Background: The treatment of severe and chronic mental disorders, such as schizophrenia and related syndromes, is largely based on community mental health services. Aims: The objective of the present study was to assess hospital admissions and length of hospital stay in patients with schizophrenia and related disorders, who are engaged to treatment with a Mobile Mental Health Unit (MMHU I-T) in a defined rural catchment area in Greece. Method: Data were retrieved retrospectively for 76 patients with schizophrenia and related disorders. For each patient, comparison was made for the same interval prior and after engagement to treatment with the MMHU I-T. Results: The average age of patients was 56 years and the mean illness duration was 28 years. The mean follow-up duration was 5.3 years. There was a statistically significant decrease in the annual average of the number of voluntary and involuntary hospitalizations and on days of hospital stay after treatment engagement with the MMHU I-T. Conclusions: Treatment of schizophrenia spectrum disorders in rural residents by the MMHUs may contribute to the reduction of patients’ admissions and length of hospital stay. Future research should address the cost-effectiveness of such interventions.

Background: Patients with severe mental illness (SMI) may be at increased risk for COVID-19-related severe morbidity and mortality. There is limited research on the vaccination rates against COVID-19 in patients with SMI. Aims: The objective of the present study is to explore vaccination rates and co-relations in patients with SMI, attending community mental health services, namely the Mobile Mental Health Units (MMHUs) in rural Greece. Method: All treatment engaged patients with SMI (schizophrenia-spectrum or bipolar disorder) with two MMHUs (MMHU of Kefalonia, Zakynthos and Ithaca, [MMHU KZI] and MMHU of the prefectures of Ioannina and Thesprotia [MMHU I-T]) in rural Greece were enrolled prospectively over a six-month period. The MMHU I-T had adopted a more proactive approach to patients’ vaccination, by informing patients and caregivers for its benefits. Results: Data were analyzed for 197 patients with SMI. The overall vaccination rate was 68.5% and did not differ from the respective rates in the general population. There were no differences in vaccination rates among patients attending the two MMHUs, nor among patients with different diagnoses (schizophrenia spectrum disorders or bipolar disorder). Vaccination was not associated with gender, educational level, history of alcohol and substance abuse, illness duration, or number of previous hospitalizations, whereas the effect size of age was moderate. In more than half non-vaccinated patients the refusal to get vaccinated was associated with fears and concerns as well as false beliefs that are encountered in the general population. Conclusion: In the present sample of treatment-engaged rural patients vaccination rates against COVID-19 appear to be satisfactory. There were no differences in vaccination rates with regard to the interventions that were applied to enhance vaccination. It seems that other forms of intervention should be applied to reluctant patients to modify their attitudes toward vaccination.

The objective of the present study was to measure the very long-term outcome in community-dwelling patients with a diagnosis of psychosis and to search for possible correlations of outcome with clinical factors. The sample included 55 psychotic patients with at least 15 years of disease duration (M = 32.1 years). For the estimation of the outcome, the Health of the Nations Outcome Scale and the Clinical Global Impression Scale were used. A total of 34.5% of the patients had a good outcome, whereas 27.3% had poor outcome. Outcome was found to be correlated to symptoms, and it was significantly worse in patients living with other severely mentally ill family members. In our study, outcome was good in more than a third of patients. Both symptoms and social functioning were associated with outcome. This study may have some implications for mental healthcare delivery.

Background: Mental healthcare service delivery in rural and remote areas in Greece is challenging due to socioeconomic and geographical reasons, and distant facilities. To address the needs of the underserved areas, the Greek state has launched a number of Mobile Mental Health Units (MMHUs). Aim: The objective of the present study was to explore the differences among two MMHUs, one being run by a university general hospital (MMHU UHA) and the other being run by a nongovernmental organization (MMHU I-T). Methods: The two MMHUs deliver services in rural areas of northeast and northwest Greece, respectively. Both MMHUs use the infrastructures of the primary healthcare system and have the potential for domiciliary visits. Results: Medical and nursing staff is much more in the MMHU UHA, whereas MMHU I-T has more psychologists, social workers and health visitors. Patients attended the MMHU I-T were significantly older than the patients attended the MMHU UHA (mean age 64.5 vs. 55.3 years) and the percentage of the elderly patients in treatment with the MMHU I-T (56.5%) is significantly higher than the corresponding percentage of the MMHU UHA (20%). The proportion of patients that received home-based care by the two MMHUs was almost identical. The percentage of patients with schizophrenia spectrum disorders that attended the MMHU UHA was significantly higher. Patients with affective disorders, anxiety disorders and organic brain disorders that attended the MMHU I-T were significantly more. Conclusions: Despite the similarities among the MMHUs in rural Greece, this study recorded some important differences. The differences in staffing may be accounted for by the availability of resources. The differences in the patients’ population may be explained by the fact that the MMHU UHA was designed from its beginning to treat patients with severe mental illnesses, mainly psychoses, and it accepts loss of referrals within the general hospital’s network of psychiatric services. The MMHU I-T is an independent, locally based service that may be better perceived as an expansion of the primary care system. The results of the study could inform service practice and mental health policy.

There is a dearth of studies on gambling problems in patients with psychotic disorders. A retrospective chart review of treatment-engaged rural patients was performed. From a total of 79 patients that were included in the study, 6 had a history of gambling problems, whereas the 1-year prevalence was 5%. Most were male and they underreported their problems. The results of the study correspond to other studies that used more rigorous methodology. Gambling problems in psychotic patients in rural Greece are not uncommon. Such problems can be traced by gathering information from all those who are involved in patients’ care.