Evaluation of the Second National Mental Health Plan

Objective: To review the status of consultation–liaison psychiatry and the factors shaping it, and suggest strategies for its future development. Method: In addition to searches of the main computerized psychiatric databases and review of relevant Commonwealth of Australia publications, the author drew on discussions with national and international colleagues in his role as convenor of the International Organization for Consultation–Liaison Psychiatry. Results: Physical/psychiatric comorbidity and somatization, the conditions in which consultation–liaison psychiatry specializes, are the commonest forms of psychiatric presentation in the community. They are as disabling as psychotic disorders, and comorbid depression in particular is a predictor of increased morbidity and mortality. Acknowledging this, the Second Australian National Mental Health Plan called for consultation–liaison psychiatry to be allowed to participate fully in the mental health care system. It stated that failure to define the term ‘severe mental health problems and mental disorders’ in the First Plan had led to some public mental health systems erroneously equating severity with diagnosis rather than level of need and disability. The call has been largely unheeded. The implication for patient care is both direct and indirect; the context created for psychiatry training by such a restricted focus is helping to perpetuate the neglect of such patients. This is a worldwide problem. Conclusions: Proactive involvement with consumers is required if the problem is to be redressed. At a service level, development of a seamless web of pre-admission/admission/post-discharge functions is required if patients with physical/psychiatric comorbidity and somatoform disorders are to receive effective care, and consultation–liaison psychiatry services are to be able to demonstrate efficacy. Focus on comorbidity in the Australian Third National Mental Health Plan may force resolution of the current problems.

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Mental Health Information Development: National Information Priorities and Strategies under the Second National Mental Health Plan 1998-2003: First Edition, June 1999

PsycEXTRA Dataset ◽

10.1037/e677202010-001 ◽

1999 ◽

Keyword(s):

Mental Health ◽

Health Information ◽

Health Plan ◽

Mental Health Information ◽

Information Priorities ◽

National Mental Health ◽

National Information

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National Mental Health Plan: April 1992

PsycEXTRA Dataset ◽

10.1037/e677262010-001 ◽

1992 ◽

Keyword(s):

Mental Health ◽

Health Plan ◽

National Mental Health

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Reforming mental health services in Portugal

European Psychiatry ◽

10.1016/s0924-9338(11)72295-7 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 588-588

Author(s):

M. Xavier ◽

P. Mateus ◽

J. Caldas-Almeida

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Health Plan ◽

Homeless People ◽

List Type ◽

Term Care ◽

Financing Model ◽

National Mental Health ◽

The Impact

IntroductionAnalysis of the mental health system in Portugal reveals some positive aspects in its development through recent decades, namely in what concerns the creation of decentralised services and rehabilitation programs. Despite this, Portuguese mental health services (MHS) still suffer from significant deficiencies, in terms of accessibility, equity and quality of care. There is a large gap between the number of people affected with mental disorders and those receiving treatment: for an estimated prevalence of 16.07%, the number of people receiving treatment in MHS was estimated to be 1.7%.ObjectivesThe major objectives of the new National Mental Health Plan are:1)Assure equal access to care,2)Promote and protect human rights3)Reduce the impact of mental health disorders4)Promote community delivery of care,5)Promote the integration of MHS in the general health services.MethodsA National Coordination Body for Mental Health has been empowered to assure the implementation of the National Mental Health Plan, with external monitoring by WHO.ResultsSince the last three years, there has been significant changes and improvements at the following levels: new legislation, creation of new MHS, forensic services, financing model, residential facilities (long term care), deinstitutionalization, training, programs for homeless people, domestic violence, advocacy and stigma.ConclusionsThe implementation of the mental health plan can help to overcome some of the problems present in MHS in Portugal. Special attention should be given to the financing model, has it represents a crucial restraint to the development of the MHS.

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National Mental Health Plan: An Opportunity to Implement Psychoeducation in Portugal?

European Psychiatry ◽

10.1016/s0924-9338(09)70466-3 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

M. Xavier ◽

M. Goncalves-Pereira ◽

J. Caldas de Almeida

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Health Plan ◽

Mentally Ill ◽

Scientific Evidence ◽

Care Needs ◽

Family Interventions ◽

Effective Response ◽

National Mental Health

It is well known that due to deinstitutionalization, faster discharge from wards and insufficient community resources, direct contact of the severe mentally ill patients with their families has increased a lot in the last years.In the last two decades, mental health services across Europe developed a diversified offer of programmes, including psychoeducation and family interventions, in order to ensure an effective response to the different care needs.In Portugal, the lack of planning and consistent support in the improvement of mental health services means that the country is lagging behind significantly in this field in relation to other European countries.Concerning the specific subject of psychoeducation and family interventions for psychotic patients and their families, its true that treatment in Portugal seldom comport with the best scientific evidence, but so far there has been no pressure on the services to change this oddly situation.The new National Mental Health Plan, launched in 2008, sets that i. People with mental disorders should be involved and participate in the planning and development of the services they benefit from, and that ii. Family members of the mentally ill should be considered as important partners in care provision, and encouraged to participate in this provision and to receive the necessary training and education.Based on these principles, the Mental Health Plan may be a critical opportunity to implement psychoeducation and family interventions in Portugal. The authors address this issue, discussing also the potential role of new models of contracting, financing, accounting and monitoring.

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