"Ta spletna stran je nastala s finančno podporo Norveškega finančnega mehanizma. Za vsebino te spletne strani je odgovorno izključno Slovensko združenje za preprečevanje samomora in zanj v nobenem primeru ne velja, da odraža stališča Noslica - Programa Norveškega finančnega mehanizma."
PRESENTATION NAME: MOČ – Help to people, knowledge to experts: expanding the network of counselling centres for people in mental distress and the training of professionals on suicide prevention and strengthening mental health.
PROJECT COORDINATOR: National Institute of Public Health, Slovenia
PROJECT PARTNERS: University of Primorska – Andrej Marušič Institute (www.iam.upr.si/sl), Slovenian Association for Suicide Prevention – POSVET (www.posvet.org), OZARA Slovenia, National Association for Quality of Life (www.oraza.org)
PROJECT LEADER: Assist. Prof., D.Sc. Saška Roškar, NIJZ;
ASSISTANT PROJECT LEADER: Nuša Konec Juričič, MD, NIJZ;
PARTNER REPRESENTATIVE: Mojca Vatovec, Slovenian Association for Suicide Prevention Psychological Counselling Centre POSVET;
PARTNER REPRESENTATIVE: prof. Diego De Leo, Vita Poštuvan, University of Primorska, Andrej Marušič Institute, Slovenian Centre for Suicide Research;
PARTNER REPRESENTATIVE: Bogdan Dobnik, OZARA Slovenia, National Association for Quality of Life;
PROJECT DURATION: February 2015 – April 2016
FINANCING: Project is supported by Norwegian Financial Mechanism Programme 2009– 2014
Official webpage of the Norwegian Financial Mechanism:
National webpage of the Norwegian Financial Mechanism:
ABOUT THE PROJECT
Major differences exist in the accessibility of services in the field of mental health in Slovenia. The general objective of the MOČ – HELP TO PEOPLE, KNOWLEDGE TO EXPERTS project is to improve these services. We will strive to reach this objective by educating professionals from the primary health level, social protection and the police. We will also expand the practice of psychological counselling centres Posvet (Ljubljana and Kranj) and Tu smo zate (Celje) to other Slovenian regions.
Specific objectives of the project:
- To increase the number of primary health professionals and others who are trained to recognize mental distress and suicidal behaviour in Osrednjeslovenska, Savinjska, Koroška and Posavska region;
- To upgrade existing counselling centres (in Ljubljana, Celje, Kranj) and to establish new counselling centres for adults in mental distress in four other regions.
Target groups of the project:
- Primary health professionals and others who work with vulnerable groups and individuals;
- Adults in mental distress.
Outputs of the MOČ – HELP TO PEOPLE, KNOWLEDGE TO EXPERTS project:
- Increased capacity of primary health professionals and others in the field of mental health;
- Improved local capacities in the field of public health.
Key results of the project:
- Inclusion of at least 100 professionals in the educational programme for recognizing mental distress and suicidal behaviour;
- 3 existing psychological counselling centres for people in mental distress upgraded and 4 new ones established.
The project is financially supported by Norwegian Financial Mechanism Programme 2009–2014. National Institute of Public Health is project coordinator and other partners are: University of Primorska – Andrej Marušič Institute, Slovenian Association for Suicide Prevention – POSVET, and OZARA Slovenia, National Association for Quality of Life.
MOČ – Help to people, knowledge to experts project consists of the following working sets (WS):
- WS 1: Management and coordination;
- WS 2: Information and publicity;
- WS 3: Training programme on mental health and suicide prevention for professionals;
- WS 4: Upgrading existing counselling centres with new services and establishing new counselling centres for adults in mental distress;
- WS 5: Raising awareness;
- WS 6: Evaluation.
1 1. 1. PROJECT BACKGROUND AND SCOPE
Comprehensive analysis and outline of the mental health problem
Mental health is the basis for social and economic welfare of individual and the society and is therefore one of the most important public health domains Mental disorders on the other hand do not only represent a burden for individuals and their families but also a loss and burden for economic, social and educational systems. Some data show that in 2011 38.2 % of EU population (including Iceland, Norway and Switzerland), that is 164.8 million people, suffered from mental disorders. The most frequent were anxiety disorders (14 %), insomnia (7 %), and severe depression (6.9 %) (Witchen et al, 2011).
Depression and suicide are very common in Slovenia. If depression is not recognized and treated in time, it can lead to suicidal behaviour.
In addition to temporary mental distress among the adult population, Slovenia is mostly facing two public health problems, i.e. depression and suicide. Studies estimate that one half of people suffering from depression are not recognised on primary health care level on time and thus do not receive appropriate treatment (Kozel in dr., 2012). Unrecognised and untreated depression can lead to suicidal behaviour. In this respect, studies established that months or even weeks before committing suicide, suicidal people visited their general physician more often, but suicidal intent was not recognised (Rodi et al, 2010). Primary health care professionals as well as professionals from other sectors report problems with recognising temporary mental distress, mental problems and suicidal behaviour and with skills for working with vulnerable individuals. Therefore, it is essential to consistently and continuously work with all gatekeepers of the system (general physicians, nurses, police officers, social workers) who come in contact with vulnerable individuals (Mann et al, 2005).
In Slovenia, we have to increase the availability of psychotherapeutic treatment and psychological counselling: MOČ – HELP TO PEOPLE, KNOWLEDGE TO EXPERTS project will enable the establishment of new counselling centres (in addition to existing counselling centres in Ljubljana, Celje and Kranj).
We have to enable proper help in the form of counselling for those individuals who are highly endangered as well as for those who are experiencing temporary mental distress. Slovenia enables psychotherapeutic treatment, which is covered by health insurance, but the waiting lists are very long (even up to 6 months), which is unacceptable for people in mental distress. Because of these needs, people in Ljubljana and Celje region took the initiative and they developed and organized Counselling Centres for Adults in Mental Distress, which operate on a regional level. Counselling is available in a relatively short time (in a few weeks) and without doctor’s referral. Each individual contributes EUR 5 for one counselling hour. Until now, other regions do not have such initiatives.
The professionals who work in the field of psychological counselling also need help in strengthening their own mental health.
Work with people that are facing mental health problems is also stressful for the professionals who are offering treatment. Various studies have shown that 27 % of general physicians experience mental health problems due to work-related stress, most commonly depression, bipolar disorder, alcohol abuse and abuse of other psychoactive substances (Center et al, 2003). It is thus important to enable this group of professionals various forms of help and support. These include the presentation and learning of skills, which help professionals maintain and strengthen their own mental health (Ramirez et al, 1996).
1.1. Contribution of the MOČ – HELP TO PEOPLE, KNOWLEDGE TO EXPERTS project to solving the issue of lacking recognition of depression and suicidal behaviour
MOČ – HELP TO PEOPLE, KNOWLEDGE TO EXPERTS project is directed in each of the above described fields with the final objective of improving mental health services in Slovenia. Using programmes of training for the professional for early detection of depression and suicidal behaviour The problem of lacking recognition and treatment of endangered individuals will be solved by preparing a training programme on mental health and prevention of suicidal behaviour for primary health care professionals and others who work with vulnerable individuals (police, social workers) in the Osrednjeslovenska, Savinjska, Koroška and Posavska regions.
To increase accessibility of mental health services and counselling services by expanding the network of psychological counselling centres across Slovenia
The gaps and inequalities between individual regions in the sense of accessibility of mental health services (especially counselling) will be addressed by expanding the network of counselling centres for adults experiencing mental distress. We will upgrade the two existing counselling centres in Ljubljana and Celje with new contents and develop new counselling centres in four other regions (Posavska, Koroška, Notranjsko-kraška and Gorenjska). The expansion of the counselling centres network will:
- contribute to reducing the gap and inequalities in the accessibility of counselling for adults in mental distress;
- enable simply accessible early treatment and support for people suffering from temporary mental distress and thus prevent the slip into mental disorder;
- enable better and comprehensive treatment for people who will be recognized by primary health care professionals as endangered and who might need additional treatment and psychological counselling.
Using the programmes for strengthening mental health of the professionals working with vulnerable groups in order to influence the increase of their competences
In order to tackle mental health distress due to work-related stress (especially among primary health care professionals and others who work with vulnerable people), we will offer programmes for strengthening their own mental health for the included gatekeepers of the system. In this way, we will contribute to:
- increasing competences of professionals for their work with vulnerable individuals;
- reducing stress and other mental health problems of professionals.
1.2. Compliance with national and international documents of the area under consideration
The content of the project complies with the following national and international documents from the field of mental health:
- Proposal for the Resolution on the National Mental Health Programme 2014-2018 is the first strategic document in the field of mental health on the national level in the Republic of Slovenia. The mission of the Resolution is to maintain and improve health status of the entire population with the emphasis on providing support to vulnerable groups and the final objective to raise the quality of life of the Slovenian population. The content of the project will follow some basic principles and foundations of the Resolution, such as:
o Constant education of professionals, updating forms of promotion and protection of mental health, adaptation to actual needs;
o Decentralization and accessibility of mental health services;
o Destigmatization and inclusion of people with mental health problems; o Promotion and protection of mental health;
o Coordination of needs and sources, cost-effectiveness and evidence-based measures;
o Interdisciplinary and cross-sectoral cooperation on policy, legislation and service levels.
The project will address priority areas of the Resolution: mental distress prevention, suicide prevention and combating stigma. The resolution pays special attention to improving accessibility of mental health services and reducing inequalities between regions, greater inclusion of nurses and other health workers and other professionals in the promotion and protection of mental health and treatment of mental disorders, the improvement of cooperation with non-governmental organizations, and destigmatization. The contents of the project are intended to address the above mentioned priorities.
- Resolution on the National Social Assistance Programme 2013-2020 (ReNPSV13-20). The Line III of point 3.2 The network of public services in the field of social welfare programmes defines the Network of programmes in the field of mental health. Among other, it includes preventive programmes, information and advisory programmes with fieldwork, programmes of support and implementation of aid and self-help.
- European Pact for Mental Health and Well-Being from 2008 (and previous documents – Green Paper: Improving the Mental Health of the Population; Declaration and Action Plan for Mental Health in Europe, 2005). The content of the project addresses some of the main points of the pact:
o Prevention of suicide and depression with special emphasis on improving knowledge of health care professionals and other key figures within social sector in the field of mental health; ensuring support mechanisms for individuals after suicide attempts, and their families;
o Mental health in working environment; introduce programmes of mental health and well-being, preventive programmes for stress prevention, aggressive behaviour, use of psychoactive substances, early intervention, combating stigma and social exclusion.
1.3. Established partnerships – synergy and interdisciplinary effects for better quality in the field of mental health Each partner contributes a lot of knowledge and experience from the field of suicide prevention and strengthening mental health to the project.
Establishing new partnerships and connections enables us to follow the principle of unification and coalition of activities, which, until now, we were implementing individually although they were aimed at the same target groups and were covering the same topics, such as counselling for people in mental distress. Project partnership means added value in the sense of establishing sustainable professional interdisciplinary team, which will help the country to implement the activities of national programme for mental health.
2. Innovativeness and sustainability of project results
The project brings new solutions which go beyond existing practices in the field of mental health and suicide prevention in Slovenia. Because it is upgrading them, it is also innovative.
- The existing practice does not provide primary health care professionals and others working with the vulnerable sufficient support for strengthening their own mental health and facing workplace stress (especially when working with people in mental distress). The project and its programme for strengthening own mental health, which will be offered to professionals in the chosen regions, thus represents a new solution.
- In Slovenia, there are major inequalities and differences in the field of mental health between individual regions as regards access to counselling in the event of mental distress, which would be available without a referral, a long waiting period and without additional costs. Such counselling is currently only available in Ljubljana and Celje regions, where counselling centres for adults in temporary mental distress have been developed. These are two examples of good practices, which have been operating for a few years separately and led by two of the project partners. These practices will be unified and transferred to four additional environments or regions.
Individual counselling in the existing centres in Ljubljana and Celje will be upgraded with educational and experiential groups for the grieving, for divorced parents and for parents experiencing problems with their children. There is a great need for such groups, which has been pointed out by practising experts. However, such form of work is not included in the system. The project will also verify the possibilities and advantages of group treatment and support to people with similar experience.
3. Working sets of the MOČ – HELP TO PEOPLE, KNOWLEDGE TO EXPERTS project WORKING SET 1: Management and coordination
WORKING SET 1, leader: NIJZ
Contractual obligations will be implemented in the framework of this working set. NIJZ, as te working set leader id responsible for management and coordination of the project and for harmonized implementation of all project activities and working sets.
Working set 1 is composed of individual subunits or activities, which represent the foundation for easy monitoring of reaching time and content milestones of the project:
- Establishing, coordinating and managing the project group Project joins four partner institutions: NIJZ, OZARA, Posvet and UPR IAM. At first, a smaller working group of representatives from each project partner will be set up. The main activities of this subunit involve managing and coordination of the working group and other partners or participants of the project activities. At least 20 meetings of this working group are planned throughout the duration of the project.
- Administrative management of the project This subunit will focus on financial, schedule and staff management of the project to allow project dynamics to run smoothly.
- Implementation of reporting This subunit will include the implementation of monthly, interim, annual and final reports which will serve as the basis for monitoring the project progress and for the preparation of reimbursement claims.
WORKING SET 2: Information and publicity, WORKING SET 2 leader: NIJZ
This working set includes activities of informing and notifying the public on the existence of the project, its objectives, activities, effects and the results.
It will be carried out by the following planned communication activities:
- Organization of 4 press conferences in order to inform the public on the progress of the project.
- Preparation of press releases and the planning of media releases which will serve for the information of the public on project activities and their progress.
We plan publications in local, regional and national media; however, the emphasis will be on the media in the regions where the programme will be implemented. We will especially focus on informing the public in the regions about the new counselling centres for adults in distress:
o Cooperation with the media in different radio and television broadcasts;
o Cooperation with the media for the preparation of different printed press releases.
For the efficient information of the public on local and national level throughout the duration of the project, we plan to at least 7 press releases and 5 appearances on TV or radio shows.
- Online information and publications
Next to the above mentioned communication activities, we plan the preparation and publication of online stories and news and the establishment of links between existing websites of project partners and others who are connected with the project. We plan at least 10 online publications.
WORKING SET 3: Training programme on mental health and suicide prevention for professionals
WORKING SET 3 leaders: NIJZ and UPR IAM
This working set includes the preparation of a training programme on mental health and suicide prevention for primary health care and other professionals. Furthermore, all professionals included in training programme will be offered the possibility to join the programme aimed at strengthening their own mental health.
- A training programme on mental health and suicide prevention for primary health care professionals We will develop a training programme on mental health and suicide prevention for general physicians and nurses in Koroška, Savinjska, Osrednjeslovesnka and Posavska region.
The programme will address the following:
o Timely recognition of mental distress and mental disorders (with emphasis on depression);
o Strengthening skills for working with individuals in distress; o Recognizing suicidal individuals; o Strengthening skills for working with suicidal individuals;
o Working with family members of vulnerable groups. We will also inform these professionals about the newly set up counselling centres in their region where they can appoint the individuals who they believe would benefit from additional treatment.
- A training programme on mental health and suicide prevention for other professionals
We will develop a training programme on mental health and suicide prevention for professionals in Koroška, Savinjska, Osrednjeslovesnka and Posavska region (police, social workers), who work with vulnerable individuals.
The programme will address the following:
o Recognizing mental distress (with emphasis on depression);
o Recognizing suicidal individuals; o Strengthening skills for working with individuals in distress and suicidal people;
o Working with family members of vulnerable groups. We will also inform these professionals about the newly set up counselling centres in their region where they can appoint the individuals who they believe would benefit from additional treatment.
We plan to include at least 100 primary health care and other professionals in this programme.
- Programme for the professionals to strengthen their own mental health
The activities will be aimed at professional form Savinjska, Osrednjeslovenska, Koroška and Posavska regions who will be included in our training programme on suicide prevention and recognizing mental distress. A programme will be prepared for these professionals in order to strengthen their own mental health and to prevent their burnout – the Nara programme – Power for medical doctors through mindfulness. It will be based on Mindfulness-Based Cognitive Therapy and will be comprised of 9 meetings where participants will recognize dysfunctional mental and emotional patterns and start changing them. The programme will include at least 100 professionals.
WORKING SET 4: Upgrading existing counselling centres with new services and establishing new counselling centres for adults in mental distress
WORKING SET 4 leaders: POSVET and NIJZ
This working set includes the setting up of four new counselling centres for adults in temporary mental distress in regions where they do not exist yet. This will be done by following the model of existing counselling centres in Ljubljana, Celje and Kranj. Individual counselling in existing counselling centres will be upgraded with group treatment for the grieving and for parents. Individual counselling will be offered to adults who found themselves in mental distress due to different life situations (problems at work, school or relationships, unemployment, retirement, different types of losses) and who cannot manage the distress by themselves but at the same time do not need the help of a psychiatrist or medications. Professionally managed educational experiential groups will be offered to the grieving, divorced parents and parents experiencing problems with their children. Due to the numerous problems in the society, the need for such groups is dramatically increasing.
The activities of this working set include:
- Preparing training for counsellors and receptionists in the newly established counselling centres
The training will include the following topics: the most common types of temporary mental distress; the most common mental disorders; the principles of treating persons in mental distress– the first contact; the principles of counselling in the case of temporary mental distress; experiential work. We plan to carry out the trainings, workshops and lectures using multiple lecturers.
o The implementation of lectures with multiple lecturers in the duration of 34 hours;
o Implementation of workshops in the duration of 34 hours.
We will prepare a training programme for new counsellors, which will last 68 hours. Our goal is to gain 13 new counsellors who will be trained for working in counselling centres and counsellor for working in reception offices.
- Setting up new counselling centres
We plan to set up the foundations for new counselling centres in Notranjsko-kraška, Gorenjska, Koroška and Posavska regions. We wish to enable counselling at least twice a week in the duration of 3 hours per day. We will offer informative materials on counselling centres.
- Operation of counselling centres for people suffering from temporary mental distress
This subunit includes individual counselling for adults and management of counselling centres in the duration of 16 months.
Individual counselling for adults includes: o Immediate relief of the individual in the case of emotional distress (fear, anxiety, concern, apathy, etc.);
o Understanding, support and motivation for the change in case of problems that originate in interpersonal relationships, unemployment, different losses, problems at work, etc.;
o Counselling for couples and families. In addition to counselling, this subunit also includes:
o Financial timeline and human resources management of counselling centres;
o Booking clients; o Arranging counsellors; o Managing client records;
o Evaluation of client satisfaction; o Statistical analysis of client and counselling data;
o Supervision of counsellors.
WORKING SET 5: Raising awareness
WORKING SET 5 leaders: OZARA and partners
This working set focuses on raising the awareness of the general public on the importance of mental health, mental problems, their causes and signs as well and on suicidal behaviour. Special emphasis is given to destigamitaztion of mental problems and distress and to strengthening the awareness that timely professional help is important in case of problems.
This working set includes various activities that will inform the broader public about the importance of mental health, signs and causes of mental distress, and suicidal behaviour:
- Lectures for broader public;
- Preparing an informative leaflet with basic information on the signs and causes of mental distress, including suicidal behaviour;
- Airing an add on mental health on TV and radio stations;
- Giving out posters with information about mental health;
- Public event with the aim of raising awareness.
WORKING SET6: Evaluation
WORKING SET 6 leaders: NIJZ and partners
This working set includes activities aimed to evaluation the efficiency of our programme or its individual segments. Efficiency of the programme will be evaluated through different qualitative and quantitative indicators.
The activities in this set include a review of different qualitative and quantitative indicators used to evaluate the efficiency of the programme:
- Satisfaction evaluation of professionals included in the training programme on mental health;
- Evaluation of the change of competences and skills for working with individuals in mental distress (before and after the programme);
- Evaluation of the effects the programme for strengthening mental health of professionals had on their experience of work-related stress.
One of the important (long-term) indicators is also the monitoring of the suicide rate in the chosen regions.
4. The network of MOČ counselling centres
When you need a talk, advice or help, turn to MOČ counselling centres
Psychological counselling centres of The network of MOČ counselling centres are intended for:
- Individuals (individual counselling);
- Couples (couples counselling);
- Families (family counselling).
You can talk with counsellors in psychological centres about problems, such as:
- Troubles in family or partner relationships (challenges of parenting and upbringing, troubles in relationships, divorce, etc.);
- Distress due to different life situations and crises (loss of job, failure in studying, loss of a loved one, leaving of children, retirement, etc.);
- Emotional distress (sever concerns or fears, anger, sadness, melancholy, feeling of emptiness, anxiety, depressiveness, etc.)
- Coping with severe illness, disability;
- Distress you cannot manage by yourself;
- Addiction problems;
- Thinking of suicide;
- Losing a sense of life.
Professional help is easily accessible
The counsellors are trained professionals with different specialities. The ensure confidentiality, respect and acceptance. The discussion takes place in confidential and comfortable environment and it last from 45 to 60 minutes.
You do not need a referral for the counselling: during the project (until April 2016), the counselling if free of charge. It is carried out in 9 counselling centres across Slovenia. It is intended for adults, aged 18 years or more.The counselling is not intended for treatment or long-term psychotherapeutic treatment.
CONTACTS OF COUNSELLING CENTRES, INFORMATION AND BOOKING
LJUBLJANA: Center za psihološko svetovanje POSVET, Mestni trg 8, Ljubljana, booking: every day between 8.00 A.M. and 8.00 P.M, T: 00 386 31 70 47 07, E: firstname.lastname@example.org
CELJE: Svetovalnica za prvo psihološko pomoč v stiski TU SMO ZATE, Območna enota Celje, Nacionalni inštitut za javno zdravje, Ipavčeva 18, Celje, booking: every day between 8.00 A.M. and 3.00 P.M, T: 00 386 31 77 87 72, E: email@example.com
KRANJ: Center za psihološko svetovanje POSVET, Upravna enota Kranj, Slovenski trg 1, Kranj, booking: every day between 8.00 A.M. and 8.00 P.M, T: 00 386 31 70 47 07, E: firstname.lastname@example.org. Delovanje svetovalnice Posvet Kranj delno sofinancira Mestna občina Kranj
SLOVENJ GRADEC: Psihološka svetovalnica POSVET – TU SMO ZATE, Mladinski kulturni center Slovenj Gradec, Ozare 18, Slovenj Gradec, booking: every day between 8.00 A.M. and 8.00 P.M, T: 00 386 31 70 47 07, E: email@example.com
POSTOJNA: Psihološka svetovalnica POSVET – TU SMO ZATE, Center za socialno delo, Novi trg 6, Postojna, booking: every day between 8.00 A.M. and 8.00 P.M, T: 00 386 31 70 47 07, E: firstname.lastname@example.org
SEVNICA: Psihološka svetovalnica POSVET – TU SMO ZATE, Zdravstveni dom Sevnica, Trg svobode 14, Sevnica, booking: every day between 8.00 A.M. and 8.00 P.M, T: 00 386 31 70 47 07, E: email@example.com
LAŠKO: Psihološka svetovalnica POSVET – TU SMO ZATE, Občina Laško, Mestna ulica 2, Laško, booking: every day between 8.00 A.M. and 8.00 P.M, T: 00 386 31 70 47 07, E: info@ posvet.org
NOVA GORICA: Psihološka svetovalnica POSVET – TU SMO ZATE, Območna enota Nova Gorica, Nacionalni inštitut za javno zdravje, Vipavska cesta 13, Rožna Dolina, Nova Gorica, booking: every day between 8.00 A.M. and 8.00 P.M, T: 00 386 31 70 47 07, E: firstname.lastname@example.org
MURSKA SOBOTA: Psihološka svetovalnica POSVET – TU SMO ZATE, Lendavska 1, Murska Sobota, Murska Sobota, booking: every day between 8.00 A.M. and 8.00 P.M, T: 00 386 31 70 47 07, E: email@example.com 5.
Norwegian Institute of Public Health - www.fhi.no
Norwegian Financial Mechanism and EGP Financial Mechanism (Slovene website) - www.norwaygrants.si
The EEA Grants and Norway Grants (basic website in English) - eegrants.org
Ministry of Health of the Republic of Slovenia - www.mz.gov.si
Government Office for Development and European Cohesion Policy - www.svrk.gov.si
Posvet - www.posvet.org
Ozara - www.ozara.org
Živ? Živ! online station for understanding suicide - www.zivziv.si
TO SEM JAZ online counselling service for young people - www.tosemjaz.net
MED OVER NET Health portal with counselling forums for adults - www.med.over.net
This content was created with the financial support of Norwegian Financial Mechanism. National Institute of Public Health and partners – Slovenian Association for Suicide Prevention – POSVET, University of Primorska – Andrej Marušič Institute and National Association for Quality of Life – OZARA Slovenia – are solely responsible for this content, which does not in any case reflect the views of the Norwegian Financial Mechanism Programme.