How to estimate need for mental healthcare in a psychiatric network?

Leontien JANSEN1, Koen DEMUNCK2, Ronny BRUFFAERTS1

1Center for Public Health Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
2Mental Health Network Kwadraat, Roeselare, Belgium

INTRODUCTION

Estimating the de facto use of mental health services and referrals to inpatient and outpatient treatment are essential components of population monitoring in ongoing healthcare reforms. These form the potential for a better understanding of the different care pathways used, and may provide care planners, clinicians, and stakeholders with essential information This study focuses on monitoring the number, nature, and types of referrals within a psychiatric healthcare network in Belgium and aims to track changes in the notified population, thereby providing a robust tool for population monitoring.



METHODS

The study implements a template-based approach to estimate patient referrals, referring symptoms, treatment sectors and treatment types, and delays in initiating treatment after referral. Data collection involves periodic monitoring of the number, nature, and specific types of referrals. This approach allows for the systematic observation and analysis of population dynamics and patterns. Additionally, the tool developed through this method serves as a means to track and evaluate evolutions in care pathways over time.



RESULTS

The estimated de facto proportion of referrals in the psychiatric network where the study took place was 3.9% per year on the level of the adult general population. Psychiatric hospitals and emergency rooms were major entry points for patients with emotional problems (46.6%). Anxiety and mood problems accounted for 41%, substance use for 25%, suicidal thoughts and behaviors for 13%, and externalizing problems for 3-4% of the referrals. 7/10 referred patients started treatment within a month upon referral. Patients referred to sheltered housing, community mental health centers, and mobile crisis teams had the longest delays in starting treatment.



DISCUSSION-CONCLUSION

The actual proportion of treatment need is estimated at 3.9% of the adult population. Monitoring service use and track changes in the notified population are key to ensuring equitable access and improving outcomes in mental health care.