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Description
As reported by national and WHO statistics, Portugal stands as the European country with the highest prevalence of mental disturbance. The estimated figure of 1/5 of the population that experienced such disturbance on any 12 months period, is notably higher in Alentejo. This inland region has, not unrelatedly, significantly higher rates of suicide, unemployment and isolation, combined with poorer levels of income, education, social support and health services coverage. “Dialogues – Proximity Mental Health” is a project that aims to therapeutically support people with psychotic episodes, severe mental disorders or in psychiatric crisis and not institutionalised. With a strong component of awareness raising in the community, it aims to alleviate the isolation, stigma and social exclusion of this target audience, strengthening the defence of their rights and promoting a more active integration into society.
Summary of project results
The project aimed to address the significant issue of mental health disorders among adults in Portugal. One in four adults experienced at least one episode of mental disorder in their lifetime, with 3% being severe and/or debilitating. The country faced severe shortages in identifying, treating, and following up with adults with mental disorders, especially in integrating responses and conditions for (re)socialization. There was a lack of specialized interventions based on scientific evidence and supported by result monitoring and research. The lack of crisis intervention teams, excessive use of hospital emergencies, and the number of compulsory hospitalizations were particularly severe, contrary to international recommendations.
The North Alentejo region highlighted this shortage of community and proximity intervention services, which could lead to more favorable clinical outcomes and reduce the impact of mental disorders on disability and social/civic exclusion processes. The project aimed to address these challenges by implementing the Open Dialogue model, which focuses on integrated therapy for mental disorders and civic and social empowerment of individuals, families, and communities.
The project implemented a series of activities aimed at addressing mental health issues in the North Alentejo region. It focused on two main components: raising awareness and connecting community agents, and providing therapeutic support to individuals with mental disorders and their families.
In the first component, the project presented its therapeutic approach to various entities in the Portalegre district, seeking synergies with other organizations. It collaborated with partners to promote the project, presented at the 9th Congress of the Alentejo Psychiatric Association, and participated in a major interview program on local radio. The project also created a website, social media pitches, and printed brochures to disseminate information. Public presentations and meetings were held to engage formal and informal partners, as well as different entities and professionals in the district.
In the second component, the project provided therapeutic support by receiving clinical referrals, organizing the team, and scheduling initial meetings. It received 26 referrals, with 23 having at least one therapeutic meeting and 22 signing consent for participation. The project conducted 156 therapeutic meetings involving 67 individuals, including with family members, friends, and professionals from the social support network
The external evaluator considered the project to have had a very positive impact on the participants. They noted that for the type of support provided, it would have been impossible to meet the initially set targets. Of the 22 people supported throughout the project, 16 showed clear improvement in their professional situations, validated using instruments such as the Global Assessment of Functioning (GAF) and the Work and Social Adjustment Scale (WSAS). All 22 individuals received psychiatric consultations, benefiting from the services provided.
The organization also conducted a needs assessment and action plan, which led to the development of a five-year strategic plan. This comprehensive approach ensured that the project not only addressed immediate needs but also laid the groundwork for sustained support and improvement in the participants'' lives.
The project''s impact extended beyond individual beneficiaries, contributing to the overall well-being and social integration of those involved.
Summary of bilateral results
The Norwegian partner has extensive experience in collaborative and dialogical processes, which was crucial in training the clinical team and guiding therapeutic alignment. Members of the Norwegian University participated in RS Foundation events, presenting on the therapeutic system. As a result of this collaboration, the RS Foundation''s clinical team is now capable of independently providing training in this therapeutic system, while continuing to collaborate with the Norwegian University for supervision. This partnership also led to an expansion of entities involved with the RS Foundation in pursuing similar objectives, particularly in the United Kingdom, Canada, and Italy. In Portugal, we have received inquiries from various regions about potential future training in our therapeutic systems.