50 4th international symposium health for all …symposium will traditionally be held in rijeka,...

4th INTERNATIONAL SYMPOSIUM HEALTH FOR ALL?! MENTAL HEALTH!50 51RIJEKA, MAY 6th 2016 ABSTRACT BOOK

MENTAL HEALTH!

4th INTERNATIONAL SYMPOSIUM

MAY 6th 2016 FACULTY OF MEDICINEUNIVERSITY OF RIJEKA

HEALTH FOR ALL?!

Department of Public Health, Faculty of Health Studies, University of Rijeka

Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka

Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka

hfa.uniri.hr

PATRONAGE/

SPONZORS/

President of Croatia Kolinda Grabar—Kitarović

University of Rijeka

University of Rijeka Foundation

City of Rijeka

1RIJEKA, MAY 6th 2016 ABSTRACT BOOK

MENTAL HEALTH!

4th INTERNATIONAL SYMPOSIUM

MAY 6th 2016 FACULTY OF MEDICINEUNIVERSITY OF RIJEKA

HEALTH FOR ALL?!

Department of Public Health, Faculty of Health Studies, University of Rijeka

Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka

Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka


ABSTRACT BOOK

Publisher:Department of Social Medicine and EpidemiologyDepartment of Social Sciences and Medical HumanitiesFaculty of Medicine, University of Rijeka, CroatiaDepartment of Public Health Faculty of Health Studies, University of Rijeka, Croatia

Editors:Vanja Vasiljev MarchesiMaja Miloš

Design:Vedran Matić

Print:Tiskara Sušak, Rijeka, Croatia

CIP number is avalable at catalogue of University library Rijeka under the number 130918032

ISBN 978-953-7957-48-3

Publisher and editors are not responsible for any errors in the content or linguistic expressions in the abstracts published in this handbook.

4th International symposium “Health for all?! Mental Health!”

Rijeka, Croatia, May 6th 2016

Faculty of Medicine, University of Rijeka

organized by:Department of Social Medicine and EpidemiologyDepartment of Social Sciences and Medical HumanitiesFaculty of MedicineDepartment of Public HealthFaculty of Health Studies

hosted by:University of Rijeka, CroatiaMedical Faculty


The patron of The Fourth Symposium “Health for all?! Mental Health!”

President of Croatia Kolinda Grabar – Kitarović

Ministry of Health

University of Rijeka

Welcome by the Symposium President

Dear Colleagues and Guests,

It is our honour to invite you to participate in the 4th Symposium „Health for All?! Mental Health!“.

Symposium will traditionally be held in Rijeka, Croatia. It will be focused on mental health as a Global Development Priority. According to World Health Organization, mental disorders impose an enormous disease burden on societies throughout the world.

The Symposium is aimed at bringing together a wide variety of specials in the field of mental health with the purpose to show good practice examples, latest trends and improvements, new strategies and policies with the main goal of exchanging experience.

You will have certainly a meaningful experience and opportunities to join conversations in formal and informal environment. An exciting and informative conference program includes invited lectures, workshops on a variety of topics, poster presentations and various social programs. All members of the “Health for all?!” Organizing Committee are looking forward to meet you in Rijeka, Croatia.

Sincerely,

Professor Tomislav Rukavina, MD, PhD

Symposium Chairman: Tomislav Rukavina, MD., Ph.D.,Department of Social Medicine and EpidemiologyFaculty of Medicine, University of Rijeka

Members of the Organizing Committee:Meri Cucančić (Administrative Secretary), Vanja Vasiljev Marchesi, Lovorka Bilajac, Gordana Šimunković, Maja Miloš, Darko Roviš, Denis Juraga, Iva Rinčić, Amir Muzur, Morana Tomljenović

Meeting website: http://hfa.uniri.hr/

Meeting Site: Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka

Web site: http://www.medri.uniri.hr/hr/


Time Table May 6th 2016

Hall of Faculty of Medicine

8,00 - 9,45 Registration

8,00 - 9,45 Poster display

Room 1

09,45 - 10,00 Opening ceremony

10,00 - 11,30 Main Session 1: Reasons for investing in mental health promotion and prevention

11,30 - 11,45 Coffee break

11,45 – 13,15 Main Session 2: Social and Emotional skills in the corelation with mental health

13,15 – 14,00 Lunch and poster viewing

14,00 – 15,30 Main Session 3: Moving beyond evidence based interventions in mental health

15,30 – 17,00 Main Session 4: Capacity building in local community

19,30 - Farewell dinner

Program

Room 1

MAIN SESSION 1: Reasons for investing in mental health promotion and prevention

10,00 – 11,30 Chairmen: Darko Roviš, Gordana Šimunković

MS1-1 Harrie Jonkman, Netherlands: The promise of risk and protective factors for prevention and promotion. Overview, results and new frontiers

MS1-2 Marina Kuzman, Croatia: The reasons to act – adolescents and mental health in the Croatian health system

MS1-3 Stjepan Orešković, Tea Vukušić Rukavina, Croatia: From Mental Health Strategies to Affordable, Cost-Effective and Feasible Interventions: The Role for NNT and NNH

MS1-4 Kruno Topolski, Croatia: Challenges in protection of metal health in Homes for children without proper parental care

Discussion

11,30 – 11,45 Coffee break

Room 1

MAIN SESSION 2: Social and emotional skills in the correlation with mental health

11,45 – 13,15 Chairmen: Morana Tomljenović, Lovorka Bilajac

MS2-1 Carmel Cefai, Malta: Building resilience to promote mental health in children and young people

MS2-2 Vladimir Takšić, Sanja Smojver Ažić, Croatia: Frameworks for emotional and social learning during childhood and adolescence.

MS2-3 Natko Gereš, Berta Bacinger-Klobučarić, Diana Uvodić-Đurić, Sanja Dolar, Marko Đurić, Marina Payerl-Pal, Croatia: MenCare - Working with men on caregiving in Međimurje County through Supertata campaign

MS2-4 Željko Ključević, Grbić M, Parać Z, Ursić J, Croatia: Connect through colours, approach through pictures

MS2-5 Darko Roviš, Dolores Peruč, Tina Jenuš, Croatia: European territorial cooperation project (IPA CLOUD) - Innovative monitoring, diagnostics and epigenetics: A gene x environment interactions pilot study

Discussion

13,15 – 14,00 Lunch


Program

Room 1

MAIN SESSION 3: Moving beyond evidence based interventions in mental health

14,00 – 15,30 Chairmen: Denis Juraga, Maja Miloš

MS3-1 Amir Muzur, Iva Rinčić, Croatia: What is to be based on evidence basedness in mental health?

MS3-2 Daina Udovicich Corelli, Darko Roviš, Croatia: Screening for mental health

MS3-3 Andrea Mataija Redžović, Darko Roviš, Croatia: Evidence-based prevention programs implementation

MS3-4 Branka Meic Salie, Croatia: Respecting human rights of persons with psychosocial disability

Discussion

Coffee

Room 1

MAIN SESSION 4: Capacity building in local community

15,30-17,00 Chairmen: Vanja Vasiljev Marchesi, Tomislav Rukavina

MS4-1 Josipa Bašić, Croatia: Prevention Science - Mental and Behavioral Disorders Prevention and Mental Health Promotion: PhD study's overview

MS4-2 Darko Roviš, Tomislav Rukavina, Croatia: (Mental) Health Promotion and Drug Prevention Study: A specialist postgraduate study at UNIRI

MS4-3 Zrinka Ćavar, Mirjana Orban, Danica Romac, Boris Gracin, Marija Kučan Jukić, Andreja Šimurina Borovečki, Croatia: Development and implementation history of Department for Mental Health and Addiction Prevention in Teaching Institute for Public Health MD Andrija Stampar

MS4-4 Paula Senković, Croatia: Prevention programs of drug abuse in Primorsko-goranska County

Discussion

17,00 Coffee

19,30 - Farewell dinner and dancing music

Poster Section

1. Vranko M, Hruškar P, Velimirović I, Brečić P. - Differences in social competence self-assesment of patientes diagnosed with depression due to the form of treatment

2. Vranko M, Hruškar P, Velimirović I, Brečić P. - Social competence self-assesment of patientes diagnosed with depression

3. Vučica I, Smoljanović M, Pranic S, Jerončić Tomić I. - Some characteristics of mental illness and behavioral disorders in people, over 65 years in the Split-Dalmatia Country

4. Vasiljev Marchesi V, Roviš D, Šimunković G, Miloš M, Juraga D, Bilajac L, Rukavina T: The holistic approach to treatment, social and economic reintegration of drug addicts


Contents

Section 1: Reasons for investing in mental health promotion and prevention 13

The promise of risk and protective factors for prevention and promotion. Overview, results and new frontiers 14

The reasons to act – adolescents and mental health in the Croatian health system 15

From Mental Health Strategies to Affordable, Cost-Effective and Feasible Interventions: The Role for NNT and NNH 17

Challenges in protection of metal health in Homes for children without proper parental care 18

Section 2: Social and emotional skills in the correlation with mental health 19

Building resilience to promote mental health in children and young people 20

Frameworks for emotional and social learning during childhood and adolescence 21

MenCare - Working with men on caregiving in Međimurje County through Supertata campaign 22

Connect through colors, approach through pictures 23

European territorial cooperation project (IPA CLOUD) - Innovative monitoring, diagnostics and epigenetics: A gene x environment interactions pilot study 24

Section 3: Moving beyond evidence based interventions in mental health 25

What is to be based on evidence basedness in mental health? 26

Screening for mental health 27

Evidence-based prevention programs implementation 28

Respecting human rights of persons with psychosocial disability 29

Section 4: Capacity building in local community 31

Prevention Science – Mental and Behavioral Disorders Prevention and Mental Health Promotion: PhD study overview 32

(Mental) Health Promotion and Drug Prevention Study: A specialist postgraduate study at UNIRI 33

Development and implementation history of Department for Mental Health and Addiction Prevention in Teaching Institute for Public Health MD Andrija Stampar 34

Prevention programs of drug abuse in Primorsko-goranska County 35

Poster Section 37

The holistic approach to treatment, social and economic reintegration of drug addicts 38

Some characteristics of mental illness and behavioral disorders in people, over 65 years in the Split-Dalmatia County 39

Differences in social competence self-assesment of patientes diagnosed with depression due to the form of treatment 40

Social competence self-assesment of patientes diagnosed with depression 41


SECTION 1REASONS FOR INVESTING IN

MENTAL HEALTH PROMOTION AND

PREVENTION


Harrie JonkmanVerwey-Jonker Instituut, Nederland

The promise of risk and protective factors for prevention and promotion. Overview, results and new frontiers

During the last 25 years many things happened in the field of prevention of mental, emotional and behavioral problems and disorders among youngsters. Some main topics will be mentioned. Communities that Care is a preventive strategy in which this new scientific knowledge is taken into account. Some important topics will be presented. This program works in different countries, among them the Netherlands and Croatia. During the last years a EU study group worked on the comparison of the results, also on the research of delinquency and drug use of youngsters, risk and protective factors in seven different countries. Some of these results will be presented. In the last part of the presentation we make recommendations to move prevention forward during the next years.

Contact:Dr. Harrie JonkmanVerwey-Jonker [email protected]

Marina KuzmanTeaching Institute of Public Health „Dr. Andrija Štampar“, Croatia

The reasons to act – adolescents and mental health in the Croatian health system

Positive sense of mental health is the foundation for well-being and effective functioning for an individual and for a community. This core concept of mental health is consistent with its wide and varied interpretation across cultures. Mental well-being historically has been misunderstood and often forgotten. Recognizing its comprehensive importance in human's life, organizations, institutions and professionals have spent the last decades actively addressing the barriers that prevent access to mental health care and campaigning for the full incorporation of mental health in worldwide public health. The research showed striking evidence that there is a strong link between the protection of basic civil, political, economic, social, and cultural rights of people and their mental health. In times when conflicts between individuals and communities are on the increase and economic disparities are widening, this message is especially relevant. Research has established overlapping pathways in which individual's mental and physical health mutually influence each other, interacting with social and environmental influences on health. Physiological systems, including genetic, neuroendocrine and immune functioning are acting along with health behaviour, term which embraces range of activities, such as eating, physical activity, smoking, alcohol abuse, safe sexual practices, and adhering to medical therapies.Adolescence is unique, vulnerable and striking period of human life, where pathways of influence and possible long-lasting consequences in the adult- life meet and interact. Adolescents are a vulnerable group and often lack the cognitive abilities and legal status to make responsible and independent decisions concerning their own interests. Their emotional, social and economic environment can greatly influence their emotional and physical development.There are complex interactions between the determinants of health, behaviours and mental health at all stages of life, especially strong in adolescence. Evidence indicates that the social factors associated with mental ill-health are also associated with alcohol and drug use, delinquent behaviour and low school performance. The association between low self-esteem and symptoms of depression are in young people linked with smoking, binge drinking, eating disorders and unsafe sex, putting them at risk of a range of diseases including sexually transmitted diseases.Health and wellbeing of children and adolescents is in Croatia highly ranked and recognized. Research revealed different aspects of mental health and wellbeing among Croatian adolescents. Risk behaviours as smoking and drinking alcohol are very much present among Croatian youth, so young people aged 15-16 are highly engaged in smoking, drunkenness or binge drinking compared to other European countries. Marijuana use is not above European average. In comparison to other European countries, Croatian adolescents are quite rarely engaged in early sexual intercourse. The connection to parents and friends and perception of communication with parents are very well perceived and protective aspect of bonding should be considered while analysing the present situation and planning


the preventive and promoting activities. Interrelation between behaviour and mental health as poor school performance, delinquent behaviours, prescription medication use, symptoms of depression and low self-perception are also found. In Croatia availability of the youth friendly health services did not remain just a vague and remote idea. Based on the traditional health organization, taking into account public health recommendation and organizational and financial circumstances, appropriate services have been created and offered. School and adolescent health services, aiming at the preventive activities for children and adolescents, have been organized in Croatia for more than 50 years. The services underwent several organizational changes and are recently working within institutes of public health, offering health program widely spread within schools and universities across the country. The program, beyond traditional physical examinations, vaccination and health education, includes counselling activities for children, parents and teachers. The counselling is offered for different challenges, as chronic diseases or school performance, but also on the mental and behavioural health, predominantly connected to educational process. Along with this, within institutes of public health, services for mental health and addiction prevention exist, comprising wide range of activities regarding addiction prevention and treatment for adults, and also for young people and their families. The activities range from educational program for teachers, parents or other professional dealing with youth, than population surveys to individual counselling and psychotherapy. Being aware that mental health promotion and the prevention of mental disorders are overlapping and related, but deriving from different conceptual principles and frameworks, institutes of public health organized also specific health promotion units, aiming at the wide range of health promotion activities. There is a commitment within public health system in Croatia to make mental health promotion a part of comprehensive health strategy. Health professionals (and health planners) are often too preoccupied with the immediate problems of those who have a somatic disease to be able to pay attention to needs of the population with „hidden“ needs. They also find it difficult to ensure that the rapidly changing social and environmental conditions have strong influence on mental health. Mental health can be improved through the collective action of society and therefore intersectoral action is increasingly recognized as necessary to address the social determinants of mental health.

Contact:Marina Kuzman, MD, PhDTeaching Institute of Public Health „Dr. Andrija Štampar“, [email protected]

Stjepan Oreskovic, Tea Vukušić Rukavina University of Zagreb School of Medicine,Andrija Stampar School of Public Health, Croatia

From Mental Health Strategies to Affordable, Cost-Effective and Feasible Interventions: The Role for NNT and NNH

Aim/Objective: To outline the development of evidence-based mental health care in Croatia. To review the evidence now being employed to evaluate mental health. To analyze mental health policy in Croatia and compare to best practices in European Union. To define what is to be considered effective and efficient mental health policy and mental health treatment in Croatia. Summary of Materials and Methods We made an effort to compare National Strategy for Protection of Mental Health in Croatia 2011-2016 to Green Paper Improving the mental health of the population: Towards a strategy on mental health for the European Union. The idea was to establish relationship between normative policies and instruments employed to measure impact evidence. The Evidence Based Mental Health policy is sometimes seen as oversimplifying complex problems and offering only limited help in the grey zones of medicine, where scientific evidence is incomplete or conflicting. However, although medical interventions play a central role in tackling challenges, they alone cannot address and change social determinants.. The method that has been proven as reliable and empirical is the number needed to treat (NNT) and its counterpart, the number needed to harm (NNH). This two methods are commonly used measures of effect in studies of mental health treatments. The question is what would be the results of employing NNT method to analysisi of different policies and strategic mental health measures in Croatia. Results In line with the WHO strategy, a comprehensive approach is needed. Public policy should cover the provision of treatment and care for individuals, but also action for the whole population in order to promote mental health, to prevent mental ill health and to address the challenges associated with stigma and human rights. Different treatment methods such as Cognitive behavioural interventions; psychological support for those at risk; training health care professionals in prevention, recognition and treatment of mental health problems including but not limited to pharmaceutical related policies. The measurable outcomes among others should be level of wellbeing, physical health, new knowledge & skills, quality of relationships, sexual satisfaction, use of services, productivity and public safety. Conclusion There is a evident need in Croatia to employ methods that are reliable for comparison of different internatonal and national strategie and their impact on the mental health outcomes. The analytic instruments may vary from analyisis of mental health status of the population to comparative health care policies, analysis of best practices and comparative methods and techniques such as NNT.

Contact:Professor Stjepan OreškovićAndrija Stampar School of Public Health, University of Zagreb School of [email protected]


Kruno TopolskiStudent of Master study of Physiotherapy, Faculty of Health Studies, University of Rijeka, Croatia

Challenges in protection of metal health in Homes for children without proper parental care

Mental health of children and youth is becoming great public health challenge. Promotion of mental health should be emphasised as priority when children and youth are concerned. Unfortunately, more efforts should be invested in promotion of mental health of vulnerable population such as - youth from Homes for children without proper parental care (in short: Homes for children). The aim of this paper is to show risk factor „leaving Homes for children“ in relation to protective factors. When leaving Homes for children youth is inadequately prepared for independent life. They are recognised as a group that faces risk of social exclusion and thus face risk of development health problems, especially mental health problems. After leaving Homes for children, youth are experience problems with continuation of education, employment and housing. In order to empower youth from Homes for children it is essential to work on development of protective factors from the moment they enter institution. The purpose of this work is to elaborate the sport, social support and strengths as the most important components of protection of mental health of youth from Homes for children. In conclusion, it is essential to work on protective factors and promotion of mental health of children and youth from Homes for children. In order to prepare them for independent life and for confrontation with variety of challenges they face while leaving institution, special attention should be put on strengths and stimulation of their involvement in different kinds of activities in Homes and in local community.

Contact:Kruno Topolski, bacc. physioth.Student of Master study of Physiotherapy, Faculty of Health Studies, University of [email protected]

SECTION 2 SOCIAL AND EMOTIONAL

SKILLS IN THE CORRELATION WITH MENTAL

HEALTH


Carmel CefaiUniversity of Malta

Building resilience to promote mental health in children and young people

Increasing social, economic and emotional pressures and stresses in children’s lives are putting the mental health and wellbeing of many children at risk, with about 20% of children facing mental health difficulties during the course of any given year, possibly going up to 50% amongst children from social disadvantaged areas. Half of mental health difficulties begin before the age of 14, underlining the need for early intervention and mental health promotion from an early age. The resilience perspective seeks to break the adversity/disadvantage - mental health problems trajectory by providing children at risk with the personal and social resources needed to protect them against adversity and promote their continued growth and healthy development. This presentation discusses the evidence based processes which have been found to promote children’s health and wellbeing in the face of risk and disadvantage. It also presents a newly developed European resilience programme for schools, called RESCUR Surfing the Waves, and describes how it may be used in the classroom by primary school teachers.

Contact:Professor Carmel CefaiFaculty for Social Wellbeing, University of [email protected]

Vladimir Takšić, Sanja Smojver-AžićFaculty of Humanities and Social Sciences, University of Rijeka, Department of Psychology, Croatia

Frameworks for emotional and social learning during childhood and adolescence

The aim of the presentation is to explain theoretical and practical framework for emotional and social learning (SEL), and to demonstrate all the steps in the Program for Emotional Literacy (EL) developed by psychologists from Yale University and adapted to Croatian setting. It is grounded in theory of emotional intelligence (EI) and Mayer - Salovey four-branch model. The Model defines EI as a set of abilities to perceive, understand, facilitate, regulate and manage one’s own and emotions of other persons. During the last decade, the large body of research confirms that social and emotional competencies can be learned through school-based curriculum activities. Evaluations of school-based SEL programmes from kindergarten to secondary school found evidence for multiple benefits of SEL programmes. Students who participated in EL Program showed significant improvements in their social and emotional literacy: better vocabulary of emotions, understanding of emotions, labelling the emotions. Also, empathy, positive attitudes towards school, classroom behaviour, academic performance and social relationships are improved, while there is a decrease in conduct-related problems and emotional distress.According to recommendations, programs for development of emotional and social competence have to be integrated in school curriculum and offered to all students. The Croatian National Curriculum Framework for pre-school education and general compulsory elementary and secondary education has proposed cross-curricular topics related to personal and social development and health. Successful implementation of the programs in schools would be more effective via education of educators.

Contact:Vladimir Takšić, PhDFaculty of Humanities and Social SciencesDepartment of [email protected]


Natko Gereš1, Berta Bacinger-Klobučarić2, Diana Uvodić-Đurić2, Sanja Dolar3, Marko Đurić1, Marina Payerl-Pal21 NGO Status M, Croatia2 Institute of Public Health Međimurje County, Croatia3 Center for Social Welfare - Family Center Čakovec, Croatia

MenCare - Working with men on caregiving in Međimurje County through Supertata campaign

MenCare is a global fatherhood campaign. It´s mission is engaging men as equal, nonviolent fathers and caregivers with a goal of achieving family well-being and gender equality. This abstract presents a project being implemented in cooperation between the NGO Status M, Institute of Public Health Međimurje County and Center for Social Welfare - Family Center Čakovec, running in the period between June 2015 and June 2016., called MenCare – engaging men in achieving gender equality in Međimurje County. Project supports men as providers of care, engaged in antenatal and early childhood care, through the community campaign and behavior change training for young and future fathers. It aims at empowering men in sharing the duties and roles within households, benefiting men themselves through giving them a feeling of greater involvement in the lives of their children, but also empowering women, through enabling relationship satisfaction, in the same time leading to the greater developmental outcomes of children and stronger connections between children and their fathers. Engaging men includes changing their behavior on the individual level to deconstruct the features of patriarchal masculinity, supporting change on the relationship level by reducing expectations from men as dominant controllers of families and supporting men on a community level by positively using them as a resource for dealing with issues such as GBV, alcoholism, corporal punishment and absent parenthood through providing alternative in the form of gender equitable participation in childcare. The project has reached more than 140 beneficiaries through direct training and more than one thousand secondary beneficiaries through awareness raising campaign Supertata.

Contact:Natko Gereš, MDNGO Status [email protected]

Željko Ključević, Mirela Grbić, Zvonimir Parać, Jadranka Ursić Public Health Institute of Split-Dalmatia County, Service of mental health, Croatia

Connect through colors, approach through pictures

Aim/objective: Drawing attention to the need to maintain and improve the mental health of children and young people with developmental difficulties, including people with disabilities. Materials/examinees and methods: Creative and experiential workshops on the topic "Emotions and Colours" include various art and computer techniques used in order to design templates for tapestries representing the project's outcome materials. A specific means of communication was applied through the two-way socialisation between primary and secondary school pupils and people with difficulties. The effects and aims of project activities were evaluated through a survey which included 359 examinees. 83 pupils were from secondary schools and 276 pupils were from primary schools. The survey consisted of 8 questions, both open ended and closed ended. Results: Over nine-tenths of the examinees are mostly satisfied (26.7%) or completely satisfied (65.2%) with the project. Only 3 examinees (0.8%) expressed their dissatisfaction concerning the project while 25 examinees (7%) said they were partially satisfied with the project. Based on these statistics it is obvious that the project idea was successfully implemented. Conclusions: By participating in the project, pupils from primary and secondary schools raised their awareness concerning the problems of people with difficulties and removed the stigma attached to being different. Raising awareness is supposed to stimulate the inclusion of children and young people with difficulties in social communication and interaction with their peers.

Contact:Željko Ključević, MDPublic Health Institute of Split-Dalmatia CountyService of mental health [email protected]


Darko Roviš1,2,3, Dolores Peruč1, 2, Tina Jenuš2 1 Teaching Institute for Public Health of Primorsko-goranska County, Croatia2 Medical Faculty at Univestity of Rijeka, Croatia3 Faculty of Health Studies, University of Rijeka, Croatia

European territorial cooperation project (IPA CLOUD) - Innovative monitoring, diagnostics and epigenetics: A gene x environment interactions pilot study

This cross border project (A Comprehensive approach to the prevention, treatment and social and economic reintegration of illicit drug users, IPA CLOUD) was approved in 2015 to a consortium of academic, public health and nongovernmental organizations form Rijeka, Croatia and Kopar, Slovenia. One of the work packages includes activities developing innovative approaches to drug monitoring, diagnostics and epigenetics. For this purpose a pilot study was designed regarding gene x environment interactions of the genetic and epigenetic profiles and neurotropic biomarkers and psychosocial conditions and outcomes related to drug addiction. Aims of the study are to determine the prevalence of the genetic polymorphism of 5-HTTLPR and BDNF regions, DNA methilation profiles of SLC64A as well as sera levels of neuropeptid Y and SP among opiate drug addicts and among student population. Furthermore the aim is to determine associations and interactions of the genetic and epigenetic profiles, neurotropic biomarkers and psychosocial conditions and outcomes such as childhood trauma, parental bonding, stress coping skills, personal psychopathology and substance abuse.A blood sample of 9ml for blood serum and 4ml for DNA extraction was taken form 135 drug addict’s registered at Institute for Public Health, Rijeka and 138 control subjects form students and employees of University of Rijeka and Institute for Public Health, Rijeka. Additional 50+50 subjects were recruited at Kopar, Slovenia site. Both groups completed a comprehensive psychosocial questionnaire which included PAI, BIS-11, CTQ, CD RISC, Risk Taking Scale, Parental Bonding Instrument, DUDIT and AUDIT. Initial results show significant associations and interactions between genes, environment conditions and psychosocial outcomes.

Contact:Darko Roviš, PhDTeaching Institute for Public Health of Primorsko-goranska CountyFaculty of Medicine, Univestity of RijekaFaculty of Health Studies, University of [email protected]

SECTION 3 MOVING BEYOND EVIDENCE BASED

INTERVENTIONS IN MENTAL

HEALTH


Amir Muzur, Iva RinčićFaculty of Medicine, University of Rijeka, CroatiaFaculty of Health Studies, University of Rijeka, Croatia

What is to be based on evidence basedness in mental health?

Even in clinical psychiatry, the usefulness of „evidence-based medicine“ has been strongly debated because of the necessary limitations and only relative value of the majority of typical studies published. When it comes to a more general notion of „mental health,“ however, the appropriateness of evidence basedness results even more disputable. The present paper tries to stress the neglected or underestimated importance of vague but constantly motivating human „values,“ hardly measurable and comparable but sometimes still efficient prevention and healing methods, social interactions and individual variations – all lost in „sample“ studies but crucial for the construction of complex mental health. Key words: psychiatry, evidence-based medicine, mental health.

Contact:Professor Amir Muzur, MD, PhDFaculty of Medicine, Department of Social Sciences and Medical Humanities, University of RijekaFaculty of Health Studies, Department of Public Health, University of [email protected]

Daina Udovicich Corelli1, Darko Roviš1,2,31 Teaching institute for public health of Primorsko-goranska county, Department of mental health, Croatia2 Faculty of Medicine, University of Rijeka, Croatia3 Faculty of Health Studies, University of Rijeka, Croatia

Screening for mental health

Aim/Objective: Research and practice show that 12-27% of adolescents feel difficulties related to mental health. Unfortunately, only 15-30% of those who need it, get help. The aim of screening methods and early detection is to reduce the gap between the real needs of the adolescent and the services provided. Summary of materials/examinees and methods In accordance with the change of the Health Care legislation and under the Agreement with the Croatian Institute for public Health on the organization of activities for mental health care in 2010, in September 2010 was launched a comprehensive program "Screening for Mental Health of 7th graders“ in Rijeka. A simple and short screening questionnaire called "Strength and difficulties questionnaire (SDQ)" was used for this purpose. It is a known and proven instrument, which has been in use in Europe and the United States, whose purpose is the early detection of the risk for possible problems in mental health of children and young people. The students answerd the screening test during the regular medical examination in 7th grade. Results In 2001. screening included all students 7th grade elementary schools in the City of Rijeka. Of children covered about 15% were invited to a counselling interview. The turnout was about 30-40%. Children and parents had the possibility to engage in activities that could help them in dealing with current problems and prevent future ones. Conclusions The intention is to implement the measure to the entire population of 7th graders in the Primorsko-goranska County, to make the mental health protection methods become more systematic, continuous and comprehensive. For a successful screening and later referral to counseling, a good cooperation between school health services, mental health professionals and school staff is necessary.

Contact:Daina Udovicich Corelli, mag.psych. Teaching institute for public health of Primorsko-goranska county, Department of mental [email protected]


Andrea Mataija Redžović1, Darko Roviš1,2,3: 1 Teaching institute for public health of Primorsko-goranska county, Department of mental health, Croatia2 Faculty of Medicine, University of Rijeka, Croatia3 Faculty of Health Studies, University of Rijeka, Croatia

Evidence-based prevention programs implementation

The last decade was marked by increased interest in evidence-based prevention programs that cover all areas of children's lives: education, behavior, health, relationships and emotional well-being. The implementation of a new generation of programs, such as PATHS and LST, aims at promoting socio-emotional competence and preventing mental and behavioral problems, including experimental drug use. Pilot implementation of PATHS program in Croatia was conducted from 2007 to 2010 in primary schools in Pore? and Labin in Istria county. After that, the program was implemented from 2010 to 2012, in 15 primary schools and 6 preschools in Zagreb, Rijeka and Istria. "The promotion of mental health and life skills development program ", as a local LST adaptation, is being implemented for 11 years in more than 50 elementary schools in Primorje-Gorski Kotar County, with over 10,000 participating students a year. PATHS evaluation showed improvements in the field of learning and prosocial behavior, as well as the emotional regulation skills and reducing the symptoms of withdrawal and depression, a positive effect on reducing ADHD symptoms, attention difficulties and aggressive behavior of all involved children - preschool and school age. Life skills program significantly slowed the increase of substance use incidence. PATHS program can be implemented in Croatia and with certainty expect positive outcomes for children in lower grades of primary school. The program can be marked as a model program. Life skills program is acceptable and sustainable long-term adaptation for Croatian academic setting.

Contact:Andrea Mataija Redžović, univ.spec.sanit.publ.Teaching institute for public health of Primorsko-goranska county, Department of mental [email protected]

Branka Meic SalieDisability Ombudsman's Office, Croatia

Respecting human rights of persons with psychosocial disability

In the youngest international human rights treaty Convention on the Rights of Persons with Disabilities (CRPD) the United Nations recognized persons with mental health problems which in interaction with various barriers in the society limit their participation as persons with disabilities. The Disability Ombudsman’s Office protects, promotes and monitors rights of persons with disabilities including persons with mental or psychosocial disability. In this presentation we will look into the impact of the social model of disability on treatment and care of persons with psychosocial disability as well as core principles that should guide all interventions. One of the core principles is respect of human dignity even and in particular in situations of psychosocial crisis. A person’s impairment should not limit their right to exercising full legal capacity, right to free and informed consent and respect for liberty and security which prohibits involuntary and coercive treatments. Moreover, service providers have an obligation to provide support for full enjoyment of all human rights including the duty to provide reasonable accommodation. One of the most widely violated rights of persons with psychosocial disability in Croatia is the right to live independently in the community. Persons with psychosocial disabilities are the most numerous category of persons with disabilities completely excluded from the community and placed in institutions because of lack of community support services. Hospitalization seems to be prevailing and very often only available model of treatment and there is a lack of alternatives to coercive treatments.

Contact:Branka Meic Salie, BA, advisor of disability ombudswoman Disability Ombudsman's [email protected]


SECTION 4 CAPACITY BUILDING IN LOCAL

COMMUNITY


Josipa BašićRetired professor from Faculty of Education and Rehabilitation Sciences, University of Zagreb, Croatia

Prevention Science – Mental and Behavioral Disorders Prevention and Mental Health Promotion: PhD study overview

This presentation will include the overview of PhD study Prevention Science and Disability Study at University of Zagreb Faculty of Education and Rehabilitation Sciences. It will consist of reasons which were important to start to prepare this PhD: what kind of competences will students have after they finishing PhD study, how study is organized, which mandatory and elective courses are involved in the study, in what kind of occupations are students involved during the study. Also it will be mentioned who is involved in developing this study (institutions and scientists from Croatia and from US, The Netherland, Slovenia), who were the first generation students to recognize what was the main goals of this PhD study in the field of capacity building to encourage evidence-based and science-based promotion and prevention practice, research and policy making. In general, this presentation will offer some answers like - why is it important to have postgraduate study in the field of mental health promotion and prevention of behavioral and mental disorders in Croatia.

Contact:Professor Josipa Bašić[email protected]

Darko Roviš, Tomislav Rukavina Teaching Institute for Public Health of Primorsko-goranska County, CroatiaFaculty of Medicine, Univestity of Rijeka, CroatiaFaculty of Health Studies, University of Rijeka, Croatia

(Mental) Health Promotion and Drug Prevention Study: A specialist postgraduate study at UNIRI

An effective mental health promotion and prevention requires a comprehensive public health approach across sectors, each influencing different aspects that influence an individual’s health. For achieving population-level effects, a prevention system must have a range of capacities, such as a competent workforce, organizational capacity, strong coalitions and partnerships, effective leadership, available resources and public support. There is a need for developing competent workforce among mental health promotion specialists who facilitate and support the development of policy and practice across a range of settings and among the wider workforce drawn from across different sectors such as health, education, employment, community and non-governmental organisations. According to the national strategy for higher education and life-long learning, priority should be to increase availability of various postgraduate specialist programmes, especially multidisciplinary ones, as this approach offers best flexibility and adaptability towards the changing needs of the societies. In order to pursue this aim, Medical Faculty and Faculty of Science and Arts engaged in development of curriculum for postgraduate specialist study in Health promotion and drug prevention. A two year postgraduate study was developed and piloted in 2007-2010 and the first generation of health promotion and drug prevention specialists were promoted at 2013. The core curriculum included modules on: Socio-emotional development of children and youth; Epidemiology of substance abuse; Development, early detection and treatment of addiction and other risk behaviours; Health promotion and mental health promotion; Prevention strategies and evidence based programs; Development of health promotion and prevention programs and Health promotion practicum. Through elective courses students were able to additionally engage in fields of socio-emotional competencies, physiology of substance abuse, primary health care and health promotion; statistics; communication skills etc.

Contact:Darko Roviš, PhDTeaching institute for public health of Primorsko-goranska county, Department of mental healthFaculty of Medicine, University of RijekaFaculty of Health Studies, University of [email protected]


Zrinka Ćavar, Mirjana Orban, Danica Romac, Boris Gracin, Marija Kušan Jukić, Andreja Šimurina BorovečkiTeaching Institute for Public Health “Dr. Andrija Stampar”, Department for Mental Health and Addiction Prevention, Croatia

Development and implementation history of Department for Mental Health and Addiction Prevention in Teaching Institute for Public Health MD Andrija Stampar

Aim: We would like to present development history of Department for Mental Health and Addiction Prevention (DMHAP) and implemented evidence based interventions and programs. Summary: As way to profile DMHAP we have used a SWOT analysis which includes strengths and weaknesses of the Department as well as opportunities and threats for the Department. Results: Our strengths are well educated multidisciplinary staff which provide evidence based interventions and programs in mental health promotion (Facebook, film-therapy), primary (skills training, education and competences training), secondary (early detection and intervention, on-line consultation for specialists) and tertiary prevention (follow up and rehabilitation), and provide some special programs (non-smoking school). All interventions and programs have quality accreditation based on ISO standards. Our weakness is shortage of staff in regard to region which we cover. One of opportunities is co-operation with Department for Public Health, Department for School Medicine and with Civil Society Organization in mental health promotion and primary prevention activities. One of threats is possible change of law which is not evidence based and which could result in lower quality of Mental Health Care activities. Conclusion: DMHAP in Zagreb is organized as easy accessible, affordable and anti-stigmatic service and is example how should be organized all national DMHAP-s in regard to quality standards for Mental Health Care service with diversity of mental health specialists which provide evidence based interventions and programs based on assessment of clients needs.

Contact:Zrinka Ćavar, MDTeaching Institute of Public Health „Dr. Andrija Štampar“[email protected]

Paula SenkovićStudent of Bachelor study of Physiotherapy, Faculty of Health Studies, University of Rijeka, Croatia

Prevention programs of drug abuse in Primorsko-goranska County

Adolescents are often motivated to seek new experiences and drug abuse presents one of the most challenging task in modern times. An estimated quarter of European adults, 80 million people, have used an illicit drug during their lifetime. The latest available data from Croatian Institute of Public Health showed that the number of 7.812 treated drug addicts in Croatia, of which 682 are from Primorsko-goranska County. The aim of this paper is to draw attention to some prevention programs of drugs abuse that are evidenced in the Register of programs and projects guided by the Department of drug abuse prevention of Government of Croatia. According to Department of drug abuse prevention of Government of Croatia data’s, there were 17 programs in Primorsko-goranska county registered in 2014. These programs are implemented by both primary school and high school, and non-governmental organizations in county. Although the Register of programs and projects guided by the Department of drug abuse prevention of Government of Croatia provides a good overview to drug prevention programs in Primorsko-goranska county, the constraint of this analysis is the fact that it does not contain information’s about all programs held in some time and place.

Contact:Paula SenkovićStudent of Bachelor study of Physiotherapy, Faculty of Health Studies, University of [email protected]


POSTER SECTION


Vanja Vasiljev Marchesi1,2, Darko Roviš1,2,3, Gordana Šimunković1, Maja Miloš1, Denis Juraga1, Lovorka Bilajac1,3, Tomislav Rukavina1,2,31 Faculty of Medicine, University of Rijeka, Department of Social Medicine and Epidemiology, Croatia2 Faculty of health Studies, University of Rijeka, Department of Public Health, Croatia3 Teaching Institute of Public Health of Primorsko-goranska County, Rijeka, Croatia

The holistic approach to treatment, social and economic reintegration of drug addicts

Main goal of this work is to present the ongoing IPA project named “The holistic approach to treatment, social and economic reintegration of drug addicts” which refers to building the multidisciplinary and multisector cross border (Croatia, Slovenia) capacity for challenges of modern needs of drug addicts. This project is financed by the Instrument for Pre-Accession Assistance (IPA) 2007.-2013. and includes six partners from Primorsko-goranska county (Croatia) and Coastal-Kras area (Slovenia). The main goals of the projects are cross border connection of capacities of public health, universities, non-governmental organizations with the aim of health protection, and focus of drug addiction prevention and drug enforcement; exchange of knowledge and experiences in drug treatment, rehabilitation and drug abuse; connection of resources and capacities of scientific and public health institutes in the field of innovative diagnostic, monitoring and epigenetics; connection of universities of the two regions for developing a new area of high education in southeast Europe. Faculty of Medicine as a partner is included in formation of the curricula of scientific doctoral study of Public Health, and developing two lifelong learning programs for the professionals working in the field of health promotion. This project promotes regional approach of resolving drug addiction challenges according to EU Drugs Strategy (2005.-2012.).

Contact:Assistant Professor Vanja Vasiljev Marchesi, M.Sc, PhDFaculty of Medicine University of Rijeka, Department of Social Medicine and EpidemiologyFaculty of health Studies University of Rijeka, Department of Public [email protected]

Iris Jerončić Tomić1, Shelly Pranić1, Inga Vučica2, Mladen Smoljanović21 Medical School, University of Split, Department of Public Health, Croatia2 Institute of Public Health Split-Dalmatia County, Department of Public Health, Croatia

Some characteristics of mental illness and behavioral disorders in people, over 65 years in the Split-Dalmatia County

Every fourth person at some period in their life has mental problems or a mental illness. Depression is the leading public health. Despite the large numbers of patients with mental disorders, they are often hiding and neglected, and are stigmatized by society. This work is based on data from the NIPH Split-Dalmatia County, Gerontology Center. In 2014, users aged ≥ 65 accounted for one-fifth (20,5%) of all users in the PHC. In comparison with previous years, there was a decrease in the use of PHC, 18,8% in the group „Mental illness and behavioral disorders“. In regard to individual diseases / conditions, the largest reduction occurred in patients with neurosis and stress related affective disorders (-24,7%). Unlike PHC, we observed an increase in the number of hospitalizations, up 22%. Mental illnesses are the third cause of mortality. The Split-Dalmatia County has twice the standardized mortality rate in respect to Croatia. Only Scandinavian countries and the Netherlands have higher mortality rates than the SplitDalmatia County, in compared to other EU countries. As far as the use of health care is concerned, residents have adapted to the conditions of the economic recession, do not recognize the disease, or have accepted the current situation and do not seek health care if it is not necessary. Hospitalizations for these diseases are increasing, contrary to the established disease / condition in PHC which has seen a significant decline. The data are confirmed by an increase in the number of patients with more severe illness that require hospitalization.

Contact:Assistant Professor Iris Jerončić Tomić, MD, PhDMedical School, University of Split, Department of Public Health

[email protected]


Mirta Vranko1,2, Petra Hruškar1, Irena Velimirović2, Petrana Brečić11 University Psyhiatric Hospital Vrapče, Department of Affective Disorders, Croatia2 University of Zagreb, Faculty of Education and Rehabilitation Sciences, doctoral student

Differences in social competence self-assesment of patientes diagnosed with depression due to the form of treatment

Social competence is part of emotional intelligence that refers to the effective functioning in the social context. Depressive disorders are often associated with significantly disrupted social functioning. Stump et al. (2009) suggest Dodge's (1985) definition, according to which social competence is a multidimensional construct that includes interpersonal relationships, frequency of interaction, a positive self-concept and social and cognitive skills. In this context it is interesting to reflect on those suffering from depression that actively participate in different social contexts and form a part of urban culture. The aim of this paper is to observe and evaluate social competence of patients diagnosed with depression taking into account their views and perceptions of their own social competence. The study included 100 participants. A part of the sample is formed by patients who were hospitalized at University Psyhiatric Hospital Vrapće at the time of the survey. The other part of the sample involves patients who were engaged in the program of daily hospitals and social therapy program in the context of outpatient treatment. The results point out the need of strengthening social competence in different contexts. It is expected that participants involved in outpatient treatment and daily hospitals will award more points on the given scale of social competence and therefore have higher scores, and will also percive their own social competence as better.

Contact:Mirta Vranko, MDUniversity Psyhiatric Hospital Vrapče, Department of Affective Disorders [email protected]

Mirta Vranko1,2, Petra Hruškar1, Irena Velimirović2, Petrana Brečić11 University Psyhiatric Hospital Vrapče, Department of Affective Disorders, Croatia2 University of Zagreb, Faculty of Education and Rehabilitation Sciences, doctoral student

Social competence self-assesment of patientes diagnosed with depression

Social competence is part of emotional intelligence that refers to the effective functioning in the social context. Depressive disorders are often associated with significantly disrupted social functioning. Stump et al. (2009) suggest Dodge's (1985) definition, according to which social competence is a multidimensional construct that includes interpersonal relationships, frequency of interaction, a positive self-concept and social and cognitive skills. In this context it is interesting to reflect on those suffering from depression that actively participate in different social contexts and form a part of urban culture. The aim of this paper is to observe and evaluate social competence of patients diagnosed with depression taking into account their views and perceptions of their own social competence. The study included 100 participants, who were hospitalized at University Psyhiatric Hospital Vrapće at the time of the survey. Considering the results of our research we can conclude that the individualization of treatment programs can strengthen the level of social functioning of patients. Also, we can observe the strengthening of social competence as a protective factor in preventing relaps.

Contact:Mirta Vranko, MDUniversity Psyhiatric Hospital Vrapče, Department of Affective Disorders [email protected]


Faculty of Medicine, University of RijekaBrace Branchetta 20, RijekaCroatia

The Faculty of Medicine in Rijeka was founded 50 years ago on the 21st of November 1955, the first such faculty established in Croatia outside the Zagreb. Since 1957/58, the Faculty of Medicine council has worked independently as the Faculty of Medicine’s professional council. The Faculty of Medicine is a public higher education institution that as part of the Rijeka University organizes university and professional courses and developes educational and scientific activities in the biomedical and healthcare areas. Moreover, the school prepares students for their future profession on the basis of the latest scientific insights and methods. The Faculty of Medicine is also engaged in fulfilling the social interests of its students and promotes international, especially European, cooperation in higher education and scientific activities.

Faculty of Health Studies, University of Rijeka Viktora Cara Emina 5, RijekaCroatia

Faculty of Health Studies, University of Rijeka is the youngest member of our University founded in October 2014. This is the first faculty on the University level in Croatia that educate health care professionals (nursing, midwifery, medical laboratory engineers, radiology engineers and physiotherapists) through bachelor and master’s degree (masters nursing education is available in three different courses – management in nursing, mental health and clinical nutrition, medical laboratory engineers and physiotherapy). The main goal of the Faculty is medical education and to provide firm and long-term connection among basic research, clinical practice and public health, as well as to meet increasing demands for applied research, combined with a responsible and ethical scientific conduct.

50 4th international symposium health for all …symposium will traditionally be held in rijeka,...

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