Effectiveness of a mobile mental health unit for people with psychosis or bipolar disorder in underserved rural areas of Crete/Greece

Background Psychosis and bipolar I disorder are severe mental disorders with significant adverse impacts on patients, their families and society overall. Patients’ follow-up in rural areas is often challenging owing to stigma and limited access to mental health services. Aims The primary aim was to evaluate the effectiveness of follow-up by a mobile mental health unit (MMHU) operating in underserved rural areas of Crete in preventing readmissions to hospital across its 10 years of operation. Additionally, we investigated sociodemographic and clinical factors associated with patients’ readmissions. Method The study included 288 patients with psychosis (n = 201) or bipolar disorder (n = 87). The effectiveness of the MMHU is assessed by comparing patients’ voluntary and involuntary admissions pre- and post-follow-up. Results Hospital readmissions were reduced by half and involuntary readmissions by 50–70%. This effect was significant for patients with both single and multiple prior admissions. Regression analysis revealed that older age, depot medication, no substance misuse history and being ever married were associated with reduced readmissions. Also, the normative visit frequency of 5–9 visits per year (approximately 1 visit every 1.5 months) was associated with reduced readmissions. Conclusions The operation of an MMHU in rural Crete is effectively preventing overall and involuntary readmissions, particularly when patients are followed up on a regular basis. These findings highlight the effectiveness of community services in addressing the mental health needs of people living in rural and remote areas with limited access to mental health services.