May 6, 2022
By Prof Nikos Stefanis MD, FRANZCP
Professor Nikos Stefanis, University of Athens shares exciting news about the establishment of early psychosis services in Greece. Greece will now join just a few countries in the world who are funded to provide government-based nation-wide coverage of early intervention psychosis services. He outlines the key steps involved in achieving this milestone and an upcoming international Early Intervention in Psychiatry conference and series of workshop coming up in June.
Responding to the recommendation from the Ministry of Health in Greece, the Ministry of Finances announced in March 2022 the allocation of considerable funds drawn from the Recovery and Resilience Facility of the European Commission (RRF) for the establishment and initial operation of 10 Early Intervention Services for Psychosis (EISP) within the National Health Service (NHS). They are to be developed imminently across the country since the upcoming tendering process organized by the Ministry of Health is scheduled for May 2022.
This fortunate development is the accumulation of combined efforts by numerous colleagues and stake holders who have tirelessly advocated for Mental Health reform in Greece. If one was to trace the origins of the effort, still a work in progress, one would probably date it back to 2008 when the only community based EISP to ever operate in Greece was established by the Department of Psychiatry, University of Ioannina as a novel research project.. It instilled hope in many by offering an alternative vision to the dominant hospital-based model of care offered until then to young patients with a first episode of psychosis (FEP). It also produced an important estimate of the annual incidence of FEP (30/100000 population) in Greece, a prominent argument utilized in consequent debates over the necessity of establishing such community-based services.
In 2011 the first official recommendation for the implementation of EISP in Greece was described in the National Revision Plan for Mental Health reform “Psychargos 2011-2020”. In 2015 the Athens FEP research study was launched by the A’ Department of Psychiatry, consequently evolving into the first prospective study of FEP in the country, providing much needed local information on clinical outcomes for policy makers. Awareness in the principles of early intervention was further promoted by our post graduate education program on Early Intervention in Psychosis (conducted annually since 2018). Consequently, a committee under the Ministry of Health was formed in late 2018 with a mandate to examine the legal and organizational framework for the implementation of EIPS services. The current government adopted the recommendations and proceeded to bring the legislation to Parliament (Official Government Gazette of the Hellenic Republic, A 256 – 23.12.2020) thus establishing EISP as a legal entity within the NHS.
Even though there is still much to be done, such recent advances raise justified optimism for a new era of reform in community mental health in Greece. However, complacency is unwarranted. Sustainability of government-based funding should be secured in the long run and integration of EISP with existing mental health services has proven to be a challenging process. Nevertheless, it appears that Greece will join the few countries which provide central government-based and nationwide coverage of EISP.
You can learn more about early psychosis service development in Greece by viewing Prof Stefanis presentation at our recent virtual conference. This will be available to view on our Youtube channel soon. Stay tuned to our social media channels for updates.
Nikos C. Stefanis MD, FRANZCP, is Professor of Psychiatry at the National and Kapodistrian University of Athens (NKUA) in Greece and Vice-Director of the University Mental Health Research Institute in Athens. He is the Chair of the First Episode Psychosis (FEP) Task Force within the World Federation of Societies of Biological Psychiatry and the Greek Psychiatric Association. In his current clinical capacity, he runs a national referral center for FEP at Eginition Hospital, A’ Department of Psychiatry, NKUA.
He trained in Psychiatry at the Maudsley Hospital/Institute of Psychiatry, London UK and in CBT at Oxford University UK. He worked as Professor of Psychiatry at the School of Psychiatry and Clinical Neurosciences, The University of Western Australia (2010-2013). He has been a reviewer for more than 20 high impact journals including Molecular Psychiatry, the American Journal of Psychiatry, Biological Psychiatry, Schizophrenia Bulletin in which he has published aspects of his personal research.
His main academic interests have gravitated towards the better understanding of the complex interplay between genetic and environmental risk factors that shape the vulnerability for major psychiatric disorders. He is a vocal advocate for mental health reform in Greece. His academic work has been published in more than 80 high impact international peer reviewed journals