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Int. J. Environ. Res. Public Health 2018, 15(6), 1131; https://doi.org/10.3390/ijerph15061131

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

1
Clinic of Psychiatry and Clinic of Public Health Välskärinkatu 12 and Stenbäckinkatu 9, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
2
Unit for Mental Health, National Institute for Health and Welfare (T.H.L.), Mannerheimintie 168, FI-00270 Helsinki, Finland
3
Public Health Medicine, University of Helsinki and Helsinki University Hospital, FI-000014 Helsinki, Finland
4
University of Tampere School of Health Sciences and Tampere University Hospital, Lääkärinkatu 1, FI-33014 Tampere, Finland
5
University of Turku, FI-20014 Turku, Finland
6
Lohja Hospital Area, Sairaalakatu 8, 08200 Lohja, Finland
7
Turku University Hospital and University of Turku, Kiinanmyllynkatu 4-8, FI-20520 Turku, Finland
8
Department of Social Services and Health Care, City of Helsinki, FI-00099 Helsinki, Finland
*
Author to whom correspondence should be addressed.
Received: 16 April 2018 / Revised: 17 May 2018 / Accepted: 28 May 2018 / Published: 31 May 2018
(This article belongs to the Special Issue Mental Health and its Social and Cultural Implications)
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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. View Full-Text
Keywords: mental health care; health service research; integrated care; European Service Mapping Schedule-Revised mental health care; health service research; integrated care; European Service Mapping Schedule-Revised
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Ala-Nikkola, T.; Pirkola, S.; Kaila, M.; Joffe, G.; Kontio, R.; Oranta, O.; Sadeniemi, M.; Wahlbeck, K.; Saarni, S.I. Identifying Local and Centralized Mental Health Services—The Development of a New Categorizing Variable. Int. J. Environ. Res. Public Health 2018, 15, 1131.

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