EU_Psych_NewsRound.qxp 3/7/08 02:25 Page 7
In Brief
The European Psychiatric Arena – In Brief
Trends, Statistics and Clinical Research
Study Highlights Inadequate You Talking to Me? Peer-based Psychosocial Care for
Knowledge of Adult Autism A computer-simulated trip on the London Asylum Seekers Proves Effective in
Prevalence in the UK Underground has revealed significant Dutch Case Study
The National Autistic Society (NAS) has called on paranoid ideation in a representative cross- The Transcultural Psychosocial Organization
the UK government to launch a nationwide adult section of the general population. The (TPO) recently reported the successful
autism prevalence study after their report found investigation, devised by Dr Daniel Freeman implementation of a ‘peer-based’ psycho-
that 86% of local government authorities had along with computer scientists at King’s social care system for Dutch asylum seekers,
insufficient epidemiological data. Due to the lack College, involved 200 volunteers undergoing a in which former refugees and asylum seekers
of clinical understanding in previous decades, carefully constructed four-minute train were trained as paraprofessional counsellors
many adults may not have received adequate journey. Forty per cent of participants to offer community psychiatry support. The
diagnosis of their autism as children; as a result, experienced at least one irrationally paranoid project, described recently in Transcultural
66% of local authorities and 77% of primary care thought, usually centring on sexual or violent Psychiatry, found that a non-Western
trusts do not have accurate data on how many intent, in the neutral computer-animated interventional strategy applied to the
adults with autism live in their area of jurisdiction. characters, or avatars. Dutch setting benefited asylum seekers,
The report, based on the largest ever patient, who are unable to access conventional
family and carer survey in the UK, found that lack “In the past, only those with a severe mental psychiatric support despite suffering from
of government and primary care support left illness were thought to experience paranoid depression, somatic complaints, substance
63% of autistic adults heavily dependent on their thoughts, but now we know that this is simply abuse and trauma.
families, and that 92% of their often elderly not the case,” concluded Dr Freeman. “About
parents are worried about their child’s future one-third of the general population regularly Over a six-month period, 14 active counsellors
when they are longer able to care for them. ■ experience persecutory thoughts.” registered 241 sessions with 74 clients from
29 countries including Somalia, Kosovo,
Europe Could Follow American Dr Freeman is also pioneering the use of virtual Kazakhstan and Afghanistan. Informal support
Lead in Rehabilitating the Mentally reality and interactive immersive computer from trained peers proved effective due to
Ill to Work environments in understanding schizophrenic their increased sensitivity to the experience of
Entry-level employment followed by on-the-job delusion, taking advantage of improvements in mass traumatisation and geographical
training, termed individual placement and virtual reality equipment in terms of both dislocation, as well as their shared language
support (IPS), may be more effective in hardware – which is constantly decreasing in and contextual history. Benefits to trained
rehabilitating mentally ill patients than size and therefore becoming less intrusive – peers included improved self-esteem, future
vocational training followed by work placement, and software – which can generate perspective, development of skills and even
according to a study at the University of Oxford. increasingly complex and sophisticated graphic work opportunities. These results suggest that
The randomised controlled trials, led by environments. “The use of interactive ‘peer-based’ psychosocial care systems assist
Professor Tom Burns, took place over 18 months immersive computer environments allows asylum seekers who struggle to access formal
in centres across Europe. It comprised patients one of the key variables in understanding domestic healthcare services. ■
with schizophrenia (80%), bipolar disorder psychosis – social environments – to be
(17%) and other severe mental illness (3%). controlled, providing exciting applications for Sources: The National Autistic Society, Burns T, The Lancet, Freeman D,
Unemployment rates for such patients can be as research and treatment,” writes Dr Freeman. ■ British Journal of Psychiatry, Kieft et al.
high as 95%.
Mentally Ill Patients Who Worked for at Least One Day, by Centre
Fifty-five per cent of IPS patients worked for at
90
least one day compared with 28% of
IPS
80
Vocational service
vocational services patients (see figure
70
opposite); 13% of IPS patients dropped out of
60
the trial compared with 45% of the vocational
patients; and 20% of IPS patients were re-
50
r
c
entage
admitted to hospital compared with 31% of
Pe
40
those on vocational services. The results show 30
that, despite differences in welfare systems and
20
labour markets, IPS can be as successful in
10
Europe as it has been in the US, where it is the
0
dominant strategy. ■ London Ulm Rimini Zurich Groningen Sofia
EUROPEAN PSYCHIATRIC REVIEW 7
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