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

Ala-Nikkola, Taina; Pirkola, Sami; Kontio, Raija; Joffe, Grigori; Pankakoski, Maiju; Malin, Maili; Sadeniemi, Minna; Kaila, Minna; Wahlbeck, Kristian

doi:10.3390/ijerph110808456

Cited by 19 publications

(41 citation statements)

References 27 publications

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“…These instruments have been used within different international studies like the European Psychiatric Services: Inputs linked to Outcome Domains and Needs (EPSILON) that identified and described mental health services for people with schizophrenia in five catchment areas (Becker et al 2002). It has also been used for the comparison of small catchment areas in Italy and Spain (Salvador-Carulla et al 2005); for the regional analysis of service delivery and social and demographic factors in Piedmont (Italy) ; for the comparison of regions in Norway and Russia (Barent) (Rezvyy et al 2007); and in national comparisons in Finland, Germany, Poland and Catalonia (Spain) (Böcker et al 2001;Trypka et al, 2002;Ala-Nikkola et al 2014a;Fernandez et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Standard comparison of local mental health care systems in eight European countries

Gutiérrez-Colosía

Salvador‐Carulla

Salinas-Pérez

et al. 2017

Epidemiol Psychiatr Sci

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Aims. There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services hamper like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems' Effect on the Quality of Mental Health Care in Europe) project.Methods. A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description and Evaluation of Services for Long Term Care in Europe, DESDE-LTC). All publicly funded services universally accessible to adults (≥18 years) with a psychiatric disorder were coded. Care availability, diversity and capacity were compared across these eight local MHS.Results. The comparison of MHS revealed more community-oriented delivery systems in the areas of England (Hampshire) and Southern European countries (Verona -Italy and Girona -Spain). Community-oriented systems with a higher proportion of hospital care were identified in Austria (Industrieviertel) and Scandinavian countries (Sør-Trøndelag in Norway and Helsinki-Uusimaa in Finland), while Loiret (France) was considered as a predominantly hospital-based system. The MHS in Suceava (Romania) was still in transition to community care.Conclusions. There is a significant variation in care availability and capacity across MHS of local areas in Europe. This information is relevant for understanding the process of implementation of community-oriented mental health care in local areas. Standard comparison of care provision in local areas is important for context analysis and policy planning.

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Section: Introductionmentioning

confidence: 99%

Standard comparison of local mental health care systems in eight European countries

Gutiérrez-Colosía

Salvador‐Carulla

Salinas-Pérez

et al. 2017

Epidemiol Psychiatr Sci

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“…Kyselyllä selvitettiin yksikön toimintaa sekä henkilöstön resursointia. Palvelukartoituksen tekemiseksi käytettiin lasten ja nuorten palveluihin sovellettua ESMS-R-työkalua (European Service Mapping Schedule, Revised, kuvio 1), joka on todettu aiemmissa tutkimuksissa toimivaksi tavaksi jäsentää olemassa olevia palveluntarjoajia (11,17,21). Aiemmin ESMS-työkalua on käytetty osana vastaavia aikuisille suunnattuja palvelunkartoituksia ja tutkimuksia yhdeksässä Euroopan maassa toteutettavaa REFINEMENT-hanketta varten.…”

Section: Aineiston Keruu Ja Esms-r Menetelmäunclassified

“…Analyysissä huomioitiin aineiston suhteellisen pieni koko ja aiemmissa tutkimuksissa REFINE-MENT-aineiston käsittelyyn toimivaksi havaitut menetelmät (21,25). Osittain samojen menetelmien käyttö mahdollistaa nuorten ja aikuisten palvelun vertailun.…”

Section: Aineiston Analyysiunclassified

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Nuorten mielenterveyspalvelut – määrä, tarjonta ja kohdentuminen Uudenmaan alueella

Hedman¹,

Vastamäki²,

Joffe³

2018

SLA

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Nuorten pahoinvointi on ollut keskeisenä huolena viimeaikaisessa tutkimuksessa ja julkisessa keskustelussa. Erityisesti lastensuojelun asiakaslapsille kasautuu paljon kuormittavia tekijöitä. Nuoria lähellä olevat palvelut sekä varhainen puuttuminen ovat tehokkaimpia lisäämään yhteiskuntaan kiinnittymistä. Suomessa on käynnissä laaja palvelurakenneuudistus, mutta muutoksen tueksi tarvittava tutkimustieto on kuitenkin puutteellista. Tutkimuksessa kuvataan nuorten mielenterveyspalveluita Uudenmaan alueella vuonna 2014. Kaikki Uudenmaan alueen nuorille tarkoitetut mielenterveyspalvelut kartoitettiin ja toiminnot luokiteltiin nuorille sovelletulla ESMS-R-työkalulla. Palveluita tarkastellaan lukumäärän, monipuolisuuden ja avohoidon henkilöstöresurssien perusteella sekä suhteutetaan lastensuojelun asiakasnuorten määrään. Nuorten hyvinvoinnin riskitekijät ja palveluiden monipuolisuus korreloivat alueen väkiluvun kanssa. Avohoidon henkilöstön resursointi ei ollut suhteessa väkimäärään, lastensuojelun avohuollon asiakkaisiin tai kodin ulkopuolelle sijoitettuihin. Lisäksi monilla alueilta puuttuivat kokonaan esimerkiksi päivätoimintojen ja liikkuvan avohoidon palvelut. Tarkastelun perusteella alueen nuorten mielenterveyspalveluiden avohoito vaikuttaisi eriarvoiselta ja sattumanvaraiselta. Tulokset ovat tarpeen suunniteltaessa palveluiden kehittämistä siten, että kaikilla nuorilla on tarjolla yhtäläisiä palveluita kotikunnasta riippumatta. Nämä asiat tulisi huomioida myös tulevassa sosiaali- ja terveyspalveluiden uudistuksessa.

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“…Likewise, in Finland, the MHS strategy 2010–2015 is aimed at developing more patient-centered, community-based and integrated psychiatric and somatic services, while further limiting the use of hospital-based services [18,19,20,21]. Despite the policy of investing in community care and the deinstitutionalization process, most MHS resources in Southern Finland are still allocated to hospital and non-hospital residential services, while low-threshold outpatient services are scarce [21,22,23].…”

Section: Introductionmentioning

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

Cited by 19 publications

References 27 publications

Standard comparison of local mental health care systems in eight European countries

Standard comparison of local mental health care systems in eight European countries

Nuorten mielenterveyspalvelut – määrä, tarjonta ja kohdentuminen Uudenmaan alueella

Regional Correlates of Psychiatric Inpatient Treatment

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