scholarly journals Patterns of Mental Healthcare Provision in Urban Areas: A Comparative Analysis for Informing Local Policy

2020 ◽  
Author(s):  
MaryAnne Furst ◽  
Jose Salinas-Perez ◽  
Mencia R. Gutiérrez-Colosia ◽  
John Mendoza ◽  
Nasser Bagheri ◽  
...  

Abstract ObjectiveUrbanisation presents specific challenges for the mental wellbeing of the population. An understanding of availability of existing service provision in urban areas is necessary to plan for the needs of people with mental illness in these contexts to identify gaps in care provision and inform policy and planning. This study aims to provide an analysis of the availability and diversity of mental health care in urban areas in Australia , and compare it with benchmark areas in Europe (Finland and Spain) and South America (Chile). MethodDESDE-LTC, an instrument for service classification and description of services providing long term care was used to analyse and compare service provision in Australia (Australian Capital Territory (ACT)), to other urban areas in Australia (Western Sydney, Perth North and South East Sydney) and to benchmark areas in other countries (Spain, Finland and Chile), using a standard healthcare ecosystems approach. Services from all relevant care sectors were calculated per 100,000 adults.ResultsWe identified commonalities in the pattern of mental health care in urban regions in Australia when compared to urban regions internationally, as well as gaps in care provision common to all study areas.ConclusionThese results highlight the relevance of an ecosystems approach to service planning in mental health care at the local level, and the use of a standardised instrument able to provide valid comparisons. There is a need for models of care sensitive to mental health care ecosystem indicators.

Author(s):  
Hossein Tabatabaei-Jafari ◽  
Jose A. Salinas-Perez ◽  
Mary Anne Furst ◽  
Nasser Bagheri ◽  
John Mendoza ◽  
...  

Australia has a population of around 4 million people aged 65 years and over, many of whom are at risk of developing cognitive decline, mental illness, and/or psychological problems associated with physical illnesses. The aim of this study was to describe the pattern of specialised mental healthcare provision (availability, placement capacity, balance of care and diversity) for this age group in urban and rural health districts in Australia. The Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) tool was used in nine urban and two rural health districts of the thirty-one Primary Health Networks across Australia. For the most part service provision was limited to hospital and outpatient care across all study areas. The latter was mainly restricted to health-related outpatient care, and there was a relative lack of social outpatient care. While both acute and non-acute hospital care were available in urban areas, in rural areas hospital care was limited to acute care. Limited access to comprehensive mental health care, and the uniformity in provision across areas in spite of differences in demographic, socioeconomic and health characteristics raises issues of equity in regard to psychogeriatric care in this country. Comparing patterns of mental health service provision across the age span using the same classification method allows for a better understanding of care provision and gap analysis for evidence-informed policy.


2017 ◽  
Vol 28 (2) ◽  
pp. 210-223 ◽  
Author(s):  
M. R. Gutiérrez-Colosía ◽  
L. Salvador-Carulla ◽  
J. A. Salinas-Pérez ◽  
C. R. García-Alonso ◽  
J. Cid ◽  
...  

Aims.There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services hamper like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems’ Effect on the Quality of Mental Health Care in Europe) project.Methods.A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description and Evaluation of Services for Long Term Care in Europe, DESDE-LTC). All publicly funded services universally accessible to adults (≥18 years) with a psychiatric disorder were coded. Care availability, diversity and capacity were compared across these eight local MHS.Results.The comparison of MHS revealed more community-oriented delivery systems in the areas of England (Hampshire) and Southern European countries (Verona – Italy and Girona – Spain). Community-oriented systems with a higher proportion of hospital care were identified in Austria (Industrieviertel) and Scandinavian countries (Sør-Trøndelag in Norway and Helsinki-Uusimaa in Finland), while Loiret (France) was considered as a predominantly hospital-based system. The MHS in Suceava (Romania) was still in transition to community care.Conclusions.There is a significant variation in care availability and capacity across MHS of local areas in Europe. This information is relevant for understanding the process of implementation of community-oriented mental health care in local areas. Standard comparison of care provision in local areas is important for context analysis and policy planning.


2018 ◽  
Vol 48 (2) ◽  
pp. 247-266 ◽  
Author(s):  
Jennifer Nazareno

The U.S. government has a long tradition of providing direct care services to many of its most vulnerable citizens through market-based solutions and subsidized private entities. The privatized welfare state has led to the continued displacement of some of our most disenfranchised groups in need of long-term care. Situated after the U.S. deinstitutionalization era, this is the first study to examine how immigrant Filipino women emerged as owners of de facto mental health care facilities that cater to the displaced, impoverished, severely mentally ill population. These immigrant women–owned businesses serve as welfare state replacements, overseeing the health and illness of these individuals by providing housing, custodial care, and medical services after the massive closure of state mental hospitals that occurred between 1955 and 1980. This study explains the onset of these businesses and the challenges that one immigrant group faces as owners, the meanings of care associated with their de facto mental health care enterprises, and the conditions under which they have operated for more than 40 years.


2018 ◽  
Vol 26 (6) ◽  
pp. 590-594 ◽  
Author(s):  
Mary Anne Furst ◽  
Jose A Salinas-Perez ◽  
Luis Salvador-Carulla

Objectives: Concerns raised about the appropriateness of the National Disability Insurance Scheme (NDIS) in Australia for people with mental illness have not been given full weight due to a perceived lack of available evidence. In the Australian Capital Territory (ACT), one of the pilot sites of the Scheme, mental health care providers across all relevant sectors who were interviewed for a local Atlas of Mental Health Care described the impact of the scheme on their service provision. Methods: All mental health care providers from every sector in the ACT were contacted. The participation rate was 92%. We used the Description and Evaluation of Services and Directories for Long Term Care to assess all service provision at the local level. Results: Around one-third of services interviewed lacked funding stability for longer than 12 months. Nine of the 12 services who commented on the impact of the NDIS expressed deep concern over problems in planning and other issues. Conclusions: The transition to NDIS has had a major impact on ACT service providers. The ACT was a best-case scenario as it was one of the NDIS pilot sites.


2010 ◽  
Vol 175 (10) ◽  
pp. 805-810 ◽  
Author(s):  
Richard J. Pinder ◽  
Nicola T. Fear ◽  
Simon Wessely ◽  
Geoffrey E. Reid ◽  
Neil Greenberg

2005 ◽  
Vol 20 (S2) ◽  
pp. s266-s269 ◽  
Author(s):  
D.L. Tosevski ◽  
B. Pejuskovic

AbstractAimTo describe principles and characteristics of mental health care in Belgrade.MethodsBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.ResultsDisastrous events in the country and the region caused an increase of mental and behavioral disorders for 13.5% in the last few years, thus making them the second largest public health problem (after cerebro-vascular diseases). The overall morbidity and mortality are on the rise. Intense acute and chronic stress, as well as the accumulated traumas caused significant psychological sequelae, especially to vulnerable people.DiscussionWhilst various issues of mental health care in Belgrade overlap with those in other European capitals, there are also some specific problems and features. Due to prolonged adversities, the health system has deteriorated and is facing specific challenges. However, the transformation of mental health services has been initiated, with a lot of positive movements, such as preparation of the National policy for mental health care as well as the Law for protection of mentally ill individuals.


2001 ◽  
Vol 36 (4) ◽  
pp. 207-216 ◽  
Author(s):  
H. J. Salize ◽  
A. Horst ◽  
C. Dillmann-Lange ◽  
U. Killmann ◽  
G. Stern ◽  
...  

2003 ◽  
Vol 43 (2) ◽  
pp. 105-110
Author(s):  
Sharon Riordan ◽  
Stuart Wix ◽  
M Sayeed Haque ◽  
Martin Humphreys

A diversion at the point of arrest (DAPA) scheme was set up in five police stations in South Birmingham in 1992. In a study of all referrals made over a four-year period a sub group of multiple contact individuals was identified. During that time four hundred and ninety-two contacts were recorded in total, of which 130 were made by 58 individuals. The latter group was generally no different from the single contact group but did have a tendency to be younger. This research highlights the need for a re-evaluation of service provision and associated education of police officers and relevant mental health care professionals.


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