scholarly journals EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
W. Gaebel ◽  
A. Kerst ◽  
B. Janssen ◽  
T. Becker ◽  
M. Musalek ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Care Coordination ◽  
Mental Healthcare ◽  
Advantages And Disadvantages ◽  
Meta Review ◽  
Effectiveness And Efficiency

Abstract Background. The quality of mental health services is crucial for the effectiveness and efficiency of mental healthcare systems, symptom reduction, and quality of life improvements in persons with mental illness. In recent years, particularly care coordination (i.e., the integration of care across different providers and treatment settings) has received increased attention and has been put into practice. Thus, we focused on care coordination in this update of a previous European Psychiatric Association (EPA) guidance on the quality of mental health services. Methods. We conducted a systematic meta-review of systematic reviews, meta-analyses, and evidence-based clinical guidelines focusing on care coordination for persons with mental illness in three literature databases. Results. We identified 23 relevant documents covering the following topics: case management, integrated care, home treatment, crisis intervention services, transition from inpatient to outpatient care and vice versa, integrating general and mental healthcare, technology in care coordination and self-management, quality indicators, and economic evaluation. Based on the available evidence, we developed 15 recommendations for care coordination in European mental healthcare. Conclusions. Although evidence is limited, some concepts of care coordination seem to improve the effectiveness and efficiency of mental health services and outcomes on patient level. Further evidence is needed to better understand the advantages and disadvantages of different care coordination models.

scholarly journals Understanding barriers to accessing mental health services for newcomers to Canada using Peterborough, Ontario, as an illustrative example

2021 ◽  
Author(s):  
Nurun Layla Chowdhury
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Cultural Barriers ◽  
Accurate Information

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.

How Can Guidance Recommendations Contribute to Better Mental Health?

2017 ◽  
Vol 41 (S1) ◽  
pp. S12-S12
Author(s):  
W. Gaebel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
European Countries ◽  
Healthcare Provision ◽  
Distributed Resources ◽  
Deutschland Gmbh

IntroductionIn European countries, the quality of mental healthcare services is often limited due to scarce and inequitable distributed resources, and inefficient use of existing resources. Against this background, the EPA Guidance provides recommendations on how to optimize quality of mental healthcare for all European countries.ObjectivesProvision of guidance recommendations in order to support optimization and harmonization of mental healthcare services in European countries.MethodsBy means of evidence and consensus-based methods EPA guidance papers are developed by experts in psychiatry and related fields [1].ResultsAs of 2012, five EPA guidance series have been developed and published [2]. They focus on various aspects of mental healthcare and clinical situations that have not been covered by medical guidelines yet but are considered important to deliver high quality mental healthcare. Papers deal amongst others with topics relating to quality assurance of mental health services, as quality of mental health service structures and processes, and building trust in mental health services.ConclusionsEPA guidance recommendations can improve mental healthcare provision and thereby contribute to better mental health of persons receiving mental healthcare. For this purpose, recommendations need to be widely disseminated and implemented in European countries.Disclosure of interestUnterstützung bei Symposien/Symposia Support− Janssen-Cilag GmbH, Neuss− Aristo Pharma GmbH, Berlin− Lilly Deutschland GmbH, Bad Homburg− Servier Deutschland GmbH, München− Fakultätsmitglied/Faculty Member− Lundbeck International Neuroscience Foundation (LINF), Dänemark

scholarly journals Use of Mental Health Services for Patients Diagnosed with Major Depressive Disorders in Primary Care

2021 ◽  
Vol 18 (3) ◽  
pp. 885
Author(s):  
Laura González-Suñer ◽  
Cristina Carbonell-Duacastella ◽  
Ignacio Aznar-Lou ◽  
Maria Rubio-Valera ◽  
Maria Iglesias-González ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Depressive Disorders ◽  
Mental Healthcare ◽  
Major Depressive ◽  
Use Of Services

Major depressive disorder (MDD) is one of the most disabling diseases worldwide, generating high use of health services. Previous studies have shown that Mental Health Services (MHS) use is associated with patient and Family Physician (FP) factors. The aim of this study was to investigate MHS use in a naturalistic sample of MDD outpatients and the factors influencing use of services in specialized psychiatric care, to know the natural mental healthcare pathway. Non-randomized clinical trial including newly depressed Primary Care (PC) patients (n = 263) with a 12-month follow-up (from 2013 to 2015). Patient sociodemographic variables were assessed along with clinical variables (mental disorder diagnosis, severity of depression or anxiety, quality of life, disability, beliefs about illness and medication). FP (n = 53) variables were also evaluated. A multilevel logistic regression analysis was performed to assess factors associated with public or private MHS use. Subjects were clustered by FP. Having previously used MHS was associated with the use of MHS. The use of public MHS was associated with worse perception of quality of life. No other sociodemographic, clinical, nor FP variables were associated with the use of MHS. Patient self-perception is a factor that influences the use of services, in addition to having used them before. This is in line with Value-Based Healthcare, which propose to put the focus on the patient, who is the one who must define which health outcomes are relevant to him.

scholarly journals Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Siobhan Reilly ◽  
Catherine McCabe ◽  
Natalie Marchevsky ◽  
Maria Green ◽  
Linda Davies ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Medical Records ◽  
Secondary Care ◽  
Mental Healthcare ◽  
The Uk

Background There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. Aims This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. Method We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. Results The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. Conclusions The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.

scholarly journals Understanding barriers to accessing mental health services for newcomers to Canada using Peterborough, Ontario, as an illustrative example

2021 ◽  
Author(s):  
Nurun Layla Chowdhury
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Cultural Barriers ◽  
Accurate Information

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.

scholarly journals “I Am Not My Illness!”: Navigating the Mental Healthcare System in New Orleans

2019 ◽  
Author(s):  
◽  
Saira Mehmood ◽  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Critical Race Theory ◽  
Mental Health Services ◽  
Health Services ◽  
New Orleans ◽  
Healthcare System ◽  
Mental Health Professionals ◽  
Mental Healthcare ◽  
Mental Illnesses

This research examines the experiences of individuals diagnosed with chronic mental illnesses and how they navigated the mental healthcare system in New Orleans, Louisiana. To realize the main research objective, I analyzed how individuals with chronic mental illnesses perceive mental illness and stigma; the services individuals use to address their mental health needs and the barriers they face in this process; who individuals disclose their mental illness to and under what contexts; and how individuals diagnosed with mental illness and their caregivers understand and embody recovery. Situated between medical anthropology and urban anthropology, it examines the challenges individuals diagnosed with chronic mental illness and caregivers encounter in utilizing mental health services. Using critical race theory and studies on whiteness, I analyze the intersectional identities of individuals to understand how various axes of identities such as race, gender, age, and religion affect how people utilize mental health services, conceptualize stigma, how this is related to disclosure, and what recovery means to them. While I use stigma scales to measure various types of stigma, I triangulate this data with observations from participant-observation and interviews to reconceptualize stigma in what Tyler and Slater (2018) argue for approaching the social and political dynamics of stigma and acknowledging history. I do this through the use of stigma syndemics. Central to this is the role of mental health professionals and other key stakeholders, and how they interact with individuals utilizing community mental health services. I examine how past experiences such as trauma and incarceration limit access to housing programs, employment, and how this affects recovery. Lastly, I argue that for effective advocacy on mental health to occur, synergistic activism through coalition building needs to transpire between all the entities that affect individuals who have mental illnesses.

EPA guidance on the quality of mental health services

2012 ◽  
Vol 27 (2) ◽  
pp. 87-113 ◽  
Author(s):  
W. Gaebel ◽  
T. Becker ◽  
B. Janssen ◽  
P. Munk-Jorgensen ◽  
M. Musalek ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Quality Indicators ◽  
Mentally Ill ◽  
Empirical Studies ◽  
Mental Healthcare ◽  
Specific Level ◽  
Country Specific

AbstractThe main aim of this guidance of the European Psychiatric Association is to provide evidence-based recommendations on the quality of mental health services in Europe. The recommendations were derived from a systematic search of the best available evidence in the scientific literature, supplemented by information from documents retrieved upon reviewing the identified articles. While most recommendations could be based on empirical studies (although of varying quality), some had to be based on expert opinion alone, but were deemed necessary as well. Another limitation was that the wide variety of service models and service traditions for the mentally ill worldwide often made generalisations difficult. In spite of these limitations, we arrived at 30 recommendations covering structure, process and outcome quality both on a generic and a setting-specific level. Operationalisations for each recommendation with measures to be considered as denominators and numerators are given as well to suggest quality indicators for future benchmarking across European countries. Further pan-European research will need to show whether the implementation of this guidance will lead to improved quality of mental healthcare, and may help to develop useful country-specific cutoffs for the suggested quality indicators.

The EPA Guidance Project: Guidance for Mental Healthcare in Europe

2015 ◽  
Vol 12 (01) ◽  
pp. 5-11
Author(s):  
I. Großimlinghaus ◽  
J. Zielasek ◽  
W. Gaebel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Graduate Training ◽  
Action Plan ◽  
Stakeholder Involvement ◽  
Mental Healthcare ◽  
World Health ◽  
Post Graduate Training ◽  
Health Organization

Summary Background: The development of guidelines is an important and common method to assure and improve quality in mental healthcare in European countries. While guidelines have to fulfill predefined criteria such as methodological accuracy of evidence retrieval and assessment, and stakeholder involvement, the development of guidance was not standardized yet. Aim: In 2008, the European Psychiatric Association (EPA) initiated the EPA Guidance project in order to provide guidance in the field of European psychiatry and related fields for topics that are not dealt with by guideline developers – for instance due to lack of evidence or lack of funding. The first three series of EPA Guidance deal with diverse topics that are relevant to European mental healthcare, such as quality assurance for mental health services, post-graduate training in mental healthcare, trust in mental health services and mental health promotion. Results: EPA Guidance recommendations address current and future challenges for European psychiatry. They are developed in accordance with the World Health Organization (WHO) European Mental Health Action Plan.

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