Research

Research Program

The research programme of the Ludwig Boltzmann Institute for Social Psychiatry for the years 2008 - 2010 focuses on two subject areas, which are prominent in the current discussion on health politics, especially in Europe:

  1. Mental and physical health as well as human rights in the case of marginalized and high risk groups of society
    The main research areas are health promotion, the provision of adequate services for these groups and the protection of human rights. The main focus is on strengthening the user perspective, quality of life, stigma and discrimination. 
  2. Societal support and coping strategies, helpseeking and service use behaviour in the case of mental disorders
    Persons with mental problems - regardless of the fact whether they fulfil the criteria of WHO ICD-10 or not - use various kinds of "coping strategies", from the negative end of the spectrum, suicidal behaviour, over more or less informal helpseeking in the social network, to the use of institutionalized facilities in the non-psychiatric and psychiatric sector. Projects carried out in this area are taking also aspects of cost efficiency and quality assurance into account.

 

Current Projects

Projects financed in cooperation with EU

EUGATE - European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe

ITHACA - Institutional Treatment, Human Rights and Care Assessment

PROMO - Best Practice in Promoting Mental Health in Socially Marginalized People in Europe

DATAPREV - Developing the Evidence base for Mental Health Promotion and Prevention in Europe: a database of programmes and the production of guidelines for policy and practice

 

Other Projects

"Pharmacy Project": Clients with mental health problems in pharmacies

DRG - Financing systems of inpatient psychiatry

Time series analysis of suicide rates, antidepressant prescriptions and density of psychotherapists

Attempted suicide and suicide - a 30 years' follow up

"Fools'Tower" project: Analysing the dynamics of admissions and discharges in the 19th century

WHO Indicators for psychiatric care

Stigma Coping with Schizophrenia

TRIPS - Mental disorders in the general hospital

 

EUGATE - European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe

Background and Objectives
Meeting health needs of migrants and minorities is a challenge for Public Health. Inequitable variation in utilization of health care services between migrants and minorities concerns both health care providers and policy makers in Europe.
The EUGATE project therefore aims to investigate European Best Practice for improving Access, Quality and Appropriateness of Migrant Health Care.

Methods
The project has three parts of data collection and one final part of synthesizing and interpreting all findings to reach conclusions on recommendations for best practice of health care for immigrants: A document research will address legislation and directives regulating health care for immigrants. Moreover, a Delphi process of expert opinion will investigate what constitutes best health care for immigrants in Europe and finally a primary data collection through interviews with practitioners in health services will be conducted in each country.

Duration & Financing
The EUGATE project is funded by the European Commission DG Sanco, its duration is from January 2008 to December 2010.

For further information please contact our project website:
http://www.eugate.org.uk/

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ITHACA - Institutional Treatment, Human Rights and Care Assessment

Background and Objectives
The acronym ITHACA stands for Institutional Treatment, Human Rights and Care Assessment. There is widespread concern that conditions for many people with mental ill health, mental disability or dependency in institutions in Europe fall short of standards compatible with agreed human rights treaties and conventions, and do not consistently prevent abuse. The ITHACA project will document the factors necessary to create and successfully implement policy to promote the human rights, dignity and general health status of residents in such institutions, based upon the best available evidence and experience.

Methods
The collaborative efforts of 16 organizations involved in ITHACA will produce a monitoring toolkit based on the CRPD. The toolkit will provide information on monitoring practices, explain appropriate human rights literature and conventions and outline an on-site visit audit. This audit/monitoring visit will involve a team of monitors who would make observations of the physical conditions and the quality of care received by service users.

Duration & Financing
The ITHACA project is funded by the European Commission DG Sanco, its duration is from May 2007 to April 2010.

For further information please contact our project website: www.ithacastudy.eu

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PROMO - Best Practice in Promoting Mental Health in Socially Marginalized People in Europe

Background and Objectives
Promoting mental health and preventing mental ill health among the increasing groups of socially marginalized people is a major challenge to European societies. Consistent guidelines on promoting mental health and preventing mental ill health do not exist. Information on what constitutes best practice is fragmented.

PROMO brings together a multidisciplinary consortium of experts from 14 diverse member states (covering more than 85% of the total EU population) to consolidate the knowledge in the field and identify best practice. PROMO will define guidelines for best practice and disseminate the findings widely among the relevant stakeholder groups in Europe. Finally, it will highlight barriers for the implementation of the guidelines and suggest solutions.

Methods
Six different factors of social marginalization are considered: (1) unemployment, (2) homelessness, (3) sex work, (4) having a refugee or asylum seeking status, (5) being an illegal/undocumented person, and (6) being a member of an ethnic minority group. Focusing on major cities, two geographic areas were selected (in Vienna the districts Ottakring and Brigittenau) to assess systems of health and social services for the people concerned. Assessment tools for services and systems of services have been developed by experts using a Delphi process. Legislation and policies concerning the target groups are reviewed. The quality of service is assessed by interviewing experts in the field of mental health promotion of the socially marginalized. Service strengths, weaknesses and special challenges by providing care for the target groups will be analysed. Finally best practice will be identified and disseminated.

Duration & Financing
The PROMO project is funded by the European Commission DG Sanco, its duration is from September 2007 to December 2010.

For further information please contact our project website:
http://www.promostudy.org/

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DATAPREV - Developing the Evidence base for Mental Health Promotion and Prevention in Europe: a database of programmes and the production of guidelines for policy and practice

Background
Mental disorders are already accounting for 20% of all European ill health and premature death. But mental ill health can be reduced by implementation of evidence based mental health promotion and mental disorder prevention programmes. A lack of access to evidence base knowledge, however, is a barrier to the implementation of effective programmes. So the WHO Helsinki Action Plan for mental health called for an integrated set of databases to be developed.

Objectives
Among the objectives are first of all to increase the knowledge across EU member states of mental health promotion and disorder prevention policies and practice. Then, a standardized online information system collecting available mental health promotion and mental disorder prevention practice is developed. Programme outcomes for increased cognitive and emotional development, reduced mental ill health, decreased psychiatric symptoms and disorders, and improved positive mental health are described. The social and economic outcomes such as increased education attainment and decreased sick leave costs are outlined. Finally, the evidence base is quantitatively and qualitatively synthesized to support policy making, research and practice.

Methods
The methods are various. First, developing a protocol for identifying, describing and appraising promotion and prevention programmes. Then developing a software for inputting and searching selected programmes. Identifying evidence and outcomes of main settings as well as describing cost-effectiveness and economic outcomes of main settings. Especially important are dissemination and cross-fertilization: Networks' and Country's knowledge management. Finally, a European Conference will be organised to enhance knowledge-sharing and finally develop guidelines and capacity building.

Duration & Financing
The project is funded by the European Commission DG Research, the duration of the project is from 2007 to 2011.

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"Pharmacy Project"
Background & Objectives
Pharmacies are not only important for health care because of selling medication, but also because they are a low-threshold opportunity to get health information. This study should help to find out how pharmacists see mental disorders of their clients and how they judge their own role concerning these clients.

Methods
In a pilot-study a questionnaire was tested with 30 pharmacists, which will be sent out to all pharmacists in Austria by the Austrian Chamber of Pharmacists.

Duration
2007 - 2011

Financing
Own resources of the institute, in kind means of the Austrian Chamber of Pharmacists.

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DRG - Financing systems of inpatient psychiatry
Background & Objectives
The cost explosion in the health care system has lead to reduce costs. One method of financing in-patient care is the flat rate approach, depending on the diagnosis (DRG = Diagnosis Related Groups), in contrast to the previous daily rate approach. First experiences with the DRG system show that psychiatry seems to be in a disadvantaged situation if the DRG approach is used.

Methods
The hospital financing methods in Austria, Germany and Rumania are compared to investigate the different effects on in-patient psychiatry.

Duration
2007 - 2009

Financing
Own resources

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Suicidal behaviour and helping services
Background & Objectives
The suicide rates of various countries, among them Austria, show a decreasing tendency in the last 20 years. The reasons are not clear. One possibility in Austria could be the increased use of antidepressants during this time, but also the increased availability of psychotherapy.

Methods
Time series analysis of suicide rates, antidepressants prescriptions and density of psychotherapists are carried out.

Duration
2008 - 2011

Financing
Own resources of the institute.

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Attempted suicide and suicide - a 30 years' follow up
Background & Objectives
Attempted suicide and suicide are often seen as a differently severe form of the same phenomenon. In this 30 years prospective follow up study the risk of dying of suicide after a suicide attempt is investigated.

Methods
Actuarial analysis of death certificates of a cohort of 276 patients, who attempted suicide in 1971, with regard to dying of suicide during the following 30 years. Publication phase.

Duration
2002 - 2011

Financing
Own resources of the institute.

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"Fools' Tower" project
Background & Objectives
The characteristics of patients admitted to the "Fool Tower" of the Vienna General Hospital in 1811 and 1812 as well as duration of admittance are investigated and thus make a comparison with the actual situation of in-patient psychiatric care possible.

Methods
Analysis of newly discovered historical documents for the mentioned period by establishing an electronic database.

Duration
2008 - 2011

Financing
Own resources of the institute.

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WHO Indicator Project
Background & Objectives
The World Health Organisation (Regional office for Europe) together with the European Commission have initiated the Declaration of Helsinki (2005), in which the health ministers of the European region commit themselves to an improvement of mental health. Subsequently, in the so-called "Base line Project" data about the respective situation in the member countries were collected and published. In the present project indicators shall be worked out, which allow to monitor the progress concerning the mental health situation.

Methods
Meetings of experts, EFQM

Duration
2008 - 2010

Financing
Trimbos Institute (Utrecht), WHO Regional Office for Europe

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Stigma Coping with Schizophrenia
Background & Objectives
As many studies show, patients suffering from schizophrenia experience stigma and discrimination. The present study analyses the coping mechanisms which patients use for preventive coping in relation to stigma and discrimination.

Methods
Questionnaire survey

Duration
2008 - 2011

Financing
Own resources

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TRIPS - Mental disorders in the general hospital
Background & Objectives
It is well-known that physical illnesses have a high comorbidity with mental disorders, especially with depression and anxiety disorders. Physicians in non-psychiatric departments and general hospitals are usually not trained enough to diagnose these mental disorders. They have also very limited time-resources.

Methods
A simple and short interview was developed (TRIPS = Training for Interactive Psychiatric Screening), which can be used after a short training to diagnose depression, anxiety disorders and alcohol abuse. A screening questionnaire as well as TRIPS were used by non-psychiatric physicians für 290 patients of the Vienna General Hospital and compared with the diagnoses of psychiatrists (with the CIDI) to find out the accuracy of this simple method.

Duration
2003 - 2009

Financing
Own resources of the institute.

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Former Projects

For information on our former projects please have a look at our -> Annual Reports.