waiting times

Hospital Particular Alvor

00h03m

Medical Emergency

Hospital Particular Gambelas

00h13m

Medical Emergency

Madeira Medical Center

00h01m

Medical Emergency

Dr.ª Cristina Miguel 

Psychiatrist

Dr.ª La Salete Santos

Master’s in Psychology

Respect / Support / Overcome
New therapeutic program for mental health

HPA Magazine 8


Based on epidemiological data gathered in the last decade, it is now evident that psychiatric disorders and problems related to mental health have become the main cause of incapacity and one of the main causes of morbidity particularly in the industrialised western countries.
The prevalence of psychiatric disorders in Portugal is quite high, rated as the second highest in Europe, ranking almost equally with Northern Ireland, which occupies first place. 
Despite the statistics and a few actions implemented in recent times, mental health continues to be considered the “poor relation” of health policies and the area where less has been invested.
To counteract this situation, the HPA Health Group is making a commitment to this type of care, more specifically in specialised inpatient care, for which the concept goes over and above a new innovative therapy, developing a new philosophy of life and well-being – Project. 
This unit will soon be available in the new Clinica Particular SIIPEMOR in São Brás de Alportel and will have a diverse range of therapies and services on offer. We spoke with Dr Cristina Miguel, psychiatrist, mentor and person responsible for this project.

 



IS IT TRUE THAT THERE IS STILL A LOT OF PRECONCEPTION REGARDING PSYCHIATRIC DISORDERS?
Fortunately, there is less and less. Nowadays it is rare for a person not to personally know someone who is going through or has gone through some type of psychological disorder or symptom. The high prevalence of mental disorders, the availability of clarifying information about its causes and the efficiency of current therapies have helped dispel the preconception. When we cease to that a mental disorder is synonymous with psychological “weakness”, this preconception disintegrates. The truth is that mental health does not choose gender, age, social or cultural status, or even religion. A mental disorder can affect anyone, even those with the highest cognitive social, emotional and intelligence quotients. This happens because its aetiology is very complex and multifactorial. At the moment, there are no clinical analyses that prove a mental disorder or its underlying chemical alterations.

CAN YOU BETTER EXPLAIN WHAT CAUSES PSYCHIATRIC DISORDERS?
Just as with an organic or physical disorder, there are multiple factors associated with psychiatric disorders.
In each particular case of the disorder, there is, in its aetiology, a variable prevalence between factors we designate as biological, such as genetics, hormonal, inflammatory, vascular issues, and psychological factors. In the latter, we include the specific way each person interprets, feels and acts in life situations. When a situation has a negative emotional impact on someone, this emotional stress (feeling of fear, guilt, pain, frustration, sadness or shame) affects the neuro-biochemical balance. Then, depending on the magnitude of this influence and the biological vulnerability of the person at this level, the disorder might or might not manifest itself.
Precisely because of this, I well recognize the value of medication while facilitating the chemical (re)balance. In the majority of the cases, only in this state of greater balance is it possible to modify the psychological variables that lead to the appearance of the disorder, maintain it, and if not “worked on” can lead to new crises in future situations.

VERY OFTEN, PEOPLE SUFFER FROM PSYCHIATRIC AND EMOTIONAL ALTERATIONS FOR SEVERAL YEARS. WHY DON’T WE TAKE THE SIGNS SERIOUSLY?
We could hypothesize, such as the fact that we are very focused on ourselves and our own lives, or worse, not sensitive to the suffering of others. However, my most honest answer to this question is different, and based on various cases I treat.
I refer above all to people who are very demanding of themselves and feel responsible for everyone and everything, not letting themselves just “Be” for many years, i.e. they tend to live for others and for their jobs, forgetting about their own selves. These people have considerable difficulty in accepting and respecting their own limits and limitations. They create a social “mask”, convinced that they solve everything and that they are extremely “strong”, as if they were totally immune to stress and adversaries (which is not humanly possible). They convince themselves and others of this, until the moment arrives when the signs of psychological strain appear, and there are few who can or allow themselves to “see”. It is in a state of extreme incapacity and suffering that these people seek help. These are the cases commonly referred to as “mental breakdowns”. 

HOW DID THE INPATIENT UNIT COME ABOUT?
Initially, this idea came up from the volition (and the necessity) to create an alternative to the psychiatric hospitalisation offered by the Public Service in the Algarve region. To meet this need, Dr La Salete Santos, a clinical psychologist, and I developed this project, on one hand looking to overcome the limitations that have long been identified in public psychiatric hospitalisation and on the other hand, to innovate therapeutic intervention offered in the context of hospitalisation.
After outlining this idea, the challenge was put to us by the HPA Group, in particular Dr João Bacalhau, who by sharing our vision of the disorder and treatment of mental health, encouraged us and took a gamble on the realisation of the  Unit.

WHAT MAKES THE PROJECT UNIQUE, INNOVATIVE AND NATIONALLY RENOWNED?
We try to bring to the context of psychiatric hospitalisation the possibility of the individual not only recuperating from the symptoms (psychopathology), whose severity often leads to hospitalisation, but also as soon as possible, start a deeper process, allowing “work” on the psychological roots of these symptoms. The most innovative of this project is the unique way that this road to personal growth is presented and facilitated, according to the philosophy.

WHO IS THIS INPATIENT UNIT FOR?
This Unit is for adults who require hospitalisation for a psychiatric disorder. We treat cases of depression and stress, such as obsessive-compulsive disorders, post-traumatic stress, social phobias, panic, generalised anxiety and burnout syndrome. We receive and work with problems of personality and behaviour, such as impulsiveness, self-mutilation, prescription drug abuse and eating disorders. In the case of substance abuse, such as alcohol and other addictions, we also rely on support from Internal Medicine, especially during the withdrawal phase.

WHY DID YOU CHOOSE THE NAME FOR THIS INPATIENT UNIT?
Each day with our personal knowledge and together with patients, we learn that every one of us has extraordinary internal therapeutic resources, which we do not recognise or do not . Our Therapeutic Program is based on the discovery and activation of these personal resources. In this process, hope and self-confidence grow at the rate of individual learning, making it easier to in recovery and above all, to value the personal contribution of each of us. This conviction makes possible the individual’s acceptance, promise and personal development necessary to change to a better self-belief, even when ill. 
The name perfectly summarises this vision, which up to now we only used in reference to consultation and we wanted to bring to the context of hospitalisation. 

WHICH PERSONAL RESOURCES ARE YOU REFERRING TO AND HOW ARE THEY DEVELOPED IN THE PROGRAM? 
I that the moments of psychological suffering are unique opportunities for self-awareness and personal growth of each of us. Pain and suffering create the conditions necessary to allow us to stop and step back from the rhythm of our life. As such, this point of distancing invites us to put into perspective the problematic situations that drive us there and to observe what we think and feel about these experiences. We search for comprehension, a sense or significance for what we are going through.
This therapeutic program accompanies the patients on this voyage of self-awareness, of themselves and, in particular, of their psychological vulnerabilities, making them more aware of emotional patterns, thoughts and behaviour responsible for their suffering and their psychological symptoms. Lastly, better resources are taught through which individuals can allow themselves to “work” their weaknesses.
The majority of those who suffer from depression or stress blame the negative events of their lives for their state. If I understand correctly, they do not help themselves with this way of thinking. 
When we blame someone or a situation for our pain and suffering, we are in fact ceding power over our own emotional state to this someone or situation. That is, our health and inner peace are dependent on asking for forgiveness or change to the other, or of solving the adverse situation in question. Besides these cases of attachment to pain or upheavals, there are those in which the disorder is maintained by guilt feelings for having failed, not allowing oneself to move on with learning from errors. 
In this Therapeutic Program, we are working towards the self-responsibility of each individual by their emotional state and by their recovery, which implies, besides changes to their belief systems and convictions, learning new internal resources.

WHAT TYPES OF TREATMENT AND IN WHAT WAY ARE THEY OFFERED IN THE INPATIENT UNIT?
The Inpatient Unit offers a daily programme, set for 7 days a week, with various therapeutic modalities, individual and in group, administered in a safe, peaceful, calm ambience, away from the stress and distractions of daily life. In its structure, the Therapeutic Program integrates several elements of classic and recent therapeutic protocols, updated in a caring and innovative way that exemplifies the clinical experience of success of the Team. It is a flexible program that permits close, personalised psychological assistance, case by case, respecting the problems in question and their specifics, the social-cultural reality of the individual and their system of beliefs and convictions.
Pharmacologic treatment is used selectively whenever necessary and consented.
On a daily basis, besides the individual psychiatric and psychological and group monitoring, among others, psychoeducation, video therapy, art therapy, dance therapy, meditation and relaxation are given.. We developed Group Therapies and Clinical Hypnosis and they are presented with original, unique content in the Unit.

CAN YOU PLEASE DESCRIBE THE UNIT TO US?
This unit is on the 1st and 2nd floors of the Clinica Particular SIIPEMOR, in São Brás de Alportel. The clinic enjoys a lovely view of the mountain and the new landscape project, Parque das Amendoeiras, located on one side. The building and decoration of the Unit reflect the philosophy of the Therapeutic Program: to welcome, relax and inspire everyone who works and recovers there. The residential area, composed of a central reception, recreation room, private private or double rooms and nursing room are on the 1st floor. The 2nd floor is for individual psychological and psychiatric consultations and for most of the group therapy activities. Doctors’ offices, an ample multipurpose room and a pleasant exterior area are also on this floor, all designed with the best security measures.
The ground floor serves as a 24-hour Emergency Service, with various medical specialities and imaging exam services, which will also provide support for our Unit if necessary.