Mental Health

CASE STUDY

Project Integrate - MENTAL HEALTH

  • On September 2011, the European College of Neuropsychopharmacology (ENCP) published a study alarming on the “exceedingly high burden” of mental health disorders and brain illnesses. According to the study, 38 percent of the European population suffers each year from a brain disorder such as depression, anxiety, insomnia or dementia. Moreover, only about a third of cases receive the therapy or medication needed which implies that the impact of mental illnesses in terms of economics and social burden is enormous – said to be of hundreds of billions of euros.
     
    As part of Phase 1 of Project INTEGRATE in order to gain common insights and analyses of the level of integration of care, a case study and review of care coordination and integrated care for people with mental health challenges was undertaken by the Karolinska Institute in Sweden.
     
    Two case studies were conducted in northern and southern parts of Stockholm health system. Norrtalje: a study of the mental health services coordination in an integrated health and social care provider and purchasing unit; and Sodertalje: a study of a cooperation scheme between the county health system and the local municipality social service to provide coordinated services for people with mental health challenges.

  • Norrtalje
    To improve quality of care for all patients in the area by bringing together the management of county- health and municipality-social care services in one organisation under one management, with pooled finance and thus better coordination of clinical processes and information sharing.

    Sodertalje
    ‘To meet the need of psychiatric care in the area and provide a satisfying social life for patients with chronic mental disabilities in the Sodertalje local area of the south of Stockholm County’.

  • Norrtalje
    The local authority level: Joint governance and financing of provider-services through a joint purchasing board, combining representatives from the local municipality (social care) and the larger Stockholm county (healthcare). At provider organisation level, a structurally-integrated social and healthcare provider organisation serving many of the needs of people with mental health challenges. At clinical provider level: referral agreements between primary and secondary care services, shared procedures and protocols, some co-located health and social care providers, informal agreements for reciprocal sharing of information between an electronic medical record (EMR) accessible to all clinically-qualified health personal, and a separate social service client record. In addition, project teams combining staff from different services to improve aspects of care. At individual patient/family/friends level: care assessment and planning systems combining health and social care providers, and care coordination for specific patients.

    Sodertalje
    The integrated care arrangements involved co-location of health and social services personnel in new community mental health centers; revised referral protocols and coordination procedures; expanded care coordinator roles; joint middle-level management team of municipality mental health administrator and head psychiatrist and others.

  • Norrtalje
    In Norrtalje the integrated provider gives all care for people with mental health challenges rather than separately provided and funded health and social care.

    Sodertalje
    While the standard practice of separately funded, employed, and managed health and social care staff was maintained in this model, what was distinctive was the co-location of health and social services personnel in the mental health centers, well-specified revised referral and coordination procedures and care coordinator roles and joint middle-level management team.

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