Abstract
Background
Scientific evidence has proven greater effectiveness of community-based mental health care offering a diversity of services. Among the main barriers to mental health treatment are difficulties in the access and poor integration with general health services.
Description of the problem
The current Portuguese National Mental Health Plan promoted the transition from psychiatric hospital-based care to care provided by a network of services in the community with the inpatient unit in the local general hospital. In this presentation we will describe the main aspects of the mental health reform and some figures illustrating the functioning of one of the new mental health departments.
Results
Since 2006 three large psychiatric hospitals were closed and mental health departments are now in place according to the new model.
One example, the HFF department of psychiatry, has developed an innovative comprehensive and integrated model based in the general hospital and the community, ensuring a close coordination with primary care teams and all other relevant stakeholders in the community, offering diverse answers to patients’ needs, and preventing drop-outs.
Between 2000 and 2011, the number of admissions went from 486 to 451, first admissions from 40% to 36%, and the average number of patients treated in day hospital from 12 to 24. Liaison psychiatry consultations (2713 to 3684), community teams’ visits (10,201 to 14,756), and home visits (236 to 980) have increased significantly, while rehabilitation programs were developed in two day centers in the community.
Conclusions
The Portuguese model of mental health care, based on the principles of accessibility and equity, community involvement, recovery and human rights, and continuity of care, has promoted greater accessibility, higher quality of care, and less stigma. An important integration of mental health and general health services has taken place allowing for a close collaboration between services.
Out-of-Network Provider Use More Likely in Mental Health than General Health Care Among Privately Insured
