The Atlas of Mental Health Care project:

International development

Prof Luis Salvador Carulla

luis.salvador-carulla@anu.edu.au

Dr Mencía Ruiz Gutiérrez-Colosía

menciaruiz@uloyola.es

Evidence basedcare (EBC)

EvidenceInformed Policy (1)

Knowledge GuidedPolicy(2)

• RCT

• Expt. approach

• EBC

• Local information / Context analysis

• Epidemiology, Routine & Big data

• Expert knowledge: Practical / Implicit

• Knowledge Discovery from Data

• Complex decision support systems

Paradigm shift to Systems thinking

1. Lavis et al, Health Research Policy and Systems 2009 (SUPPORT MODEL )

2. Gibert et al, Health Research Policy and Systems 2010 (EbCA MODEL)

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Context

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• Context refers to the totality of circumstances that comprise

the milieu of a given phenomenon

• In health care it includes all sources of evidence of the local

system: geography, social and demographic factors, other

environmental factors, service availability, capacity, use and

costs. It also includes legislation and expertise on the milieu

(e.g., the historical account current state of the art)

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Evidence-

Informed

Policies

about

health

systems

Bosch-Capblanc

et al. PLOS Med

9 (3), 2012

Atlas of Mental Health Care

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Top-down, expert based atlases

(framework of scientific knowledge)

Bottom-up, survey based

Atlases (evidence)

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Add slide of history

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Targeted local planning

Employment Social Capital

Local Atlase of MH Care

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ATLAS OF MH: Spider Graphs

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Patterns of workforce capacity

The Atlas of MH Care Project

• Europe, Chile, Canada

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REFINEMENT PROJECT (EU)

REFINEMENT TOOLKIT

• REMAST: Local Atlases

(mapping)

• FINCENTO: Financing

• REQUALIT: Quality of care

• REPATO: Pathways of care

• Glossary of Terms

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REsearch on the FINancial

Systems’ Effect on the

Quality of MENTal Health

Care

REsearch on the FINancial Systems’ Effect on the

Quality of MENTal Health Care

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WP6 –Mapping Services for Mental Health Care- REMAST

REMAST tool

DESDE-LTC

WHO-AIMS

Web Atlas

Availability of main types of care, placement capacity (beds and places) and workforce

capacity per inhabitant

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-1,0

0,0

1,0

2,0

3,0

4,0

5,0

6,0

Girona (Spain)

Helsinki and Uusimaa (Finland)

Sør-Trøndelag (Norway)

Verona (Italy)

Loiret+ (France)

Industrieviertel (Austria)

Suceava (Romania)

Hampshire (England)

Graph 3. Community Residential care

MTC Res. high intensity

MTC Res. other

Beds Res. high intensity

Beds Res. other

120

100

80

60

40

20

0

Includes DESDE-LTC codes: - High intensity R8 R11- Other R9 R10 R12 R13 R14

-20

140

160

180

* Incomplete information+ Hospital Georges Daumezon: 7 psychiatric sectors

*Health care

hospital

Health care

community

Other care

community

FINCENTO-REMAST: Mapping MH Care in local areas in Europe

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Refiniment: Quality indicators in 7 local areas of EU Countries

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• key to reactivate the funding for

mental health care

• Strengthen mental health

management

• Development of an integrated,

community-oriented MHS

• Info from Remast + Requalit-

benchmark area

IMPACT OF THE STUDY

Girona

SPAIN

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FINLAND

Helsinki and Uusimaa

IMPACT OF THE STUDY

• Two psychiatric hospitals are planning to

provide specialized care with

psychiatrists on-site 24 hours

• Acute residential care for mental

disorders provided in small acute units

located at general hospitals, supported

by community care teams

• Three psychiatric hospitals were closed

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REFINEMENT ESPAÑA

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NATIONAL INTEGRATED ATLASES OF MENTAL HEALTH CARE

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CURRENT STUDIES WITH DESDE-LTC IN EUROPE

FINLAND

• Mapping of mental health care in

Finland

• Explore relation between quality of

MHC and catchment area size

• Mapping of substance abuse

services

PORTUGAL

• Mapping of mental health care in

Lisbon and Port

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REMAST

Toolkit

DESDE-A

automated

DESDE-LTC 2.0

Integrated

Atlas of Mental

Health Care

Local Care

Navigation

MChart

Technology Readiness Levels (TRL) of DESDE-LTC

(+ GIS)

ESMS

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Atlases should provide meaningful information

that improves organisational learning and

decreases ambiguity to support decision making