Patterns of mental health service utilisation in Italy and Spain

Salvador‐Carulla, Luis; Tibaldi, Giuseppe; Johnson, Sonia; Scala, Elena; Romero, C.; Munizza, Carmine

doi:10.1007/s00127-005-0860-y

Cited by 52 publications

(37 citation statements)

References 23 publications

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“…[24] compared mental health systems in Italy and Spain and found great differences related to patterns of service provision and service use between countries. They suggested that developing innovative community services is linked to low hospital bed use, high rate of day services and contact to community.…”

Section: Discussionmentioning

confidence: 99%

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Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

Ala-Nikkola

Pirkola

Kontio

et al. 2014

IJERPH

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Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule—Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data, local data on unemployment rate, length of education, age of retirement, proportion of single households, alcohol sales and a composite mental health index were used as indicators of population mental health needs. Population size correlated strongly with service diversity, explaining 84% of the variance. Personnel resources did not associate with diversity or community orientation. The indicators of mental health services need did not have the expected association with quality and quantity of services. In terms of service organization, the results may support larger population bases, at least 150,000 adult inhabitants, when aiming for higher diversity.

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Section: Discussionmentioning

confidence: 99%

“…An earlier version of the ESMS has been used previously in Finland [3] and it has been evaluated as a valid instrument in a European context [17,24,25]. In ESMS-R, mental health services are classified into 89 different Main Types of Care (MTC).…”

Section: Methodsmentioning

confidence: 99%

Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

Ala-Nikkola

Pirkola

Kontio

et al. 2014

IJERPH

View full text Add to dashboard Cite

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“…Salvador-Carulla et al [33] compared mental health systems in Italy and Spain and found great differences related to the pattern of service provision and service use between countries. They suggested developing innovative community services with low hospital bed use, high rates of day services, and contacts with the community.…”

Section: Discussionmentioning

confidence: 99%

“…We used ESMS-R for mapping [28,33] and national register-based sociodemographic data to indicate the mental health service needs of the population. The ESMS-R instrument is a valid instrument for MHS classification and comparison.…”

Section: Discussionmentioning

confidence: 99%

Regional Correlates of Psychiatric Inpatient Treatment

Ala-Nikkola

Pirkola

Kaila

et al. 2016

IJERPH

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Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components.

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“…The study was conducted in 44 centers throughout Spain from November 2007 to July 2008. Mental health services are primary funded from taxes in Spain, and LOS is free of charge [25]. …”

Section: Methodsmentioning

confidence: 99%

Number of prior episodes and the presence of depressive symptoms are associated with longer length of stay for patients with acute manic episodes

et al. 2012

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BackgroundFew studies have analyzed predictors of length of stay (LOS) in patients admitted due to acute bipolar manic episodes. The purpose of the present study was to estimate LOS and to determine the potential sociodemographic and clinical risk factors associated with a longer hospitalization. Such information could be useful to identify those patients at high risk for long LOS and to allocate them to special treatments, with the aim of optimizing their hospital management.MethodsThis was a cross-sectional study recruiting adult patients with a diagnosis of bipolar disorder (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) criteria) who had been hospitalized due to an acute manic episode with a Young Mania Rating Scale total score greater than 20. Bivariate correlational and multiple linear regression analyses were performed to identify independent predictors of LOS.ResultsA total of 235 patients from 44 centers were included in the study. The only factors that were significantly associated to LOS in the regression model were the number of previous episodes and the Montgomery-Åsberg Depression Rating Scale (MADRS) total score at admission (P < 0.05).ConclusionsPatients with a high number of previous episodes and those with depressive symptoms during mania are more likely to stay longer in hospital. Patients with severe depressive symptoms may have a more severe or treatment-resistant course of the acute bipolar manic episode.

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Patterns of mental health service utilisation in Italy and Spain

Cited by 52 publications

References 23 publications

Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

Regional Correlates of Psychiatric Inpatient Treatment

Number of prior episodes and the presence of depressive symptoms are associated with longer length of stay for patients with acute manic episodes

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