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

Author

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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
    Unit for Mental Health, National Institute for Health and Welfare (T.H.L.), Mannerheimintie 168, FI-00270 Helsinki, Finland
    Public Health Medicine, University of Helsinki and Helsinki University Hospital, FI-000014 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
    Public Health Medicine, University of Helsinki and Helsinki University Hospital, FI-000014 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
    University of Turku, FI-20014 Turku, Finland
    Lohja Hospital Area, Sairaalakatu 8, 08200 Lohja, 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
    Unit for Mental Health, National Institute for Health and Welfare (T.H.L.), Mannerheimintie 168, FI-00270 Helsinki, Finland
    Department of Social Services and Health Care, City of Helsinki, FI-00099 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)

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.

Suggested Citation

  • Taina Ala-Nikkola & Sami Pirkola & Minna Kaila & Grigori Joffe & Raija Kontio & Olli Oranta & Minna Sadeniemi & Kristian Wahlbeck & Samuli I. Saarni, 2018. "Identifying Local and Centralized Mental Health Services—The Development of a New Categorizing Variable," IJERPH, MDPI, vol. 15(6), pages 1-16, May.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:6:p:1131-:d:149955
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    References listed on IDEAS

    as
    1. Tello, Juan Eduardo & Jones, Julia & Bonizzato, Paola & Mazzi, Mariangela & Amaddeo, Francesco & Tansella, Michele, 2005. "A census-based socio-economic status (SES) index as a tool to examine the relationship between mental health services use and deprivation," Social Science & Medicine, Elsevier, vol. 61(10), pages 2096-2105, November.
    2. Peter McPherson & Joanna Krotofil & Helen Killaspy, 2018. "What Works? Toward a New Classification System for Mental Health Supported Accommodation Services: The Simple Taxonomy for Supported Accommodation (STAX-SA)," IJERPH, MDPI, vol. 15(2), pages 1-17, January.
    3. Minna Sadeniemi & Sami Pirkola & Maiju Pankakoski & Grigori Joffe & Raija Kontio & Maili Malin & Taina Ala-Nikkola & Kristian Wahlbeck, 2014. "Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?," IJERPH, MDPI, vol. 11(9), pages 1-12, August.
    4. Taina Ala-Nikkola & Sami Pirkola & Raija Kontio & Grigori Joffe & Maiju Pankakoski & Maili Malin & Minna Sadeniemi & Minna Kaila & Kristian Wahlbeck, 2014. "Size Matters — Determinants of Modern, Community-Oriented Mental Health Services," IJERPH, MDPI, vol. 11(8), pages 1-19, August.
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