Abstract
Mental health care is a critical area to better understand integrated care and to pilot the different components of the integrated care model. However, there is an urgent need for better tools to compare and understand the context of integrated mental health care in Europe. The REMAST tool (REFINEMENT MApping Services Tool) combines a series of standardised health service research instruments and geographical information systems (GIS) to develop local atlases of mental health care from the perspective of horizontal and vertical integrated care. It contains five main sections: (a) Population Data; (b) the Verona Socio-economic Status (SES) Index; (c) the Mental Health System Checklist; (d) the Mental Health Services Inventory using the DESDE-LTC instrument; and (e) Geographical Data. The REMAST tool facilitates context analysis in mental health by providing the comparative rates of mental health service provision according to the availability of main types of care; care placement capacity; workforce capacity; and geographical accessibility to services in the local areas in eight study areas in Austria, England, Finland, France, Italy, Norway, Romania and Spain. The outcomes of this project will facilitate cooperative work and knowledge transfer on mental health care to the different agencies involved in mental health planning and provision. This project would improve the information to users and society on the available resources for mental health care and system thinking at the local level by the different stakeholders. The techniques used in this project and the knowledge generated could eventually be transferred to the mapping of other fields of integrated care.
Highlights
Mental health care is a critical area to better understand integrated care and to pilot the different components of the integrated care model
The techniques used in this project and the knowledge generated could eventually be transferred to the mapping of other fields of integrated care
The primary endpoint for this study is to provide standardised rates of mental health service provision in selected study areas of 8 EU countries, according to four main domains: (a) Availability of main types of care (MTCs) in the study area as described by the total number of main type of care” (MTC) and the different types of MTCs available per 100,000 attended population; (b) Care placement capacity or rate of beds in residential basic sets of inputs (BSICs) and places assigned in structured day care to persons experiencing mental disorders in the study area; (c) Workforce capacity: rate of professional clinical staff measured in ‘Full Time Equivalents’ (FET); and (d) Geographical accessibility to Services and to BSICs as defined by its principal MTCs
Summary
Mental health care is a critical area to better understand integrated care and to pilot the different components of the integrated care model. Community mental health care is a relevant precursor of integrated care [1] It started in the 1960s in the UK and the USA and spread to the majority of Western countries by the mid 1980s following the deinstitutionalisation process and closure of old mental hospitals. The organisational components of the community care model in mental health included high-intensity coordination as in the Assertive Community Care model [2], development of multidisciplinary teams including case managers. These early contributions were not accompanied with the completion of a fully integrated care system and an efficient monitoring. Major problems persist 30 years after the community mental health care system was implemented
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