Lomest psychiatric case register: the statistical context required for planning

Abstract

Descriptive statistics derived from a psychiatric case register are presented. They may be useful for a more rational planning of new services, and provide a preliminary evaluation of the effects of the recent Act (1978) which has abolished large mental hospitals in Italy. Each component of the 1-year prevalence rates has been examined closely, and the results have indicated three main considerations: abolishing the large mental hospital does not abolish the long-stay patients still living in it, and these people will remain a heavy load on the mental health care system for a long time; the new Act has halved admission rates, but the decline may be a positive result if in-care and out-care are sufficiently integrated; treated out-patients tend to increase year by year, and they seem more and more to be "young men and middle-aged women" suffering from minor psychiatric disorders. Finally, a closer collaboration between planners and evaluators is suggested.

Estimating the coverage of mental health programmes: a systematic review

“…The programmes covered a range of mental disorders including common mental disorders, 19 , 20 severe mental illness, 21 substance misuse 22 and a combination of mental disorders 23–25 . The treatment programmes were equally varied, ranging from: a national programme increasing access to psychological therapies in England; 19 a regional methadone treatment programme in China; 22 the nationwide integration of depression treatment into primary care in Chile; 20 a national financing system to increase access to mental health specialists in Australia; 26 district-level community mental health services in Italy; 24 , 25 and regional hospital-based services for people with severe mental illness such as schizophrenia or bipolar disorder in Denmark 21 . Only two of the studies, both government-commissioned reports, evaluated coverage as part of a wider programme evaluation including the effect on patient outcomes and programme costs 19 , 26 .…”

“…Five studies determined service utilization from routine patient data collected by the programme 19 , 22 , 24 , 25 . One of these 21 collated data collected by the programme to a national level in the Danish Psychiatric Central Register, a computerized register which includes information about all admissions to psychiatric wards and outpatient contacts 27 .…”

“…This study, and one other from Italy, 25 estimate total population coverage whereby the rate of service utilization taken from patient case registers maintained by the programme is calculated per 100 000 of the total population, not the total population of people estimated to have a mental disorder.…”

A Model of a Single Comprehensive Mental Health Service for a Catchment Area: A Community Alternative to Hospitalization

“…The effica-well but analogous to that of 496 ciousness of community care as an for Salford (12). The Arezzo rate is alternative to hospital admissions higher than others published by and long-term hospitalization has Italian Services: 271 for the Loalready been described by Pasama-mest register (13), 208 for Verona- (14) and 124 for Porto. gruaio (15).…”

Admission To General Hospital Psychiatric Wards in Italy

“…This seems to demonstrate that the organizational system of care, with the availability of staff and back-up facilities outside the hospital, and the general policy of the service, community or hospital oriented, has a profound influence on the hospitalization rates. Marinoni et al (1983) have suggested that the decrease in admissions which occurred in Italy after the Reform Law may be the &dquo;obvious effect of narrowing the bottle neck&dquo;: this is certainly the case in big cities, such as Rome and Naples. The provision of GHPW beds in Mantua is in line with the North Central Italy rate, but there is a relative bottle-neck compared to Cremona.…”