Standard comparison of local mental health care systems in eight European countries

Abstract

Aims. There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services hamper like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems' Effect on the Quality of Mental Health Care in Europe) project.Methods. A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description and Evaluation of Services for Long Term Care in Europe, DESDE-LTC). All publicly funded services universally accessible to adults (≥18 years) with a psychiatric disorder were coded. Care availability, diversity and capacity were compared across these eight local MHS.Results. The comparison of MHS revealed more community-oriented delivery systems in the areas of England (Hampshire) and Southern European countries (Verona -Italy and Girona -Spain). Community-oriented systems with a higher proportion of hospital care were identified in Austria (Industrieviertel) and Scandinavian countries (Sør-Trøndelag in Norway and Helsinki-Uusimaa in Finland), while Loiret (France) was considered as a predominantly hospital-based system. The MHS in Suceava (Romania) was still in transition to community care.Conclusions. There is a significant variation in care availability and capacity across MHS of local areas in Europe. This information is relevant for understanding the process of implementation of community-oriented mental health care in local areas. Standard comparison of care provision in local areas is important for context analysis and policy planning.

Healthcare professionals’ perspectives on mental health service provision: a pilot focus group study in six European countries

“…4 Institute for Advanced Studies, University of Amsterdam, Amsterdam, The Netherlands. 5 Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium. 6 Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium.…”

“…Albeit MHC systems across Europe follow the guidelines and principles of the WHO and the MHAPE, they vary significantly in how they address the mental healthcare gap (mhcGAP). A recent article based on data from the REFINEMENT project (Research on Financing Systems' Effect on the Quality of Mental Health Care in Europe) compared mental health systems (MHS) with public coverage in specific cities or districts in eight (Austria, England, Finland, France, Italy, Norway, Romania, and Spain) European countries [5]. The researchers found variability in MHC service availability and capacity in the countries studied.…”

“…For example, in Finland, where the MHC system is considered to be communityfocused, the pattern of care was found to be hospitalbased in reality. Furthermore, in countries administering a variety of services, barriers to care exist due to fragmentation and inter-sectoral collaboration difficulties [5].…”

Everyday work, working culture and patient care. A qualitative study on professionals’ perceptions of the establishment of a specialized brief therapy unit in a district psychiatric center.

“…Whether mental health care is provided mainly at the primary or secondary care level varies a lot in Europe [31]. Researchers have claimed that collaboration between the primary and secondary mental health services is needed to provide care across systems [32], and that a shift in resource balance between the care levels is needed [33].…”

Behandlungsangebote der Adoleszenzpsychiatrie – Ergebnisse einer deutschlandweiten Erhebung

“…Die Notwendigkeit, Zugangswege zu einer bedarfsgerechten Versorgung zu erleichtern und eine systematische Transition von einem auf Kinder ausgerichteten Gesundheitssystem in die Gesundheitsversorgung für Erwachsenen zu ermöglichen, wurde in den frühen 90er-Jahren zunächst in der Kinderheilkunde für chronische körperliche Erkrankungen erkannt und umgesetzt [8,14]. Internationale Studien legen nahe, dass auch Probleme in der transitionspsychiatrischen Versorgung bestehen [5,10,15]. So zeigten die ersten Ergebnisse der Milestones-Studie, dass in 89 % aller EU-Länder die kinder-und jugendpsychiatrische und erwachsenenpsychiatrische Versorgung in getrennten Systemen stattfindet [12].…”