Differential Indication in Mental Health Care of Patients with Mental Disorders

Abstract

Patients with mental disorders are treated in different care sectors and professional disciplines. In Germany, differential indication between psychiatric and psychosomatic care, between regular hospitals and psychosomatic rehabilitation clinics as well as between outpatient, day clinic, and inpatient treatment is not precise. Differential decisions for the treatment in specific sectors are not discernable. Overview of empiric evidence about differential indication criteria. Evidence for eligible differential allocation criteria is presented. Patient criteria are categorized into medical criteria, treatment needs, and individual features. Seldom, indication criteria suggest or eliminate a certain care sector. Evidence generally is scarce and is limited to comparisons of patients already treated in different care sectors. To describe differential indication criteria and allocation decisions the structure of the mental health care system must be included. Meaningful studies about differential indication for patients with mental disorders are needed. Perspectives for systematic treatment allocation are discussed.