Mental health care in Piedmont: a description of its structure and components using a new technology for service assessment

Abstract

Objective: The northern‐Italian region of Piedmont has a total population of 4.3 million. The regional territory is currently divided into 22 local health services, each serving a population not exceeding 300 000 and incorporating a Department of Mental Health. The organization of psychiatric assistance can be described as relatively stable and conforms with the standards imposed by national regulations. Drawing upon previous research experience, and with the support of the relevant regional authorities, our survey implements the methodology developed by the EPCAT team and will eventually embrace about 80% of all local health service areas in this region. Methods: The survey was preceded by a number of preliminary steps including the training of four researchers, inter‐rater reliability testing (particularly for the International Classification of Mental Health Care), and the adjustment of the methodology developed by the EPCAT team to facilitate understanding and use of the instrumentation by the psychiatric professionals involved in the data collection. Results: This paper summarizes data on the structure and components of the mental health service in three areas of Piedmont, with special reference to structures funded by the National Health System. Conclusion: Overlooking the imbalances affecting both the resources available for different populations, and the operational profiles of psychiatric agencies of the same type, our data allow an assessment of the descriptive and comparative capabilities of the proposed methodology.

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)

“…The feasibility of ESMS/ DESDE was considered adequate in all of them, although the coding system requires intensive training. The instruments ESMS, DESDE and DESDE-LTC have shown optimal levels of consistency, descriptive validity and inter-rater reliability in studies conducted by the core group [17,41,20], [22]. The ontological properties, content analysis and hierarchical structure of the DESDE-LTC classification has also been published [22,42].…”

“…Pilot and demonstration studies have been carried out in Spain [41,20], Italy [17] and Australia [48].…”

“…The European Service Mapping Schedule (ESMS) was developed to facilitate the classification of mental health services and the standardised description of the care system for adults experiencing mental health problems by the EPCAT group (European Psychiatric Care Assessment Team) between 1994 and 1997, and it was published in 2000 [16,17]. This system evaluation toolkit also included the International Classification of Mental Health Care (ICMHC) [18], which evaluated the different modalities of care available in a service, and the European Socio-demographic Schedule (ESDS) [19] for the standardised description of the sociodemographic characteristics of local catchment areas.…”