Use of an integrated Atlas of Mental Health Care for evidence informed policy in Catalonia (Spain)

Fernández, Ana; Salinas-Pérez, José A.; Gutiérrez-Colosía, Mencía R.; Prat-Pubill, B.; Serrano‐Blanco, Antoni; Molina, C.; Jordà, Esther; García‐Alonso, Carlos R.; Salvador‐Carulla, Luis

doi:10.1017/s2045796014000511

Cited by 33 publications

(41 citation statements)

References 21 publications

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“…These instruments have been used within different international studies like the European Psychiatric Services: Inputs linked to Outcome Domains and Needs (EPSILON) that identified and described mental health services for people with schizophrenia in five catchment areas (Becker et al 2002). It has also been used for the comparison of small catchment areas in Italy and Spain (Salvador-Carulla et al 2005); for the regional analysis of service delivery and social and demographic factors in Piedmont (Italy) ; for the comparison of regions in Norway and Russia (Barent) (Rezvyy et al 2007); and in national comparisons in Finland, Germany, Poland and Catalonia (Spain) (Böcker et al 2001;Trypka et al, 2002;Ala-Nikkola et al 2014a;Fernandez et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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

Gutiérrez-Colosía

Salvador‐Carulla

Salinas-Pérez

et al. 2017

Epidemiol Psychiatr Sci

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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.

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Section: Introductionmentioning

confidence: 99%

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

Gutiérrez-Colosía

Salvador‐Carulla

Salinas-Pérez

et al. 2017

Epidemiol Psychiatr Sci

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“…Detailed mapping of all relevant structures at the local level, similarly to what has been developed in other countries [91,92], should be added to future research to describe with more precision services availability as there are strong hypotheses on its association with the LOS [38,42]. …”

Section: Discussionmentioning

confidence: 99%

The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry

Gandré

Gervaix

Thillard

et al. 2017

IJERPH

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International recommendations for mental health care have advocated for a reduction in the length of stay (LOS) in full-time hospitalization and the development of alternatives to full-time hospitalizations (AFTH) could facilitate alignment with those recommendations. Our objective was therefore to assess whether the development of AFTH in French psychiatric sectors was associated with a reduction in the LOS in full-time hospitalization. Using data from the French national discharge database of psychiatric care, we computed the LOS of patients admitted for full-time hospitalization. The level of development of AFTH was estimated by the share of human resources allocated to those alternatives in the hospital enrolling the staff of each sector. Multi-level modelling was carried out to adjust the analysis on other factors potentially associated with the LOS (patients’, psychiatric sectors’ and environmental characteristics). We observed considerable variations in the LOS between sectors. Although the majority of these variations resulted from patients’ characteristics, a significant negative association was found between the LOS and the development of AFTH, after adjusting for other factors. Our results provide first evidence of the impact of the development of AFTH on mental health care and will provide a lever for policy makers to further develop these alternatives.

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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%

“…We are currently completing more detailed studies of its use by planners and policy makers, similar to what has been done with other atlases. 12 The impact analysis of the mental health atlas of Western Sydney will be reported when completed.…”

Section: Future Researchmentioning

confidence: 99%

“…Consequently, they would be more able to make and communicate steps needed to implement any change in the system. 12 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. Starting from an analysis of the pattern of adult mental health care, with a focus on the gaps detected, we identify some of the main reforms that may close these gaps.…”

Section: Introductionmentioning

confidence: 99%

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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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Use of an integrated Atlas of Mental Health Care for evidence informed policy in Catalonia (Spain)

Abstract: Policy makers can use Atlases to detect gaps and inequities in the provision of care for people with mental health needs.

Cited by 33 publications

References 21 publications

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

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

The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry

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

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