Effectiveness and efficiency of integrated mental health care programmes in Germany: study protocol of an observational controlled trial

Stierlin, Annabel S.; Herder, Katrin; Helmbrecht, Marina Julia; Prinz, Stefanie; Walendzik, Julia; Holzmann, Marco; Becker, Thomas; Schützwohl, Matthias; Kilian, Reinhold

doi:10.1186/1471-244x-14-163

Cited by 14 publications

(21 citation statements)

References 29 publications

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“…As a consequence, persons with SMI who elect to refrain from professional treatment often rely on other methods to self‐medicate, such as using alcohol or illicit substances, which is a common phenomenon observed in the SMI population (Brown, Bennett, Li, & Bellack, ). Thus, contemporary treatment for individuals with SMI should not only focus on the holistic self but also empower individuals by increasing their capacity for autonomy and ability to live a more independent and productive life (Stierlin et al, ).…”

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confidence: 99%

“…To date, most of empirical research available on IBPH has focused on various models of integration (Everett et al, ; Manderscheid & Kathol, ); protocols associated with empowerment, quality of life, patient satisfaction, and health economic measures (Stierlin et al, ); and organizational capacity for service integration in community‐based addictions (Guerrero, Aarons, & Palinkas, ), with each inquiry demonstrating promising outcomes for both health care providers and clients who participated in the integrated approach. However, rigorous outcome research demonstrating the effectiveness of IBPH services and its impact on holistic client functioning remains sparse.…”

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confidence: 99%

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Examining the Effectiveness of Integrated Behavioral and Primary Health Care Treatment

Schmit

Watson

Fernandez

2018

Jour of Counseling & Develop

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Using a quasi‐experimental, pre–post test design of 196 persons diagnosed with serious mental illness, the authors compared the effectiveness of an integrated behavioral and primary health care (IBPH) treatment approach vs. a treatment‐as‐usual approach over a 12‐month period. A profile analysis of 5 mean difference scores, each representing a separate component of client holistic functioning, indicated that individuals receiving IBPH experienced a 24‐times greater improvement in overall functioning. Recommendations for treatment and client care are provided.

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confidence: 99%

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confidence: 99%

Examining the Effectiveness of Integrated Behavioral and Primary Health Care Treatment

Schmit

Watson

Fernandez

2018

Jour of Counseling & Develop

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“…Some assessment efforts for the adult ADHD patients by other psychologists in the MTPA-model were done. In Germany, Stierlin et al [41] have evaluated integrated mental health care programs, and the authors maintain that the deinstitutionalization of mental health patients did not cut the expenses, but that was not the case in our extended MTPA-model. The resources to redesign or reengineer the integrated mental and health care were gained from the existing resources by closing two of the four inpatient wards.…”

Section: Results From Applying Toc and 5fs To The Cdssassisted Adult mentioning

confidence: 99%

“…A commonly held belief in mental health and social care is that the care for patients must be offered by multiprofessional community mental health teams [41]. In Finland, the newly given law of social care [44] points out the importance of multi-professional assessment of social care clients.…”

Section: Discussionmentioning

confidence: 99%

Improving the productivity and efficiency of an integrated mental and addiction care

Kemppinen¹,

Korpela²,

Elfvengren³

et al. 2017

FinJeHeW

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This paper suggests that the productivity and efficiency of social and health care services can be improved considerably by redesigning and streamlining the processes. The paper presents the theory of constraint (TOC) and fivefocusing step (5FS) solution to the productivity and efficiency problems of an integrated mental and addiction care outpatient clinic (MTPA-model) team. The MTPA is an integrated walk-in clinic where clinical decisions on key patient groups are supported by a clinical decision support system (CDSS). One of the critical service processes of the MTPA is a CDSS-assisted adult ADHD diagnostics process.The aim of the paper is to describe the improvement of productivity and efficiency of a typical multidiscipline team of MTPA-model. A combination of the action research approach and design science research was applied to solve the emerging service process problems and create a CDSS. The paper outlines the principles of the TOC applied for the established CDSS-assisted adult ADHD diagnostics process. The bottlenecks or constraints of an adult ADHD process are defined. The data from the designed CDSS and the currently used electronic health record provided material for applying the 5FS methodology for improving the productivity and efficiency of the adult ADHD process.We suggest that applying the 5FS-process of TOC to mental and addiction care processes generally, and to the multi-professional team especially, is an effective way to negotiate constructively about the bottlenecks or constraints of the process and improve the productivity and efficiency of integrated mental health and addiction care services and operations. Based on the results, a general framework for improving the productivity and efficiency of a multi-professional team and health care services organization by applying the 5FS methodology is proposed.

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“…There are examples that controlled studies can be done with the key outcomes relating to patient experiences, such as empowerment (Stierlin et al 2014). However, this requires a change in the perspective of what matters in healthcare from a providers' and funding agencies' perspective towards the perspective of patients.…”

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confidence: 99%

Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness

Bramesfeld

Stegbauer²

2016

Epidemiol Psychiatr Sci

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The World Health Organisation has defined health service responsiveness as one of the key-objectives of health systems. Health service responsiveness relates to the ability to respond to service users’ legitimate expectations on non-medical issues when coming into contact with the services of a healthcare system. It is defined by the areas showing respect for persons and patient orientation. Health service responsiveness is particularly relevant to mental health services, due to the specific vulnerability of mental health patients but also because it matches what mental health patients consider as good quality of care as well as their priorities when seeking healthcare. As (mental) health service responsiveness applies equally to all concerned services it would be suitable as a universal indicator for the quality of services’ performance. However, performance monitoring programs in mental healthcare rarely assess health service performance with respect to meeting patient priorities. This is in part due of patient priorities as an outcome being underrepresented in studies that evaluate service provision. The lack of studies using patient priorities as outcomes transmits into evidence based guidelines and subsequently, into underrepresentation of patient priorities in performance monitoring. Possible ways out of this situation include more intervention studies using patient priorities as outcome, considering evidence from qualitative studies in guideline development and developing performance monitoring programs along the patient pathway and on key-points of relevance for service quality from a patient perspective.

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Effectiveness and efficiency of integrated mental health care programmes in Germany: study protocol of an observational controlled trial

Cited by 14 publications

References 29 publications

Examining the Effectiveness of Integrated Behavioral and Primary Health Care Treatment

Examining the Effectiveness of Integrated Behavioral and Primary Health Care Treatment

Improving the productivity and efficiency of an integrated mental and addiction care

Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness

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