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The Roma people are one of the most unknown and interesting nations in Europe. Although they are severely marginalised within European societies, they have greatly influenced European culture. Despite this fact, there is a deep prejudice against them. In the region of East Macedonia and Thrace, a significant proportion of the population are Roma. Their marginalisation leads to many problems and also affects their mental health. Their psychopathological manifestations differ from the majority population. They express more somatic complaints and higher overall stress in a histrionic background. The main obstacles regarding their mental health issues and treatment appear to be the following: gender inequality, illiteracy and lack of cultural sensitivity in healthcare system. Although all of these obstacles must be removed, some are easier to remove than others. Cultural sensitivity could be applied by using more culturally sensitive diagnostic tools, improving overall training for mental health professionals and treating Roma wherever they seek help, because they often have a nomadic style of living. Telemedicine can be quite useful in serving this goal. Improving their educational status and addressing gender inequalities issues, on the other hand, are more difficult and long-term goals.
Armenia is a landlocked mountainous country between the Black Sea and the Caspian Sea, in the southern Caucasus. It shares borders with Turkey to the west, Georgia to the north, Azerbaijan to the east, and Iran and the Nakhchivan exclave of Azerbaijan to the south. Its total area is 29 743 km2. A former republic of the Soviet Union, Armenia is a unitary, multi-party, democratic nation state with an ancient cultural heritage. Armenia prides itself on being the first nation formally to adopt Christianity (in the early 4th century).
Germany has an approximate area of 357 000 km2. Its population is 82.526 million. The life expectancy at birth is 75.6 years for men and 81.6 years for women (World Health Organization, 2005). The proportion of gross domestic product allocated to the health budget is 10.8%. The per capita total expenditure on health is $2820 (international dollars here and below) and the per capita government expenditure on health is $2113 (World Health Organization, 2005). A major factor in recent German history was reunification, which had a pronounced effect on the German healthcare system.
National information on mental health services in the Philippines indicates that there are substantial gaps and inconsistencies in the delivery of mental healthcare. The recently enacted Mental Health Act legislation provides a platform for the delivery of comprehensive and integrated mental health services. However, there remain many challenges in the provision of accessible and affordable mental healthcare.
Estonia is a small country (45 000 km2) with a population of 1.3 million people. It has undergone rapid change since it gained independence from the Soviet Union in 1991. It has achieved some economic success, although there is a suggestion that this has been at the expense of the mental health and general emotional well-being of the people. In the Estonian Health Interview Survey, depressive symptoms were observed in 11.1% of respondents and their presence was strongly correlated with socio-economic status (Aluoja et al, 2004).
Hong Kong was a UK colony before 1997 but has since been a Special Administrative Region of the People's Republic of China. It is located in southern China and has an area of 1104 km2. Approximately 95% of Hong Kong's population is ethnic Chinese. Hong Kong is a developed capitalist economy, with a gross domestic product of US$301.6 billion (2009 estimate), of which about 5.5% is spent on healthcare and about 0.24% on mental health (World Health Organization, 2005). Despite the relatively low level of spending on healthcare, Hong Kong nevertheless has one of the longest life expectancies in the world (79.2 years for men; 84.8 years for women) and a very low infant mortality rate (2.93 per 1000 live births) (Central Intelligence Agency, 2010).
The Republic of Niger is a large, landlocked west African country. Around 80% of its vast land mass (1 300 000 km2) is in the Sahara Desert. Its neighbours are Mali, Algeria, Libya and Chad to the north, and Nigeria, Benin and Burkina Faso to the south. The country came under French rule in the 1890s and gained its independence in 1960, but development has been slowed by political instability, lack of natural resources and drought. In 1999, voters overwhelmingly approved a new constitution, allowing for multi-party elections, which were held later that year. An ongoing rebellion in the north makes access to much of the country difficult.
Switzerland - officially the Swiss Confederation - is a federal republic situated in central Europe. It covers an area of 41 287 km2 and has a population of just over 7 600 000. Switzerland consists of 26 federated states, of which 20 are called cantons and 6 are called half-cantons. German, French and Italian are Switzerland's major and official languages.
The following view was espoused in a 1903 Lancet editorial describing psychiatric services in the East: ‘The treatment of lunatics in the East has not yet fully emerged from the clouds of ignorance and barbarism which have surrounded it for ages.’ One of the first reformers was ‘Mr. Theophilus Waldmeier, a gentleman resident in Syria, who commenced in the spring of 1896 the work of helping and providing for the numerous sufferers from mental disease in Syria and Palestine.’ He attempted to introduce the methods of humanity and science in this field. In 1939 Bernstein described his visit to the Maristan Arghoum, a psychiatric hospital, in the city of Aleppo. He observed the complete lack of medical supervision, ‘bad’ patients being chained and the despotic rule of the ‘keeper’ of the hospital.
Argentina, the second largest country in South America is a federation of 23 provinces and its capital, the autonomous city of Buenos Aires. Its population is a little over 40 million, 50% of whom reside in its five largest metropolitan areas. The rural areas are extensively under-populated. The city of Buenos Aires and its suburb contain 15.5 million inhabitants, making it one of the largest urban areas in the world.
The Republic of Mauritius is a group of islands in the south-west of the Indian Ocean, consisting of the main island of Mauritius, Rodrigues and several outer islands, situated 900 km to the east of Madagascar. It has a total land area of 2040 km2 and a population of around 1.2 million. Mauritius has a multiracial population whose origins can be traced mainly to Asia, Africa and Europe. English is the official language but French remains the most widely spoken, along with the local dialect, Creole, which is derived from French. Mauritius is classified as an upper middle income country in sub-Saharan Africa by the World Bank. It has a per capita gross domestic product (GDP) of US$13 200.
Since the mid-1980s, a profound reform in the organisation of mental health provision has been taking place in Greece (Madianos & Christodoulou, 2007; Christodoulou, 2009). The aim has been to modernise the outdated system of care (Christodoulou, 1970), which was based on in-patient asylum-like treatment, the beginning of which can be roughly dated to the second half of the 19th century (Christodoulou et al, 2010).
Botswana is a landlocked country located in southern Africa. More than two-thirds of it (70%) is covered by the Kalahari Desert, known locally as the Kgalagadi. The majority (82%) of the nearly 2 million population live in the eastern part, along the railway line from Lobatse in the south-east to Francistown in the north-east, and the rest in the central part, including the Okavango River delta.
Tajikistan, in Central Asia, gained its independence in 1991, with the break-up of the Soviet Union. There followed a period of civil war, 1992–97. In 2003, 64% of Tajikistan's population was poor, which was defined as living on less than US$2.15 per day at purchasing power parity by the UN Appeal for Tajikistan (2006). The Tajik healthcare budget appropriations decreased from 4.5% of gross domestic product in 1991 to 1.3% in 2005. The average annual rate of population growth is 2.19%. The estimated 7 320815 population of the country is mainly rural (73.5%) and about 38% of the country's population is under the age of 14. Life expectancy at birth is 62 years for males and 68 years for females. The infant mortality rate is 106.49 deaths per 1000 live births.
Ghana is a West African state that attained independence from Great Britain in 1957 and became a republican state in 1960. Its population is about 22 million (2004 estimate), distributed in ten regions. The World Health Organization (WHO) has estimated that 650000 of the population are suffering from severe mental disorder and 2166000 are suffering from moderate to mild mental disorder (see www.who.int/mental_health/policy/country/ghana/en).
Slovenia, with an area of 20 000 km2 and a population of 2 million, is one of the smallest members of the European Union. It gained its independence from Yugoslavia in 1991. The country has a gross domestic product (GDP) of US$27 300 per capita. (Largely because of its historical links with Western Europe, Slovenia has a higher GPD compared with other countries in transition in Central Europe.) The health budget represents 8.4% of GDP. Slovenia has a low birth rate and an ageing population. It is divided into 210 municipalities; however, the re organisation of government into several separate regions with more administrative and economic autonomy is in progress. The prevalence of mental illness is comparable to that in other European countries, although there are high levels of alcoholism and suicide.
This paper summarises the impact of a new triage process on referral prioritisation and waiting times in a community specialist child and adolescent mental health service (CAMHS) in Qatar. The process involves initial review of referrals by a CAMHS nurse to ensure that there is adequate clinical information, obtaining additional information from patients/families and referring clinicians by the psychiatric triage team, when necessary, followed by prioritisation and allocation of accepted referrals. The new process reduced the acceptance of inappropriate referrals, ensured prioritisation of referrals and significantly improved the service's compliance with waiting-time deadlines.
The inclusion of children with autism spectrum disorder (ASD) in typical educational settings has only recently gained momentum in Greece, responding to the recommendations of the international conventions. Reform of special education legislation spotlights the inclusion of children with autism in mainstream schools. The principal goal is to accept the diversity and heterogeneity of all students. This paper presents the educational policy for children with ASD in Greece and comments on teachers’ perceptions of inclusion. School closures due to the COVID-19 pandemic had an adverse impact on children's lives and created a new environment with different demands for educational inclusion.
Despite all the internal and external criticisms of mental health services in Libya, they remain underdeveloped across the country. The World Health Organization has made efforts to improve the country's mental health services; however, until a stable government is formed, patients with mental illness will continue to be deprived of their basic needs.
We describe mental health services in Luxembourg and how they have evolved over the past 50 years. Health services in Luxembourg are provided through a social health insurance-based system and mental health services are no exception. Additional services are offered through mixed-funding avenues drawing on social care budgets in the main. Luxembourg is closely connected with neighbouring countries, where a large proportion of its workforce live. No run-through medical training exists and the entire medical workforce, including psychiatrists, have trained in other countries. This is reflected in a rich but often non-uniform approach to the provision of psychiatric care.