Education in mental health promotion and its impact on the participants' attitudes and perceived mental health.

BACKGROUND: Although the promotion of mental health (MHP) through education and training is widely accepted, there is scarce evidence for its effectiveness in the literature from outcome studies worldwide. The present study aimed to assess the effect of a three-semester MHP educational program on the recipients' opinions towards mental illness and on their own self-assessed health. METHODS: Respondents were 78 attendees who completed the assessment battery at the first (baseline) and the last session (end) of the training course. They were primary care physicians or other professionals, or key community agents, working in the greater Athens area. The course consisted of 44 sessions (4 h each), over a 3-semester period, focusing on the principles and methods of mental health promotion, the main aspects of major psychiatric disorders, and on relevant to health skills. Assessment instruments included the Opinion about Mental Illness (OMI) scale and the General Health Questionnaire (GHQ-28). RESULTS: The mean scores of three OMI factors, that is, social discrimination, social restriction and social integration, and the two GHQ-28 subscales, that is, anxiety/insomnia and social dysfunction, were significantly improved by the end of the training course. CONCLUSIONS: The results of this study provide evidence, with limitations, for the short-term effectiveness of the implemented educational MHP program on an adult group of recipients-key agents in their community. Because interventions for strengthening positive opinions about mental illness and enhancing self-assessed health constitute priority aims of mental health promotion, it would be beneficial to further investigate the sustainability of the observed positive changes. In addition it would be useful to examine (a) the possible interplay between the two outcome measures, that is, the effect of opinions of recipients about mental health on their perceived health, and (b) the applicability of this intervention in individuals with different sociodemographic profiles.

Diachronic trends of employment outcome of prevocational training in psychiatric rehabilitation.

BACKGROUND: Although many rehabilitation programmes of prevocational training for chronic mentally ill persons living in the community have been funded, there is scarce literature about the diachronic trends of their long-term employment outcome. Thus the aim of the present study was to compare the 2-year employment outcome of three groups of chronic psychiatric outpatients, having attended similar prevocational rehabilitation programmes in different periods of time. METHODS: The first group (1984 to 1986) comprised 67 rehabilitees, the second (1988 to 1989) 53 rehabilitees and the third (2000 to 2001) 56 rehabilitees. The three groups were compared with regard to employment follow-up achievements and hospitalisation rates assessed at the end of the 2-year follow-up period by a constructed overall index, encompassing employment qualitative and quantitative characteristics. RESULTS: The third group compared to the first and second ones presented a worse employment outcome. No differences were found among the three groups with regard to hospitalisation rates. CONCLUSIONS: There has been a decline in the employment outcome of prevocational training during the current decade. This decline can be attributed to contextual adverse factors such as unemployment, a more demanding labour market and disability allowances offered by the state (the 'benefit trap'). Moreover, the training itself may be 'old-fashioned' enough, thus providing the trainees with inadequate skills to obtain and maintain a competitive job.