The first wave of Community Mental Health Centres from a quantitative evaluation and providers experience perspectives
Abstract
Objective: The aim of this study is to answer the questions that were identified in the internal quantitative impact evaluation of the pilot project Support for the Establishment of Community Mental Health Centers I. Methods: The study is based on a longitudinal research in the form of a prospective cohort study.
As part of the pilot project of five CMHC, data were collected for 18 months using the clinical assessment tools GAF, HoNOS and AQoL. Furthermore, data of the use of inpatient psychiatric care from the national health registers were used.
Statistical analysis was performed. In addition to the results of the quantitative evaluation, three short case studies of the development and functioning of CMHC are presented.
Results: A total of 441 clients who used CMHC services during the pilot project were included in the study. Recipients of care formed a highly heterogeneous group.
Gender representation was essentially balanced. Compared to the general population, lower levels of education were more represented.
From a diagnostic point of view, about four-fifths were people with a diagnosis of category F2. About half of the patients were treated for more than 10 years.
The source of the largest part of patients, about two quarters, were psychiatric clinics. According to data from the national health registers, patients had a 70% reduction in the number of days in inpatient care after entering the CMHC.
In the group of patients who used CMHC services for 12 months, there was a significant improvement in the domain of functioning, symptoms and health-related quality of life. According to the results, CMHC services are safe for the public and their users.
Discussion: Thanks to the evaluation of CMHC projects, we have the first information about the impact of this new type of service. The positive changes in the recipients of care can be described as convincing, the observed reduction in the number of hospitalization days after the start of cooperation seems promising.
At the same time, it will be appropriate to verify these findings on a larger amount of data and using more sophisticated research designs. The question of whether the introduction of CMHC into the care system will bring economic savings remains open.
In this case, it is necessary to monitor more types of costs, not just direct medical expenses.