Developing a tool for mapping adult mental health care provision in Europe: the REMAST research protocol and its contribution to better integrated care

Salvador‐Carulla, Luis; Amaddeo, Francesco; Gutiérrez-Colosía, Mencía R.; Salazzari, Damiano; González-Caballero, Juan Luis; Montagni, Ilaria; Tedeschi, Federico; Cetrano, Gaia; Chevreul, Karine; Kalseth, Jorid; Hagmair, Gisela; Straßmayr, Christa; Park, A‐La; Sfetcu, Raluca; Wahlbeck, Kristian; García‐Alonso, Carlos R.

doi:10.5334/ijic.2417

Cited by 40 publications

(58 citation statements)

References 31 publications

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“…We used ESMS-R for mapping [28,33] and national register-based sociodemographic data to indicate the mental health service needs of the population. The ESMS-R instrument is a valid instrument for MHS classification and comparison.…”

Section: Discussionmentioning

confidence: 99%

“…The ESMS-R allows for a standardized description of the key features of mental health service structures and provision, including those services provided by primary care and social services [20,24,25,26,27,28]. The data collection and instrument has been described previously [20,23,24].…”

Section: Methodsmentioning

confidence: 99%

“…The MTC are organized by the “Basic Stable Input of Care” (BSIC); i.e., the organizational units that provide the services (e.g., acute ward or day care center). MTC are allocated to six main branches of the ESMS-R: (1) information for care; (2) accessibility to care; (3) self-help and voluntary help; (4) outpatient care, (5) day care; and (6) residential care [28,29]. …”

Section: Methodsmentioning

confidence: 99%

“…Non-acute wards are defined as time-limited facilities where a fixed maximum period of residence is routinely specified (temporary stay). A facility should be classified as time-limited if a maximum length of stay is fixed for at least 80% of those entering the facility [28,30]. …”

Section: Methodsmentioning

confidence: 99%

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Regional Correlates of Psychiatric Inpatient Treatment

Ala-Nikkola

Pirkola

Kaila

et al. 2016

IJERPH

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Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Regional Correlates of Psychiatric Inpatient Treatment

Ala-Nikkola

Pirkola

Kaila

et al. 2016

IJERPH

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“…Finland, UK, Spain and Romania). 12,[16][17][18][19] The DESDE-LTC system is based on local area comparisons, which allow local planning and resource allocation at the local level.…”

Section: Methodsmentioning

confidence: 99%

Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations

Fernández

Gillespie

Smith‐Merry

et al. 2017

Aust. Health Review

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Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.

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The REFINEMENT Glossary of Terms: An International Terminology for Mental Health Systems Assessment

Montagni

Salvador‐Carulla

McDaid

et al. 2017

Adm Policy Ment Health

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Comparing mental health systems across countries is difficult because of the lack of an agreed upon terminology covering services and related financing issues. Within the European Union project REFINEMENT, international mental health care experts applied an innovative mixed "top-down" and "bottom-up" approach following a multistep design thinking strategy to compile a glossary on mental health systems, using local services as pilots. The final REFINEMENT glossary consisted of 432 terms related to service provision, service utilisation, quality of care and financing. The aim of this study was to describe the iterative process and methodology of developing this glossary.

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Developing a tool for mapping adult mental health care provision in Europe: the REMAST research protocol and its contribution to better integrated care

Abstract: Introduction: Mental health care is a critical area to better understand integrated care and to pilot the different components of the integrated care model. However, there is an urgent need for better tools to compare and understand the context of integrated mental health care in Europe.

Cited by 40 publications

References 31 publications

Regional Correlates of Psychiatric Inpatient Treatment

Regional Correlates of Psychiatric Inpatient Treatment

Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations

The REFINEMENT Glossary of Terms: An International Terminology for Mental Health Systems Assessment

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