Implementing a Community Model of Mental Health Care in Chile: Impact on Psychiatric Emergency Visits

Abstract

CMMHC implementation leads to reduction in psychiatric emergency visits, which are burdensome to both users and providers. Results support CMMHC implementation in resource-poor settings.

Psychiatric‐related Revisits to the Emergency Department Following Rapid Expansion of Community Mental Health Services

“…However, a large proportion of emergency physicians do not use or have access to coordinated systems for identifying, tracking, and following up on high utilizers of psychiatric EDs . CHCs may plausibly reduce revisits by overcoming these drawbacks in many ways . First, continuous follow‐up, combined with routine preventive care at community centers may detect changes in mental health status in a timely manner and reduce the need of emergency interventions .…”

“…Third, regional health care system capacity may determine availability or supply of specialist and primary care mental health resources that may serve as a viable alternative to ED care . Community‐based mental health services may ensure regular follow‐up, thereby reducing repeat PREDVs for a subset of cases not requiring urgent care …”

“…We examined 7.8 million outpatient psychiatric patients from 109 U.S. counties from 2006 to 2011, a period that underwent rapid expansion of mental health services at CHCs. The literature on utilization of emergency services following increases in health care access and supply shows both increases and decreases in ED visits . We therefore specify our tests as two‐tailed.…”

Multidisciplinary studies of mental health treatments in a community in Montenegro: RECOVER-E project

“…U tom kontekstu, najveći broj reformi mentalnog zdravlja se fokusirane na reviziji legislative i poboljšanju osposobljenosti pružalaca usluga primarnog nivoa zdravstvene zaštite u indentifikaciji, liječenju i upravljanju problemima mentalnog zdravlja [13,[15][16][17][18][19][20] . Ipak, sveobuhvatna implementacija i dalje je izazov, posebno što još uvijek nema dovoljno istraživanja implementacije na nacionalnom nivou servisa mentalnog zdravlja u zajednici u zemljama sa visokim i srednje-visokim nacionalnim dohotkom centralne i jugo-istočne Evrope [21] .…”

Towards community-based and recovery-oriented care for severe mental disorders in Southern and Eastern Europe: aims and design of a multi-country implementation and evaluation study (RECOVER-E)

“…Healthcare professionals and policymakers who implement mental health system reforms often focus on revising policy and legislative frameworks for mental health, deploying training or quality improvement programs for specialist and non-specialised health professionals, and piloting new delivery models [1,3,[16][17][18][19][20]. Due to limited resources, including financial and professional capacity limitations, large-scale implementation and evaluation of community-based mental health services remains a challenge for many national health care systems; in particular, there are few studies of service delivery changes in mental health care in Central and Eastern Europe [21].…”