Social Vulnerability and Mental Health Inequalities in the "Syndemic": Call for Action.

Covid-19 is referred to as a "syndemic," i.e., the consequences of the disease are exacerbated by social and economic disparity.

Dual diagnosis: A systematic review of the organization of community health services.

Background: Dual diagnosis (DD), as the co-occurrence of a substance use disorder and a psychiatric disorder, is underestimated, under-diagnosed and often poorly treated throughout the world, although it is highly prevalent in people suffering from a mental disorder.

Aims And Methods: This review analyzed 48 studies from a PubMed and PsycINFO databases search, in order to verify the state of the art regarding the organization of community health services for DD treatment.

Results: Four macro-themes have been identified: service organization, critical issues, assessment tools and evidence-based interventions.

Reducing coercion in mental healthcare.

Aims: To examine the extent and nature of coercive practices in mental healthcare and to consider the ethical, human rights challenges facing the current clinical practices in this area. We consider the epidemiology of coercion in mental health and appraise the efficacy of attempts to reduce coercion and make specific recommendations for making mental healthcare less coercive and more consensual.

Methods: We identified references through searches of MEDLINE, EMBASE, PsycINFO and CINAHL Plus.

Global mental health in high-income countries.

Over the past decade there have been significant efforts to scale-up mental health services in resource-poor countries. A number of cost-effective innovations have emerged as a result. At the same time, there is increasing concern in resource-rich countries about efficacy, efficiency and acceptability of mental health services.

Quality of care and its determinants in longer term mental health facilities across Europe; a cross-sectional analysis.

Background: The Quality Indicator for Rehabilitative Care (QuIRC) is an international, standardised quality tool for the evaluation of mental health facilities that provide longer term care. Completed by the service manager, it comprises 145 items that assess seven domains of care: living environment; treatments and interventions; therapeutic environment; self-management and autonomy; social interface; human rights; and recovery based practice. We used the QuIRC to investigate associations between characteristics of longer term mental health facilities across Europe and the quality of care they delivered to service patients.

A Tale of Two Cities: The Exploration of the Trieste Public Psychiatry Model in San Francisco.

According to the World Health Organization (WHO), the "Trieste model" of public psychiatry is one of the most progressive in the world. It was in Trieste, Italy, in the 1970s that the radical psychiatrist, Franco Basaglia, implemented his vision of anti-institutional, democratic psychiatry. The Trieste model put the suffering person-not his or her disorders-at the center of the health care system.

Community mental health care in Trieste and beyond: an "open door-no restraint" system of care for recovery and citizenship.

Since Franco Basaglia's appointment in 1971 as director of the former San Giovanni mental hospital, Trieste has played an international benchmark role in community mental health care. Moving from deinstitutionalization, the Department of Mental Health (DMH) has become a laboratory for innovation on social psychiatry, developing a model that can be defined as the "whole system, whole community" approach. The DMH provides care through a network of community services but also places great emphasis on working with the wider community with a view to promoting mental health and taking care of the social fabric.

Social network intervention in patients with schizophrenia and marked social withdrawal: a randomized controlled study.

Objective: To evaluate the efficacy and feasibility of actions intended to implement or improve patients' social network within the Italian National Health Service community mental health services.

Methods: We conducted a randomized clinical trial through a network of 47 community mental health services on patients with a diagnosis in the schizophrenia spectrum (F20 in the International Classification of Diseases, 10th Revision), who were young (aged younger than 45 years), and with a poor social network (less than 5 relationships). In addition to routine treatments, for the experimental group, the staff identified possible areas of interest for individual patients and proposed social activities taking place outside the services' resources and with members of the community.

Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

Background: The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability.

The development of the Quality Indicator for Rehabilitative Care (QuIRC): a measure of best practice for facilities for people with longer term mental health problems.

Background: Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at most risk of potential abuses of care and exploitation. This study aimed to develop an international, standardised toolkit to assess the quality of care in longer term hospital and community based mental health units, including the degree to which human rights, social inclusion and autonomy are promoted.

"A life in the community": Italian mental health reform and recovery.

There are remarkable parallels between the vision of the Italian Mental Health Reform of the 1960s and 1970s and the vision of "recovery" being promoted around the globe. Most importantly, they share a fundamental conviction in the right of individuals with mental illnesses to "a life in the community", arguing that the basic rights of social inclusion, self-determination, and citizenship provide the necessary foundation for, rather than follow after, recovery. This article describes four strategies used in the Italian Reform to actualize this vision: creating two-way streets between the mental health system and the broader community, establishing social cooperatives with joining forces with other citizens' groups, and working toward community inclusion on a person-by-person basis.

A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems.

Background: A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to identify the key components of institutional care for people with longer term mental health problems and the effectiveness of these components.

Study protocol for the development of a European measure of best practice for people with long term mental health problems in institutional care (DEMoBinc).

Background: This study aims to build a measure for assessing and reviewing the living conditions, care and human rights of people with longer term mental health problems in psychiatric and social care institutions. Protection of their human rights is imperative since impaired mental capacity secondary to mental illness can make them vulnerable to abuse and exploitation from others. They also constitute a major resource pressure for mental health services, social services, informal carers and society as a whole.