pro mente Oberösterreich - inclusion instead of exclusion.

pro mente OÖ is one of the biggest organisations offering psycho-social care and treatment. It is a crucial part of the differentiated system of social psychiatric services in Austria. First, the article describes the organization pro mente OÖ, its history and services. Then, a selection of framework conditions of social psychiatric supply is presented. In this respect some existing strengths and weaknesses of the Austrian psycho-social supply system are discussed.

[Trialogical Evaluation of a Gerontological Psychiatric Consulting and Liaison Service]. / Trialogische Evaluierung eines gerontopsychiatrischen Konsiliar- und Liaisondienstes.

Objective: The presented project shows the effects of a gerontological psychiatric consulting and liaison service (C&L) on nursing home residents and the care team. Methods: The implementation of the C&L was evaluated using a quasi-experimental design in longitudinal section of residents', nursing, medical and family perspective using quantitative and qualitative methods. Results/Conclusion: The results provide evidence for the positive effects of C&L especially in relation to the "common action" within the care team.

[Acute effects of a single bout of moderate exercise on psychological well-being in patients with affective disorder during hospital treatment]. / Auswirkungen einer moderaten Bewegungseinheit auf die psychische Befindlichkeit bei PatientInnen mit affektiven Störungen in stationär psychiatrischer Behandlung.

OBJECTIVE: To explore the effects of a single bout of exercise on psychological well-being in inpatients with affective disorder. METHODS: Thirty-four participants under hospital treatment because of affective disorder attended a supervised but self-paced 60 min Nordic Walking session. All participants completed a self-report questionnaire on psychological well-being before and after physical activity. RESULTS: A significant increase was found for calmness, activation and mood whereas the scales thoughtfulness, weakness, depression and arousal decreased. CONCLUSIONS: A self-paced but supervised single Nordic Walking session seems to be effective in improving acute psychological well-being in patients with affective disorder. Positive affective components of exercise should be addressed in clinical trials focusing on anti-depressive effects and exercise maintenance in patients with affective disorders.

["Schizophrenia has many faces" - evaluation of the Austrian Anti-Stigma-Campaign 2000-2002]. / "Schizophrenie hat viele Gesichter" - Evaluierung der österreichischen Anti-Stigma-Kampagne 2000-2002.

OBJECTIVE: In order to evaluate the effectiveness of the WPA campaign "Open the Doors - against Stigma and Discrimination because of Schizophrenia", five years upon completion of the campaign, a comparative study was performed to assess the possible changes in the general public's attitudes towards schizophrenia. METHODS: Representative population survey, based on a Quota-sampling (n = 988); face-to-face interviews with standardized questionnaires. RESULTS: The results of this study were somewhat sobering, with 22.3 % of the population not having any associations with the term "schizophrenia", 81.3 % not wanting to be further informed about the illness, and 64.1 % agreeing with the statement that patients suffering from schizophrenia are dangerous; compared to the survey in 1998, there was a significant increase within this category. Furthermore, an increase of social distance towards this group of patients has also been noted. CONCLUSION: It is to be asked whether a short intervention can change people's profound attitudes.

[Deinstitutionalization of long-stay psychiatric patients in upper Austria -- utilization of healthcare resources and costs of outpatient care]. / Die Enthospitalisierung ehemaliger psychiatrischer Langzeitpatienten in Oberösterreich -- Inanspruchnahme von Versorgungsleistungen und Kosten der ausserstationären Versorgung.

OBJECTIVE: The study was intended to evaluate the therapeutic and healthcare services utilized by 116 former long-stay patients after an average of 42.9 months of deinstitutionalization during a follow-up time of (1/2) year and to calculate the costs thus incurred. METHODS: 116 patients and their caregivers were interviewed during a period of 6 months using the German version of the Client Sociodemographic and Service Receipt Inventory. RESULTS: On average, 3.3 institutions/facilities were contacted per patient, most often by younger patients living in group homes and least often by patients in psychiatric nursing homes. During the 6-month follow-up time costs of euro 14,665 were incurred per patient. Of these costs, 87.2 % were for the residential facilities. The costs of outpatient care accounted for 41.4 % of the costs that would have been incurred for inpatient care in a psychiatric hospital. CONCLUSIONS: Deinstitutionalization of psychiatric long-stay patients in Upper Austria provided for considerable reductions in costs while maintaining a high quality of care.

[Needs for care of former long-stay-patients living outside of the psychiatric hospital]. / Der Versorgungsbedarf ehemaliger psychiatrischer Langzeitpatienten.

OBJECTIVE: The aim of this study was to assess the needs for care of 116 former long-stay patients during the first 42.9 months after discharge. METHOD: Patients and mental health professionals rated needs using the "Berliner Bedürfnisinventar" (Berlin Needs for Care Inventory). RESULTS: Out of a total of 16 needs areas, patients reported a mean number of 7.6 needs, therapists reported 10 needs. Patients with lower global functioning scores showed a significantly lower number of needs, while patients living in psychiatric nursing homes and patients with learning disabilities had a significantly higher number of needs. In most areas, agreement between patients' and therapists' assessment was good to moderate. In most areas the rate of unmet versus total needs was above 90 %. Patients received help almost exclusively from institutions or mental health services. CONCLUSION: The care needs of discharged patients were generally met and placement in institutions was considered appropriate.

[Shift of usage of medical psychiatric and psychosocial services in Upper Austria (whole territory of Austria) in the period 1965-2005]. / Der wandel der inanspruchnahme von diensten der medizinischen, psychiatrischen und psychosozialen einrichtungen in Oberösterreich (gesamt-Osterreich) 1965-2005.

Psychiatric reforms in Upper Austria have considerably improved the quality of life of psychiatric patients. Modernizing the status of acute psychiatric departments based on a bio- psycho-, social concept implemented multidimensional approach in diagnostics and therapeutic methods applied by multiprofessional teams. Prophylactic procedures and rehabilitation programs have minimized chronification of psychiatric diseases. By "late rehabilitation programs" increased autonomy, more individualized planning of life processes could be achieved even with "chronic" patients. We do not see any need to confine "chronic" psychiatric patients in psychiatric hospitals. These patients are cared for, socially integrated by special rehabilitation measures and professional rehabilitation in community-based services and units of Pro Mente Upper Austria--a non-profit organization. Problems decreased the duration of stay in psychiatric hospitals, and increased admission rates when the number of beds in psychiatric departments was considerably decreased in the course of psychiatric reforms in Austria. In our province--Upper Austria--these problems are of lesser importance because private non-profit organizations like Pro Mente Upper Austria have provided a variety of community-based services (mental health centres, day clinics, housing facilities and special services for drug addicts and geriatric patients) in ever increasing numbers. Still there is the need for further development of community-based services provided by specially trained professionals. These services are financed mainly by the state, the provincial government, the labour market services and to a small degree by funds of the European Union. In these days of reduced social budgets of the state and social departments of provincial governments it is not easy to keep our standards and meet the increased needs of our clients.

[Deinstitutionalization of long-stay psychiatric patients in upper austria - living situation, social and clinical characteristics more than one year after discharge]. / Die Enthospitalisierung psychiatrischer Langzeitpatienten in Oberösterreich - soziodemografische und klinische Daten.

OBJECTIVE: In Upper Austria, a total of 409 long-stay patients were discharged to various residential facilities between 1995 and 2000. This paper describes psychopathology and sociodemographic characteristics. METHODS: A random sample of 116 former long-stay patients were followed for an average 42.9 months after discharge. RESULTS: Patients had spent an average 19.3 years in psychiatric wards. 47 patients (40.5 %) were placed in nursing homes, 16 patients (13.8 %) in old-age homes, 32 patients (27.6 %) in other institutions and only 15 patients (12.9 %) in group homes, and 6 patients (5.2 %) with families. ICD-10 diagnosis was schizophrenia in 56 patients (48.3 %) and mental retardation in 33 patients (28.4 %). Level of social and functional disabilities was high. CONCLUSIONS: Most long-stay patients were able to live outside psychiatric hospitals, but institutional care still plays an essential role.

[Die entwicklung der psychiatrie in oberosterreich 1960 - 2000.].

Psychiatric reforms in Upper Austria have considerably improved the quality of life of psychiatric patients. Modernizing the status of acute psychiatric departments based on a bio- psycho-, social concept implemented multidimensional approach in diagnostics and therapeutic methods applied by multiprofessional teams. Prophylactic procedures and rehabilitation programs have minimized chronification of psychiatric diseases. By "late rehabilitation programs" increased autonomy, more individualized planning of life processes could be achieved even with "chronic" patients. We do not see any need to confine "chronic" psychiatric patients in psychiatric hospitals. These patients are cared for, socially integrated by special rehabilitation measures and professional rehabilitation in community - based services and units of Pro Mente Upper Austria - a non-profit organization. Problems are decreased duration of stay in psychiatric hospitals, increased admission rates when the number of beds in psychiatric departments was considerably decreased in the course of psychiatric reforms in Austria. In our province - Upper Austria - these problems are of lesser importance because private non-profit organizations like Pro Mente Upper Austria have provided a variety of community-based services (mental health centres, day clinics, housing facilities and special services for drug addicts and geriatric patients ) in ever increasing numbers. Still there is need of further development of community-based services provided by specially trained professionals. These services are financed mainly by the state, the provincial government, the labour market services and to a small degree by funds of the European Union. In these days of reduced social budgets of the state and social departments of provincial governments it is not easy to keep our standards and meet the increased needs of our clients.