Identifying Local and Centralized Mental Health Services—The Development of a New Categorizing Variable

Taina Ala-Nikkola, Sami Pirkola, Minna Kaila, Grigori Joffe, Raija Kontio, Olli Oranta, Minna Sadeniemi, Kristian Wahlbeck and Samuli I. Saarni
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Taina Ala-Nikkola: Clinic of Psychiatry and Clinic of Public Health Välskärinkatu 12 and Stenbäckinkatu 9, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
Sami Pirkola: University of Tampere School of Health Sciences and Tampere University Hospital, Lääkärinkatu 1, FI-33014 Tampere, Finland
Minna Kaila: Clinic of Psychiatry and Clinic of Public Health Välskärinkatu 12 and Stenbäckinkatu 9, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
Grigori Joffe: Clinic of Psychiatry and Clinic of Public Health Välskärinkatu 12 and Stenbäckinkatu 9, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
Raija Kontio: Clinic of Psychiatry and Clinic of Public Health Välskärinkatu 12 and Stenbäckinkatu 9, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
Olli Oranta: Turku University Hospital and University of Turku, Kiinanmyllynkatu 4-8, FI-20520 Turku, Finland
Minna Sadeniemi: Clinic of Psychiatry and Clinic of Public Health Välskärinkatu 12 and Stenbäckinkatu 9, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
Kristian Wahlbeck: Unit for Mental Health, National Institute for Health and Welfare (T.H.L.), Mannerheimintie 168, FI-00270 Helsinki, Finland
Samuli I. Saarni: Turku University Hospital and University of Turku, Kiinanmyllynkatu 4-8, FI-20520 Turku, Finland

IJERPH, 2018, vol. 15, issue 6, 1-16

Abstract: The challenges of mental health and substance abuse services (MHS) require shifting of the balance of resources from institutional care to community care. In order to track progress, an instrument that can describe these attributes of MHS is needed. We created a coding variable in the European Service Mapping Schedule-Revised (ESMS-R) mapping tool using a modified Delphi panel that classified MHS into centralized, local services with gatekeeping and local services without gatekeeping. For feasibility and validity, we tested the variable on a dataset comprising MHS in Southern Finland, covering a population of 2.3 million people. There were differences in the characteristics of services between our study regions. In our data, 41% were classified as centralized, 37% as local without gatekeeping and 22% as local services with gatekeeping. The proportion of resources allocated to local services varied from 20% to 43%. Reclassifying ESMS-R is an easy way to compare the important local vs. centralized balance of MHS systems globally, where such data exists. Further international studies comparing systems and validating this approach are needed.

Keywords: mental health care; health service research; integrated care; European Service Mapping Schedule-Revised (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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