Mental health service areas in Switzerland

Stulz, Niklaus; Jörg, Reto; Reim‐Gautier, Constanze; Bonsack, Charles; Conus, Philippe; Evans‐Lacko, Sara; Gabriel‐Felleiter, Kerstin; Heim, Eva; Jäger, Matthias; Knapp, Martín; Richter, Dirk; Schneeberger, Andres R.; Thornicroft, Sir Graham; Traber, Rafael; Wieser, Simon; Tuch, Alexandre N.

doi:10.1002/mpr.1937

Cited by 6 publications

(5 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Low utilization rates were replicated in the present sample, even though Switzerland and in particular the catchment area described in this manuscript is known for a comprehensive health care system associated with a high density of inpatient and outpatient health care providers. 23 , 39 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Just Not Enough: Utilization of Outpatient Psychotherapy Provided by Clinical Psychologists for Patients With Psychosis and Bipolar Disorder in Switzerland

Jaffé,

Loew,

Meyer

et al. 2024

Health�Serv�Insights

View full text Add to dashboard Cite

Treatment guidelines state that evidence-based psychotherapy is effective for people with psychosis and bipolar disorder and should be offered during every phase of the treatment process. However, research has indicated a lack of outpatient psychotherapeutic services for this patient group, for example, in the United States or Germany. We extend this finding by presenting survey data from Switzerland. We surveyed 112 inpatients with a diagnosis of a schizophrenia spectrum disorder or bipolar disorder and assessed outpatient treatment over the 5 years prior to their index hospitalization by using retrospective self-reports. The survey focused on psychotherapy provided by clinical psychologists. Results indicate that only 23.2% of participants retrospectively reported having utilized any outpatient psychotherapy within the reporting period and only 8% of participants reported having received a number of outpatient sessions that reaches recommended levels of psychotherapy. Exploratory analyses did not detect a significant association between self-reported utilization of outpatient psychotherapy sessions and most demographic, psychiatric, and psychological attributes, but patients with a bipolar disorder diagnosis (vs schizophrenia spectrum diagnosis) reported having utilized outpatient treatment more often. These findings are preliminary. When replicated they highlight the need for increased access to outpatient psychotherapy and better alignment between guideline recommendations and outpatient supply.

show abstract

Section: Discussionmentioning

confidence: 99%

“…21 , 22 The current discourse aiming to improve alignment and resource allocation in psychiatric and psychotherapeutic services in Switzerland, furthermore, highlights the relevance of gaining a better understanding of the utilization of mental health services. 23 , 24 …”

Section: Introductionmentioning

confidence: 99%

Just Not Enough: Utilization of Outpatient Psychotherapy Provided by Clinical Psychologists for Patients With Psychosis and Bipolar Disorder in Switzerland

Jaffé,

Loew,

Meyer

et al. 2024

Health�Serv�Insights

View full text Add to dashboard Cite

show abstract

“…Interestingly, it has also been observed that rates of hospital procedures and admissions relate more closely to the supply of services than to a community's need 24 . It has been surmised that harm could occur to those utilising excessive supply of services to those who do not need them by exposing them to risks without certain benefit 25 . Likewise, it has also been observed that with a country's increase in economic growth, there is a corresponding growth in reported mental health disorders and demand for mental health care 26 .…”

Section: Discussionmentioning

confidence: 99%

“…24 It has been surmised that harm could occur to those utilising excessive supply of services to those who do not need them by exposing them to risks without certain benefit. 25 Likewise, it has also been observed that with a country's increase in economic growth, there is a corresponding growth in reported mental health disorders and demand for mental health care. 26 This may be due to increased public awareness and support for mental health in more affluent countries, with an associated reduction in stigma allowing sufferers to seek help more readily.…”

Section: Psychiatric Workforce Numbers and Projected Rural Needsmentioning

confidence: 99%

The changing psychiatry workforce in Australia: Still lacking in rural and remote regions

Hayter,

Allison,

Bastiampillai

et al. 2024

Australian J Rural Health

View full text Add to dashboard Cite

IntroductionThere is a long standing and worsening shortage of psychiatrists in Australia particularly in rural areas. The majority of psychiatrists work in major cities.ObjectiveTo identify recent trends in the Australian rural psychiatrist workforce compared with the metropolitan workforce.DesignWe descriptively analysed population‐level data from the National Health Workforce Data Set (NHWDS), the Australian Institute of Health and Welfare (AIHW) and the Australian Bureau of Statistics (ABS).A descriptive analysis of the numbers (count) and gender of psychiatrists from 1995 to 2022 working in Australia was conducted. For the period 2013 to 2022, we analysed for rurality, gender, years' experience, hours worked, Medicare‐subsidised services provided and proportions of Specialist International Medical Graduates (SIMG) by sex, with a focus on the rural workforce. For international comparison, psychiatrist numbers were obtained for other OECD countries. The number of psychiatrists working in Australia, as per NHWDS and AIHW, was quantified. We analysed trends in demographics, hours worked and rurality of psychiatrists working in Australia in a serial cross‐sectional design.FindingsMost psychiatrists are maldistributed to major cities, while outer regional and remote areas have few resident psychiatrists. Outer regional New South Wales (NSW) and South Australia (SA) have the lowest numbers of psychiatrists per capita. The full‐time equivalent (FTE) of psychiatrists per 100 000 has increased from 12.6 in 2000 to 15.2 in 2022. However, the average hours worked by psychiatrists has declined. In total, available psychiatrist hours worked per 100 000 population has increased by 6.1% since the beginning of the millennium.DiscussionRural areas in NSW and SA have the greatest shortage of psychiatrists. Specialist International Medical Graduates and females (43% of the overall workforce) are the predominant workforce in rural areas. Although Medicare‐subsidised services per 1000 people have increased in rural areas, they remain lower than for those living in major cities.ConclusionThere remains an acute shortage of psychiatrists in many regional and remote areas of Australia, with an increasing proportion of SIMGs and females working in these areas, in the context of future increased demand.

show abstract

“…Moreover, the Swiss Health Observatory reported that 1.9 involuntary admissions per 1,000 inhabitants were registered the same year [ 25 ], one of the highest rates in Europe [ 26 ]. Despite a proclaimed shift from hospital-based to more community-based mental healthcare, inpatient care remains at the core of Switzerland’s mental health system [ 27 ]. In this context, exploring patients’ experience of hospitalisation and their feeling of being coerced while inpatient seems of utmost relevance.…”

Section: Introductionmentioning

confidence: 99%

Exploring Patients’ Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study

et al. 2023

Self Cite

View full text Add to dashboard Cite

Various coercive measures can be used to legally compel a person suffering from psychiatric disorder to undergo treatment. However, evidence suggests that patients’ feeling of being coerced is not determined solely by their being submitted to formal coercion. This study aimed to explore voluntary and involuntary patients’ experience of coercion during psychiatric hospitalisation and to identify which factors, from their perspective, most affected it. We chose a qualitative design inspired by a hermeneutic-phenomenological approach. Participants were purposively selected from six psychiatric hospitals in Switzerland. Maximum variation sampling was used to ensure the inclusion of patients with different levels of perceived coercion and different admission statuses. In-depth, semi-structured interviews were co-conducted by a research psychologist and a service-user researcher. The transcribed data underwent thematic analysis. All twelve interviewed patients described the hospitalisation as an experience of loss of control over their life due to either external or internal pressures. During the process, perceptions of these pressures varied and sometimes overlapped, leading some patients to describe their admission as a form of simultaneous protection and violation. The balance between these two contradictory feelings was affected by a variety of contextual and relational factors, as well as by the meaningfulness of the experience and the patient’s subsequent satisfaction with it. Increasing policy-makers’ and clinicians’ awareness about the main factors influencing patients’ experience of loss of control is of paramount importance in order to develop skills and strategies able to address them, reinforcing patients’ empowerment, reducing their feeling of coercion and improving their well-being.

show abstract

Mental health service areas in Switzerland

Cited by 6 publications

References 60 publications

Just Not Enough: Utilization of Outpatient Psychotherapy Provided by Clinical Psychologists for Patients With Psychosis and Bipolar Disorder in Switzerland

Just Not Enough: Utilization of Outpatient Psychotherapy Provided by Clinical Psychologists for Patients With Psychosis and Bipolar Disorder in Switzerland

The changing psychiatry workforce in Australia: Still lacking in rural and remote regions

Exploring Patients’ Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study

Contact Info

Product

Resources

About