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Elisa F, Davide T, Luisa SM, Martina M, Tommaso B, Luis SC, Barbara D, Morena F, Giulio C. Outcome analysis on individual health budgets in mental Health: finding from the Friuli Venezia Giulia Region, Italy. J Ment Health 2024; 33:159-168. [PMID: 37177819 DOI: 10.1080/09638237.2023.2210657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 04/12/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Individual Health Budget (IHB) is used for social and health integration and to facilitate processes of resource reorientation in healthcare. Despite its increased use in mental health settings, few studies investigated its effectiveness in severe mental disorders. METHODS 383 IHB beneficiaries were recruited among Mental Health Departments users of the Italian region Friuli Venezia Giulia. Data involved sociodemographic and clinical variables, IHB type and scores of Health of the Nation Outcome Scale (HoNOS) at admission to IHB programme (T0), after 12 months (T1), and after 24 months (T2). RESULTS The length and the mean number of hospitalisations and healthcare interventions decreased at T1. A significant scores' reduction from T0 to T1 evaluation was found in HoNOS total score (T-test (P) < 0.05) and in most of its items. An improvement throughout the whole evaluation period (T0 vs. T2) was found in 36% of the IHB beneficiaries, while more than 60% of them remained in the same HoNOS severity category. CONCLUSIONS Our results support the use of IHB in patients with severe mental problems, since it may contribute to an improvement in social and clinical functioning, consequently lowering the burden on MHDs.
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Affiliation(s)
- Fontecedro Elisa
- Mental Health Department, Health University Agency of Udine, Udine, 33100, Italy
| | - Tossut Davide
- Welfare Area, Friuli Venezia Giulia Region, Palmanova (UD), Italy
| | - Scattoni Maria Luisa
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Micai Martina
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Bonavigo Tommaso
- Mental Health Department, Health University Agency of Trieste, Trieste, Italy
| | - Salvador-Carulla Luis
- Health Research Institute, Faculty of Health, University of Canberra, Bruce Campus Canberra, Australia
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney
| | | | - Furlan Morena
- Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy
| | - Castelpietra Giulio
- Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy
- Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy
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Micai M, Gila L, Caruso A, Fulceri F, Fontecedro E, Castelpietra G, Romano G, Ferri M, Scattoni ML. Benefits and challenges of a personal budget for people with mental health conditions or intellectual disability: A systematic review. Front Psychiatry 2022; 13:974621. [PMID: 35990078 PMCID: PMC9386381 DOI: 10.3389/fpsyt.2022.974621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/14/2022] [Indexed: 01/04/2023] Open
Abstract
Personal budgets (PBs) may improve the lives of people with mental health conditions and people with intellectual disability (ID). However, a clear definition of PB, benefits, and challenges is still faded. This work aims to systematically review evidence on PB use in mental health and ID contexts, from both a qualitative and quantitative perspective, and summarize the recent research on interventions, outcomes, and cost-effectiveness of PBs in beneficiaries with mental health conditions and/or ID. The present systematic review is an update of the existing literature analyzed since 2013. We performed a systematic search strategy of articles using the bibliographic databases PubMed and PsycINFO. Six blinded authors screened the works for inclusion/exclusion criteria, and two blinded authors extracted the data. We performed a formal narrative synthesis of the findings from the selected works. A total of 9,800 publications were screened, and 29 were included. Improvement in responsibility and awareness, quality of life, independent living, paid work, clinical, psychological, and social domains, and everyday aspects of the users' and their carers' life have been observed in people with mental health conditions and/or ID. However, the PBs need to be less stressful and burdensome in their management for users, carers, and professionals. In addition, more quantitative research is needed to inform PBs' policymakers. Systematic Review Registration [www.crd.york.ac.uk/prospero/], identifier [CRD42020172607].
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Affiliation(s)
- Martina Micai
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Letizia Gila
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Angela Caruso
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Elisa Fontecedro
- Department of Mental Health, Friuli Centrale Healthcare Agency, Udine, Italy
| | | | - Giovanna Romano
- Directorate General of Health Prevention, Ministry of Health, Rome, Italy
| | | | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
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Kim KM, Meyer N, Hall-Lande J, Freeman R. Supervisory and administrative staff's perspectives of self-directed supports for people with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:480-487. [PMID: 34697876 DOI: 10.1111/jar.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Self-directed supports (SDS) are a model of disability service delivery that focuses on supporting increased decision-making authority and budget autonomy for people with disabilities and their families. This study identifies supervisory and administrative staff's perspectives within a self-directed, individualised budgeting programme for people with intellectual and developmental disabilities. METHOD Data were collected through 28 face-to-face interviews with supervisory and fiscal administrative staff in Minnesota, USA. RESULTS A qualitative analysis of these interviews resulted in four major themes: (1) the benefits of SDS, (2) the relationship between SDS and person-centred strategies, (3) the perception that a natural tension arises when balancing person-centred approaches with the need for consistent and fair state policy-including rules and regulations within state systems and (4) the unique challenges related to SDS benefits and challenges occurring across Minnesota. CONCLUSIONS The results indicate the importance of providing effective communication and training to all stakeholders.
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Affiliation(s)
- Kyung Mee Kim
- Department of Social Welfare, Soongsil University, Seoul, Republic of Korea
| | | | - Jennifer Hall-Lande
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Rachel Freeman
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
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Rioli G, Ferrari S, Henderson C, Galeazzi GM. Experiences, opinions and current policies on users' choice and change of the allocated primary mental health professional: a survey among directors of community mental health centers in the Emilia-Romagna region, Italy. Int J Ment Health Syst 2020; 14:41. [PMID: 32514305 PMCID: PMC7260837 DOI: 10.1186/s13033-020-00373-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 05/23/2020] [Indexed: 12/04/2022] Open
Abstract
Background The subject of how the initial allocation of the primary mental health professional (PMHP) in community mental health services is made and the frequency and management of users’ requests to choose and/or change their allocated PMHPs has been scarcely investigated. The present paper is aimed at exploring the experiences and opinions of directors of community mental health centers (CMHC) on this topic. Methods A cross-sectional survey was conducted. Electronic ad hoc questionnaires with both multiple choice and open-ended questions were e-mailed to the institutional addresses of CMHC directors in the Emilia-Romagna Region (Northern Italy) with the consent of their heads of department and the Ethical Committee. Quantitative data were analysed by means of Microsoft Excel software and STATA 14.2 (College Station, TX), while the qualitative analysis was performed using the Nvivo12 software. Results Twenty-eight questionnaires were collected (response rate: 71.8%) that were equally distributed between males and females. For the initial PMHP allocation, casual allocation by “fixed-rota” was commonly performed (39.3%). Moreover, hope for a change of prescription by a different psychiatrist was the most frequent reason for users’ requests to change their PMHP. In two mental health departments only (Parma and Bologna), written guidelines to manage users’ requests of change of PMHP were available. In this context, most participants classified the explored topics as relevant and believed that written policies, especially if shared with users, could be useful. Conclusions In Emilia-Romagna CMHCs, neither users nor professionals were generally involved in the initial choice of the PMHP. Further national-level studies should be conducted in order to confirm this finding. Additionally, written and shared guidelines for managing users’ request to choose/change their PHMP may be useful.
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Affiliation(s)
- G Rioli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy.,Department of Mental Health and Drug Abuse, AUSL Reggio Emilia, viale Amendola 2, 42122 Reggio Emilia, Italy
| | - S Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy.,Centre for Neuroscience and Neurotechnology, University of Modena & Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy
| | - C Henderson
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
| | - G M Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy.,Centre for Neuroscience and Neurotechnology, University of Modena & Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy
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A qualitative exploration of the recovery experiences of consumers who had undertaken shared management, person-centred and self-directed services. Int J Ment Health Syst 2014. [DOI: 10.1186/1752-4458-8-23] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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