Standard comparison of local mental health care systems in eight European countries

Gutiérrez-Colosía, M. R., Salvador-Carulla, L., Salinas-Pérez, J. A., García-Alonso, C. R., Cid, J., Salazzari, D., Montagni, I., Tedeschi, F., Cetrano, Gaia ORCID logoORCID:, Chevreul, K., Kalseth, J., Hagmair, G., Straßmayr, C., Park, A. L., Sfectu, R., Ala-Nikkola, T., González-Caballero, J. L., Rabbi, L., Kalseth, B. and Amaddeo, F. (2019) Standard comparison of local mental health care systems in eight European countries. Epidemiology and Psychiatric sciences, 28 (2) . pp. 210-223. ISSN 2045-7960 [Article] (doi:10.1017/s2045796017000415)

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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.

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.

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.

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.

Item Type: Article
Keywords (uncontrolled): Community-balanced care, main type of care, mental health care comparison, mental health system
Research Areas: A. > School of Health and Education > Mental Health, Social Work and Interprofessional Learning
Item ID: 29055
Notes on copyright: © Cambridge University Press 2017
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Depositing User: Gaia Cetrano
Date Deposited: 31 Mar 2020 09:29
Last Modified: 29 Nov 2022 19:10

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