen bilateral collaboration and cross
fertilisation between donors and beneficiaries.
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Define priority areas giving degrees of freedom to
creativity and innovation from candidates.
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Raise the odds for good implementation…
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…and subsequently improve care.
Find balance
EEA Grants scope
Portugal MH needs and
priorities
Programme Development
Grants expected outcomes
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“Reduced inequalities between user groups”
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“Strengthened financing systems”
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“Improved mental health services”
EEA Grants, Programme Areas, Public Health Initiatives - 2010
Mental Health in Portugal
12 MONTH PREVALENCE AND SEVERITY
COMPARISON OF THE RESULTS IN PORTUGAL, OTHER EUROPEAN COUNTRIES AND USA
%
PAÍS
MILD
MODERATE
SERIOUS
ALL
PORTUGAL
7,7
15,5
6,3
22,9
BÉLGIUM
6,4
3,3
2,4
12,0
FRANCE
9,7
6,1
2,7
18,4
GERMANY
4,5
3,3
1,2
9,1
ITALY
4,3
2,9
1,0
8,2
NETHERLANDS
8,8
3,7
2,3
14,8
SPAIN
5,3
2,9
1,0
9,2
UKRAINE
8,2
7,4
4,8
20,4
USA
9,2
9,4
7,7
26,3
(Caldas de Almeida & Xavier, 2013)
Treatment Gap
% people with severe MI without
treatment
% people with mild MI without
treatment
Median delay for the beginning of
Depression treatment
33.6%
64.9%
5 years
(Caldas de Almeida & Xavier, 2013)
Eurobarometer 2010
Data
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Annual prevalence of MH problems: 22,9%
Untreated severe mental illness: 33%
Median of delay for depression treatment: 5 years
Antidepressants use: 15% (EU average = 7%)
40% of the territory (10% of pop.) have 4% of the
HR
National Mental Health Plan
2007-2016
Mental Health Plan
Main objectives
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Assure equity in the access to MH quality care
Decentralize services and increase proximity care
Reduce impact and promote mental health
Integrate MH in PHC
Make the prevention of depression and suicide
Promote and protect human rights
Mental Health Plan
Main results
• Closed psychiatric hospitals
• Opened 15 MH services/units for adults, children
and adolescents
• Trained more than 600 MH professionals in EB
practices
• Financed 46 innovation/community MH projects
• Launched the basis to a residential and supported
care network, gathering Health and Social Affairs
Ministries.
Mental Health Plan
Partnerships
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EC - European Pact for Mental Health (2008)
WHO - Mental Health Plan evaluation (2010)
WHO - Human Rights (2011)
EC - Joint action for Mental Health leadership
(2012)
Participation in the planning of the European and
Global Mental Health Plans (2013).
However…
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In 2012 we had to refit the National Mental Health
Plan into a reality influenced by the economic crisis
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Maintaining priority areas running…
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…with increased challenges
That’s why
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We welcome the support of the grants.
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We understand it as an opportunity to improve care
and develop cooperation with out partners.
Programme Areas for Mental
Health (EEA Grants)
MH programme areas
(what we know)
1.“The financing system has created unintentional disincentives to establish
community based services.“ (Portuguese MH Plan evaluation - WHO 2010)
2.“Action is needed to tackle the steady increase in work absenteeism and
incapacity linked to stress and mental disorders.” (European Commission 2008)
3.“Integrating mental health services into primary care is the most viable way of
closing the treatment gap.” (WONCA - 2008)
4.The importance of schools in the provision of mental health related services for
children and adolescents is crucial. (WHO - 2008)
5.“Portugal is one of the more severely affected countries in Europe by the global
economic crisis in the last years.”
MH programme outcomes
1. Mental health financing system improved.
2. Mental health at work and for population groups mostly
affected by the economic crisis promoted.
3. Treatment of depression in primary healthcare improved.
4. Mental health problems prevention and mental health
promotion in schools for children and adolescents
improved.
5. Access to mental services for population groups affected
by the economic crisis improved.
MH programme outputs
1. Reports evaluating the current mental health financing and
management systems. Pilot implementation.
2. Intervention programmes on the promotion of mental
health at the workplace and support programmes to those
unemployed due to the economic crisis
MH programme outputs
3. Regional training programmes for depression treatment in
primary healthcare.
4. Regional professional training sessions in primary health
care and schools. Promotion and prevention programmes
running.
MH programme outputs
5. Reports on the impact of the economic crisis on the
population mental health and plans developed to reduce
health inequalities
Challenges
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Implementation
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History of implementation challenges:
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legislation implementation
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policy implementation
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evidence based practices implementation
(all are crucial to improve care)
Expectations
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Innovation and creativity.
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Cooperation between countries will become stronger
and go beyond the end of the projects.
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Projects itself will be sustainable after the grants.
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The Grants will help the implementation of the MH
Plan.
[email protected]