Outpatient clinics treating substance use disorders in Northwest Russia and Northern Norway: a descriptive comparative study

Abstract

Both in Norway and Russia a considerable portion of the population have substance use disorders. However, the knowledge about outpatient services treating substance use disorders in Norway and Russia is limited. This study will describe and compare outpatient clinics treating substance use disorders in Arkhangelsk in Northwest Russia and in Bodø and Tromsø in Northern Norway on availability, accessibility and treated prevalence (patients treated in one year). The managers (N=3) of the outpatient clinics (N=3) were interviewed with the European Service Mapping Schedule (ESMS) and the International Classification of Mental Health Care (ICMHC). The interviews were supplemented by e-mail and phone calls. The treatment in Arkhangelsk was mainly biologically oriented (medical), while a greater variety of methods was available in Bodø and Tromsø. The clinic in Russia was a drop-in clinic, while in Norway patients needed a referral to get an appointment in the clinic. Patients treated in Arkhangelsk (treated prevalence) was 1662, while in Bodø it was 233 and in Tromsø 220. The present study revealed great differences between the clinics involved in accessibility, availability and treated prevalence. Cultural traditions and budgeting of the mental health care system could explain some of the findings.

Standardised description of health and social care: A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs)

“…Of the articles that applied ESMS/DESDE system, 48.4% carried out a cross-sectoral evaluation, in some cases focused on specific target groups. The health sector was the focus of 18.7% of the papers; 26.7% related to specific health care: one paper described primary care services for patients with depression [51], three papers evaluated mental health and substance abuse services [33, 88, 90], one paper evaluated transition services from child and adolescent to adult mental health care [36] and others assessed other specific mental health services. One article focused on the evaluation of vocational services for people with schizophrenia [70] and nine papers described services used for specific target population like people with schizophrenia [30, 52, 53, 57, 61, 62, 70, 34] and intellectual disabilities [78].…”

“…This approach was advanced 20 years ago by the EPCAT group when the assessment of services provided by ESMS was accompanied by the standard analysis of the social and demographic context using ESDS [19], and by the description of the main modalities of care using ICMHC [18]. Whilst WHO-AIMS [38] and the Mental Health Country Profile (MHCP) [100] have been used for describing national mental health systems worldwide, ESMS/DESDE is the only system that provides local, bottom-up information that can be used across different sectors (health, social, education, employment, housing and justice) [99] and for coding services for different target groups such as mental disorders [89, 51] intellectual disabilities [78], substance abuse [33, 88, 90], general disabilities [20], aging and long term care [21, 22]. The usability of ESMS/DESDE for the analysis of local change and improvement has been tested in Catalonia (Spain) where the evolution of the mental health care system was analysed before and after the implementation of the 2006 regional mental health plan (2002–2010) [81].…”

“…Two health districts in Central Chile were evaluated in 2004/05 [69], 2008/09 [95] and 2012 [94]. Three hospital districts in Finland were assessed in 2004 [71], 2011/12 [33] and 2012/14 [84].The area of Verona (Italy) has been analysed in 2002 and 2010 [89]; and the areas in Northwest Russia and Northern Norway in 2004/05 and 2011/12 [64,88].…”

A Comparison of Mental Health Care Systems in Northern and Southern Europe: A Service Mapping Study

“…The DESDE-LTC tool adapted and extended to long-term care (e.g., child and adolescents, drug and alcohol, disabilities, elderly, and chronic illness) the previous classification system provided by the ESMS for mental health care [ 32 ]. These instruments have been used in several previous studies that compared the mental health care provision: (i) In the same region or country [ 10 , 33 , 34 ], (ii) between divergent regions or districts in two countries [ 35 , 36 , 37 , 38 ], and (iii) in local areas across different countries in Europe [ 2 ].…”

The balance of adult mental health care: provision of core health versus other types of care in eight European countries

“…areas in two countries such as Spain and Italy (Salvador-Carulla et al, 2005), Spain and Finland (Sadeniemi et al, 2018), Spain and Chile (Salvador-Carulla et al, 2008), and Norway and Russia (Dahl et al, 2017). This methodology can be used in future studies for longitudinal monitoring of service change within an area, for monitoring mental health reform in different world regions, as well as being applied to other areas of integrated care, such as for older people.…”