Institutions and services of psychiatric care in Saxony-Anhalt: assessment with the European Services Mapping Schedule

Abstract

This article describes and analyses the availability of outpatient, inpatient and community-based psychiatric care in Saxony-Anhalt, one of the federal states in the eastern part of Germany. The European Services Mapping Schedule was used to classify 365 institutions. Outpatient care was provided by an average of four private practice psychiatrists per 100,000 inhabitants, which is low when compared to the German average. Ten secure beds (forensic), 48 acute beds, 13 elective beds and 13 day hospital places per 100,000 inhabitants were available for inpatient care. Non-acute non-hospital residential services with indefinite stay and with 24 h support amounted to 240 places per 100,000, with regional differences ranging from less than 100 to more than 1000. Other facilities offering paid work or work-related activities were scarce and some services providing structured activity or social contact were available only in urban agglomerations. Overall, psychiatric care in Saxony-Anhalt is fragmented as regards providers and funding.

Factors associated with hospitalisation of patients with schizophrenia in four European countries

“…In the EPSILON study [7], the number of non-hospital residential beds was 3.5 per 100,000 population in Santander, Spain and 36 per 100,000 in Verona Italy. A subsequent study in the Sachsen-Anhalt region of Germany, using an identical methodology, reported over 200 non-hospital residential beds per 100,000 population [8]. It may be that patients living in such structures may have easier access to hospitalisation, or more need for hospitalisation.…”

“…In contrast, in Germany, the number of psychiatric beds remains relatively high and has similar capacity to community residential care such as sheltered housing [32]. The extent of provision of sheltered or staffed accommodation also varies between countries, for instance being more developed in Germany [8] than in Spain [7] or Greece [29]. In the EPSILON study [7], the number of non-hospital residential beds was 3.5 per 100,000 population in Santander, Spain and 36 per 100,000 in Verona Italy.…”

Identifying Local and Centralized Mental Health Services—The Development of a New Categorizing Variable

“…Integration is considered to be the focus of service system research [ 22 ]. However, a recent systematic review on coverage of MHS found only seven studies, but suggested that coverage data could help optimize the limited resources and the balancing of local and centralized services, despite the scarcity of studies [ 46 ]. This reinforces our starting point of the need for more research into the associations between MHS properties and health outcomes.…”

A domains-based taxonomy of supported accommodation for people with severe and persistent mental illness

“…Three studies described output planning units including: cost per housing type; beds per 100,000 population; and full time equivalent staff per resident. Service funding, provision and governance were difficult to discern, but public funding plus a mix of direct public and/or NGO service provision were mentioned in 15 studies (15,(18)(19)(20)(21)(22)(23)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38). Twelve studies described evidence for service efficacy.…”

“…These are outlined in Table 2 and summarized below. (8,18,19,21,(26)(27)(28)(29)32,33,35,37). These classification systems most commonly used three elements to delineate categories of supported accommodation: size and number of rooms of the physical structures; characteristics of the staff including their qualifications and presence on or off site; and service intensity.…”