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Whiteford H, Bagheri N, Diminic S, Enticott J, Gao CX, Hamilton M, Hickie IB, Khanh-Dao Le L, Lee YY, Long KM, McGorry P, Meadows G, Mihalopoulos C, Occhipinti JA, Rock D, Rosenberg S, Salvador-Carulla L, Skinner A. Mental health systems modelling for evidence-informed service reform in Australia. Aust N Z J Psychiatry 2023; 57:1417-1427. [PMID: 37183347 DOI: 10.1177/00048674231172113] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Australia's Fifth National Mental Health Plan required governments to report, not only on the progress of changes to mental health service delivery, but to also plan for services that should be provided. Future population demand for treatment and care is challenging to predict and one solution involves modelling the uncertain demands on the system. Modelling can help decision-makers understand likely future changes in mental health service demand and more intelligently choose appropriate responses. It can also support greater scrutiny, accountability and transparency of these processes. Australia has an emerging national capacity for systems modelling in mental health which can enhance the next phase of mental health reform. This paper introduces concepts useful for understanding mental health modelling and identifies where modelling approaches can support health service planners to make evidence-informed decisions regarding planning and investment for the Australian population.
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Affiliation(s)
- Harvey Whiteford
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Nasser Bagheri
- Mental Health Policy Unit, Health Research Institute, University of Canberra
| | - Sandra Diminic
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Joanne Enticott
- Southern Synergy, Monash Centre of Health Research & Implementation, Monash University, Dandenong, VIC, Australia
| | - Caroline X Gao
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University
| | - Matthew Hamilton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Long Khanh-Dao Le
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yong Yi Lee
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Katrina M Long
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - Patrick McGorry
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Graham Meadows
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Dandenong, VIC, Australia
| | - Cathrine Mihalopoulos
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jo-An Occhipinti
- Systems Modelling, Simulation & Data Science, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney
| | - Daniel Rock
- WA Primary Health Alliance, Perth, Australia
- Discipline of Psychiatry, Medical School University of Western Australia
- Faculty of Health, University of Canberra
| | - Sebastian Rosenberg
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Luis Salvador-Carulla
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Adam Skinner
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Jahanjoo F, Sadeghi-Bazargani H, Mansournia MA, Hosseini ST, Asghari-Jafarabadi M. A Hybrid of Random Forests and Generalized Path Analysis: A Causal Modeling of Crashes in 52,524 Suburban Areas. J Res Health Sci 2023; 23:e00581. [PMID: 37571952 PMCID: PMC10422137 DOI: 10.34172/jrhs.2023.116] [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: 03/15/2023] [Revised: 04/17/2023] [Accepted: 05/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Determining suburban area crashes' risk factors may allow for early and operative safety measures to find the main risk factors and moderating effects of crashes. Therefore, this paper has focused on a causal modeling framework. STUDY DESIGN A cross-sectional study. METHODS In this study, 52524 suburban crashes were investigated from 2015 to 2016. The hybrid-random-forest-generalized-path-analysis technique (HRF-gPath) was used to extract the main variables and identify mediators and moderators. RESULTS This study analyzed 42 explanatory variables using a RF model, and it was found that collision type, distinct, driver misconduct, speed, license, prior cause, plaque description, vehicle maneuver, vehicle type, lighting, passenger presence, seatbelt use, and land use were significant factors. Further analysis using g-Path demonstrated the mediating and predicting roles of collision type, vehicle type, seatbelt use, and driver misconduct. The modified model fitted the data well, with statistical significance ( χ230 =81.29, P<0.001) and high values for comparative-fit-index and Tucker-Lewis-index exceeding 0.9, as well as a low root-mean-square-error-of-approximation of 0.031 (90% confidence interval: 0.030-0.032). CONCLUSION The results of our study identified several significant variables, including collision type, vehicle type, seatbelt use, and driver misconduct, which played mediating and predicting roles. These findings provide valuable insights into the complex factors that contribute to collisions via a theoretical framework and can inform efforts to reduce their occurrence in the future.
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Affiliation(s)
- Fatemeh Jahanjoo
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Teymoor Hosseini
- Department of Engineering Traffic and Transportation, Faculty of the Traffic, Tehran University, Tehran, Iran
| | - Mohammad Asghari-Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Cabrini Research, Cabrini Health, Malvern, VIC 3144, Australia
- Biostatistics Unit, School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
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Graham E, Zhao B, Flynn M, Gustafson P, Irvine MA, Slaunwhite A, Orpana H, Kuo M, MacDougall L. Using linked data to identify pathways of reporting overdose events in British Columbia, 2015-2017. Int J Popul Data Sci 2022; 7:1708. [PMID: 37650030 PMCID: PMC10464869 DOI: 10.23889/ijpds.v7i1.1708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Overdose events related to illicit opioids and other substances are a public health crisis in Canada. The BC Provincial Overdose Cohort is a collection of linked datasets identifying drug-related toxicity events, including death, ambulance, emergency room, hospital, and physician records. The datasets were brought together to understand factors associated with drug-related overdose and can also provide information on pathways of care among people who experience an overdose. Objectives To describe pathways of recorded healthcare use for overdose events in British Columbia, Canada and discrepancies between data sources. Methods Using the BC Provincial Overdose Cohort spanning 2015 to 2017, we examined pathways of recorded health care use for overdose through the framework of an injury reporting pyramid. We also explored differences in event capture between linked datasets. Results In the cohort, a total of 34,113 fatal and non-fatal overdose events were identified. A total of 3,056 people died of overdose. Nearly 80% of these deaths occurred among those with no contact with the healthcare system. The majority of events with healthcare records included contact with EHS services (72%), while 39% were seen in the ED and only 7% were hospitalized. Pathways of care from EHS services to ED and hospitalization were generally observed. However, not all ED visits had an associated EHS record and some hospitalizations following an ED visit were for other health issues. Conclusions These findings emphasize the importance of accessing timely healthcare for people experiencing overdose. These findings can be applied to understanding pathways of care for people who experience overdose events and estimating the total burden of healthcare-attended overdose events. Highlights In British Columbia, Canada:Multiple sources of linked administrative health data were leveraged to understand recorded healthcare use among people with fatal and non-fatal overdose eventsThe majority of fatal overdose events occurred with no contact with the healthcare system and only appear in mortality dataMany non-fatal overdose events were captured in data from emergency health services, emergency departments, and hospital recordsAccessing timely healthcare services is critical for people experiencing overdose.
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Affiliation(s)
- Eva Graham
- Centre for Surveillance and Applied Research, Public Health Agency of Canada
| | - Bin Zhao
- British Columbia Centre for Disease Control
| | - Mallory Flynn
- Centre for Surveillance and Applied Research, Public Health Agency of Canada
- Department of Statistics, Faculty of Science, University of British Columbia
| | - Paul Gustafson
- Department of Statistics, Faculty of Science, University of British Columbia
| | | | - Amanda Slaunwhite
- British Columbia Centre for Disease Control
- School of Population and Public Health, Faculty of Medicine, University of British Columbia
| | - Heather Orpana
- Centre for Surveillance and Applied Research, Public Health Agency of Canada
- School of Epidemiology and Public Health, University of Ottawa
| | - Margot Kuo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada
| | - Laura MacDougall
- Centre for Surveillance and Applied Research, Public Health Agency of Canada
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Almeda N, Díaz-Milanés D, Guiterrez-Colosia MR, García-Alonso CR. A systematic review of the international evolution of online mental health strategies and recommendations during the COVID-19 pandemic. BMC Psychiatry 2022; 22:621. [PMID: 36127666 PMCID: PMC9486794 DOI: 10.1186/s12888-022-04257-8] [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: 03/09/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The global health crisis caused by the COVID-19 pandemic has had a negative impact on mental health (MH). As a response to the pandemic, international agencies and governmental institutions provided an initial response to the population's needs. As the pandemic evolved, the population circumstances changed, and some of these international agencies updated their strategies, recommendations, and guidelines for the populations. However, there is currently a lack of information on the attention given to response strategies by the different countries throughout the beginning of the pandemic. OBJECTIVES 1) To evaluate the evolution of online MH strategies and recommendations of selected countries to cope with the MH impact of COVID-19 from the early stages of the pandemic (15 April 2020) to the vaccination period (9 June 2021) and 2) to review and analyse the current structures of these online MH strategies and recommendations. METHODOLOGY An adaptation of the PRISMA guidelines to review online documents was developed with a questionnaire for MH strategies and recommendations assessment. The search was conducted on Google, including documents from April 2020 to June 2021. Basic statistics and Student's t test were used to assess the evolution of the documents, while a two-step cluster analysis was performed to assess the organisation and characteristics of the most recent documents. RESULTS Statistically significant differences were found both in the number of symptoms and mental disorders and MH strategies and recommendations included in the initial documents and the updated versions generated after vaccines became available. The most recent versions are more complete in all cases. Regarding the forty-six total documents included in the review, the cluster analysis showed a broad distribution from wide-spectrum documents to documents focusing on a specific topic. CONCLUSIONS Selected governments and related institutions have worked actively on updating their MH online documents, highlighting actions related to bereavement, telehealth and domestic violence. The study supports the use of the adaptation, including the tailor-made questionnaire, of the PRISMA protocol as a potential standard to conduct longitudinal assessments of online documents used to support MH strategies and recommendations.
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Affiliation(s)
- Nerea Almeda
- grid.449008.10000 0004 1795 4150Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
| | | | | | - Carlos R. García-Alonso
- grid.449008.10000 0004 1795 4150Department of Quantitative Methods, Universidad Loyola Andalucía, Cordova, Spain
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Johnson S, Dalton‐Locke C, Baker J, Hanlon C, Salisbury TT, Fossey M, Newbigging K, Carr SE, Hensel J, Carrà G, Hepp U, Caneo C, Needle JJ, Lloyd‐Evans B. Acute psychiatric care: approaches to increasing the range of services and improving access and quality of care. World Psychiatry 2022; 21:220-236. [PMID: 35524608 PMCID: PMC9077627 DOI: 10.1002/wps.20962] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Acute services for mental health crises are very important to service users and their supporters, and consume a substantial share of mental health resources in many countries. However, acute care is often unpopular and sometimes coercive, and the evidence on which models are best for patient experience and outcomes remains surprisingly limited, in part reflecting challenges in conducting studies with people in crisis. Evidence on best ap-proaches to initial assessment and immediate management is particularly lacking, but some innovative models involving extended assessment, brief interventions, and diversifying settings and strategies for providing support are potentially helpful. Acute wards continue to be central in the intensive treatment phase following a crisis, but new approaches need to be developed, evaluated and implemented to reducing coercion, addressing trauma, diversifying treatments and the inpatient workforce, and making decision-making and care collaborative. Intensive home treatment services, acute day units, and community crisis services have supporting evidence in diverting some service users from hospital admission: a greater understanding of how best to implement them in a wide range of contexts and what works best for which service users would be valuable. Approaches to crisis management in the voluntary sector are more flexible and informal: such services have potential to complement and provide valuable learning for statutory sector services, especially for groups who tend to be underserved or disengaged. Such approaches often involve staff with personal experience of mental health crises, who have important potential roles in improving quality of acute care across sectors. Large gaps exist in many low- and middle-income countries, fuelled by poor access to quality mental health care. Responses need to build on a foundation of existing community responses and contextually relevant evidence. The necessity of moving outside formal systems in low-resource settings may lead to wider learning from locally embedded strategies.
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Affiliation(s)
- Sonia Johnson
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | | | - John Baker
- School of Healthcare, University of LeedsLeedsUK
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUK,Department of PsychiatrySchool of Medicine, and Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa UniversityAddis AbabaEthiopia
| | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUK
| | - Matt Fossey
- Faculty of Health, Education, Medicine and Social CareAnglia Ruskin UniversityChelmsfordUK
| | - Karen Newbigging
- Department of PsychiatryUniversity of OxfordOxfordUK,Institute for Mental Health, University of BirminghamBirminghamUK
| | - Sarah E. Carr
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUK
| | - Jennifer Hensel
- Department of PsychiatryUniversity of ManitobaWinnipegMBCanada
| | - Giuseppe Carrà
- Department of Medicine and SurgeryUniversity of Milano BicoccaMilanItaly
| | - Urs Hepp
- Integrated Psychiatric Services Winterthur, Zürcher UnterlandWinterthurSwitzerland
| | - Constanza Caneo
- Departamento de Psiquiatría, Facultad de MedicinaPontificia Universidad Católica de ChileSantiagoChile
| | - Justin J. Needle
- Centre for Health Services Research, School of Health Sciences, City, University of LondonLondonUK
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Almeda N, Garcia-Alonso CR, Gutierrez-Colosia MR, Salinas-Perez JA, Iruin-Sanz A, Salvador-Carulla L. Modelling the balance of care: Impact of an evidence-informed policy on a mental health ecosystem. PLoS One 2022; 17:e0261621. [PMID: 35015762 PMCID: PMC8752022 DOI: 10.1371/journal.pone.0261621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022] Open
Abstract
Major efforts worldwide have been made to provide balanced Mental Health (MH) care. Any integrated MH ecosystem includes hospital and community-based care, highlighting the role of outpatient care in reducing relapses and readmissions. This study aimed (i) to identify potential expert-based causal relationships between inpatient and outpatient care variables, (ii) to assess them by using statistical procedures, and finally (iii) to assess the potential impact of a specific policy enhancing the MH care balance on real ecosystem performance. Causal relationships (Bayesian network) between inpatient and outpatient care variables were defined by expert knowledge and confirmed by using multivariate linear regression (generalized least squares). Based on the Bayesian network and regression results, a decision support system that combines data envelopment analysis, Monte Carlo simulation and fuzzy inference was used to assess the potential impact of the designed policy. As expected, there were strong statistical relationships between outpatient and inpatient care variables, which preliminarily confirmed their potential and a priori causal nature. The global impact of the proposed policy on the ecosystem was positive in terms of efficiency assessment, stability and entropy. To the best of our knowledge, this is the first study that formalized expert-based causal relationships between inpatient and outpatient care variables. These relationships, structured by a Bayesian network, can be used for designing evidence-informed policies trying to balance MH care provision. By integrating causal models and statistical analysis, decision support systems are useful tools to support evidence-informed planning and decision making, as they allow us to predict the potential impact of specific policies on the ecosystem prior to its real application, reducing the risk and considering the population’s needs and scientific findings.
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Affiliation(s)
- Nerea Almeda
- Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
| | | | | | - Jose A. Salinas-Perez
- Department of Quantitative Methods, Universidad Loyola Andalucía, Seville, Spain
- * E-mail:
| | - Alvaro Iruin-Sanz
- Instituto Biodonostia, Red de Salud Mental Extrahospitalaria de Gipuzkoa, Donostia-San Sebastián, Spain
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
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Almeda N, García-Alonso C, Salvador-Carulla L. Mental health planning at a very early stage of the COVID-19 crisis: a systematic review of online international strategies and recommendations. BMC Psychiatry 2021; 21:43. [PMID: 33451305 PMCID: PMC7809644 DOI: 10.1186/s12888-020-03015-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/14/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Mental health care systems have been dramatically affected by COVID-19. Containment measures have been imposed, with negative consequences on population mental health. Therefore, an increase in both symptomatology and mental disorder incidence is expected. This research aims to identify, describe and assess the empirical background on online strategies and recommendations developed by international organizations and governments to cope with the psychological impact of COVID-19 at a very early stage of the pandemic. METHODS The PRISMA guidelines were adapted to review online documents. A new questionnaire was developed to identify the existence of common patterns in the selected documents. Questions were classified into three domains: COVID-19 information, mental health strategies and mental health recommendations. A two-step cluster analysis was carried out to highlight underlying behaviours in the data (patterns). The results are shown as spider graphs (pattern profiles) and conceptual maps (multidimensional links between questions). RESULTS Twenty-six documents were included in the review. The questionnaire analysed document complexity and identified their common key mental health characteristics (i.e., does the respondent have the tools for dealing with stress, depression and anxiety?). Cluster analysis highlighted patterns from the questionnaire domains. Strong relationships between questions were identified, such as psychological tips for maintaining good mental health and coping with COVID-19 (question n° 4), describing some psychological skills to help people cope with anxiety and worry about COVID-19 (question n° 6) and promoting social connection at home (question n° 8). CONCLUSIONS When fast results are needed to develop health strategies and policies, rapid reviews associated with statistical and graphical methods are essential. The results obtained from the proposed analytical procedure can be relevant to a) classify documents according to their complexity in structuring the information provided on how to cope with the psychological impact of COVID-19, b) develop new documents according to specific objectives matching population needs, c) improve document design to face unforeseen events, and d) adapt new documents to local situations. In this framework, the relevance of adapting e-mental health procedures to community mental health care model principles was highlighted, although some problems related to the digital gap must be considered.
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Affiliation(s)
- Nerea Almeda
- Department of Psychology, Universidad Loyola Andalucía, Seville, Spain.
| | - Carlos García-Alonso
- grid.449008.10000 0004 1795 4150Department of Quantitative Methods, Universidad Loyola Andalucía, Seville, Spain
| | - Luis Salvador-Carulla
- grid.1001.00000 0001 2180 7477Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
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Salinas-Pérez JA, Gutiérrez-Colosia MR, Romero López-Alberca C, Poole M, Rodero-Cosano ML, García-Alonso CR, Salvador-Carulla L. [Everything is on the map: Integrated Mental Health Atlases as support tools for service planning. SESPAS Report 2020]. GACETA SANITARIA 2020; 34 Suppl 1:11-19. [PMID: 32933792 DOI: 10.1016/j.gaceta.2020.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 06/04/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This article reviews the usability of the Integrated Atlases of Mental Health as a decision support tool for service planning following a health ecosystem research approach. METHOD This study describes the types of atlases and the procedure for their development. Atlases carried out in Spain are presented and their impact in mental health service planning is assessed. Atlases comprise information on the local characteristics of the health care system, geographical availability of resources collected with the DESDE-LTC instrument and their use. Atlases use geographic information systems and other visualisation tools. Atlases follow a bottom-up collaborative approach involving decision-makers from planning agencies for their development and external validation. RESULTS Since 2005, Integrated Atlases of Mental Health have been developed for nine regions in Spain comprising over 65% of the Spanish inhabitants. The impact on service planning has been unequal for the different regions. Catalonia, Biscay and Gipuzkoa, and Andalusia reach the highest impact. In these areas, health advisors have been actively involved in their co-design and implementation in service planning. CONCLUSIONS Atlases allow detecting care gaps and duplications in care provision; monitoring changes of the system over time, and carrying out national and international comparisons, efficiency modelling and benchmarking. The knowledge provided by atlases could be incorporated to decision support systems in order to support an efficient mental health service planning based on evidence-informed policy.
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Affiliation(s)
- José A Salinas-Pérez
- Asociación Científica Psicost, Sevilla, España; Departamento de Métodos Cuantitativos, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, España.
| | - Mencía R Gutiérrez-Colosia
- Asociación Científica Psicost, Sevilla, España; Departamento de Psicología, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, España
| | - Cristina Romero López-Alberca
- Asociación Científica Psicost, Sevilla, España; Departamento de Psicología, Universidad de Cádiz, San Fernando, Cádiz, España
| | - Miriam Poole
- Asociación Científica Psicost, Sevilla, España; Asociación Nuevo Futuro, Madrid, España
| | - María Luisa Rodero-Cosano
- Asociación Científica Psicost, Sevilla, España; Departamento de Métodos Cuantitativos, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, España
| | - Carlos R García-Alonso
- Asociación Científica Psicost, Sevilla, España; Departamento de Métodos Cuantitativos, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, España
| | - Luis Salvador-Carulla
- Asociación Científica Psicost, Sevilla, España; Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia; Menzies Centre for Health Policy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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9
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Salvador-Carulla L, Almeda N, Álvarez-Gálvez J, García-Alonso C. [On the roller coaster: An abridged history of mental health planning in Spain. SESPAS Report 2020]. GACETA SANITARIA 2020; 34 Suppl 1:3-10. [PMID: 32843197 DOI: 10.1016/j.gaceta.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 05/18/2020] [Accepted: 06/02/2020] [Indexed: 01/29/2023]
Abstract
Effective mental health change in Spain started in 1985 with the Report of the Ministerial Commission for the Psychiatric Reform that recommended integrating psychiatric care into the general health system, providing care in the patient's context and for specific diagnoses. The SESPAS 2002 Report carried out an analysis of this reform and recommended the creation of a permanent ministerial commission, the design of a national map of socio-sanitary mental health services, the creation of a coordination and promotion agency for and carrying out a financial analysis of resource provision and research. Since 2004, the Technical Committee for the Mental Health Strategy boosted the elaboration of a theoretical and normative framework that unfortunately did not lead to a road map for the improvement of the system. After 2011, during the financial crisis, the Ministry of Health lost the opportunity to lead a second phase of change of the mental health care, which was evidence-based: no key technical reports were published nor was an action plan based on data developed. Currently, the 1985 community mental health model is still the general framework of mental health care with the addition of aspects related to the recovery model and the balance of care model. Significant progress has been made in developing care systems assessment methods and data-based models that could advance mental health planning. The gap between general health attention and mental health care has increased and the expected reform of the mental health system will not take place in the near future.
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Affiliation(s)
- Luis Salvador-Carulla
- Asociación Científica Psicost, Sevilla, España; Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Nerea Almeda
- Asociación Científica Psicost, Sevilla, España; Departamento de Psicología, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, España.
| | - Javier Álvarez-Gálvez
- Asociación Científica Psicost, Sevilla, España; Departamento de Biomedicina, Biotecnología y Salud Pública, Universidad de Cádiz, Cádiz, España
| | - Carlos García-Alonso
- Asociación Científica Psicost, Sevilla, España; Departamento de Métodos Cuantitativos, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, España
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10
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Samartzis L, Talias MA. Assessing and Improving the Quality in Mental Health Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010249. [PMID: 31905840 PMCID: PMC6982221 DOI: 10.3390/ijerph17010249] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/21/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022]
Abstract
Background: The mental health of the population consists of the three essential pillars of quality of life, economy, and society. Mental health services take care of the prevention and treatment of mental disorders and through them maintain, improve, and restore the mental health of the population. The purpose of this study is to describe the methodology for qualitative and quantitative evaluation and improvement of the mental health service system. Methods: This is a narrative review study that searches the literature to provide criteria, indicators, and methodology for evaluating and improving the quality of mental health services and the related qualitative and quantitative indicators. The bibliography was searched in popular databases PubMed, Google Scholar, CINAHL, using the keywords “mental”, “health”, “quality”, “indicators”, alone or in combinations thereof. Results: Important quality indicators of mental health services have been collected and presented, and modified where appropriate. The definition of each indicator is presented here, alongside its method of calculation and importance. Each indicator belongs to one of the eight dimensions of quality assessment: (1) Suitability of services, (2) Accessibility of patients to services, (3) Acceptance of services by patients, (4) Ability of healthcare professionals to provide services, (5) Efficiency of health professionals and providers, (6) Continuity of service over time (ensuring therapeutic continuity), (7) Efficiency of health professionals and services, (8) Safety (for patients and for health professionals). Discussion/Conclusions: Accessibility and acceptability of service indicators are important for the attractiveness of services related to their use by the population. Profitability indicators are important economic indicators that affect the viability and sustainability of services, factors that are now taken into account in any health policy. All of the indicators mentioned are related to public health, affecting the quality of life, morbidity, mortality, and life expectancy, directly or indirectly. The systematic measurement and monitoring of indicators and the measurement and quantification of quality through them, are the basis for evidence-based health policy for improvement of the quality of mental health services.
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Affiliation(s)
- Lampros Samartzis
- Faculty of Economics and Management, Open University of Cyprus, Latsia, Nicosia, Cyprus
- Department of Psychiatry, Medical School, University of Cyprus, Nicosia, Cyprus
- Mental Health Services, Athalassa Psychiatric Hospital, Nicosia, Cyprus
| | - Michael A. Talias
- Faculty of Economics and Management, Open University of Cyprus, Latsia, Nicosia, Cyprus
- Correspondence:
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