Comprehensive evaluation of MH care provision in Andalusia (Spain) for effective service planning

Mencia R. GUTIÉRREZ-COLOSIA1, Jose Alberto SALINAS-PÉREZ1, Francisco GONZÁLEZ-SAIZ2, Pilar CAMPOY-MUÑOZ1, María Luisa RODERO-COSANO1, Diego DIAZ-MILANES1

1Universidad Loyola Andalucia, Sevilla, Spain
2Universidad de Cádiz, Cádiz, Spain

              Andalusia has developed a public mental health (MH) care system with a community perspective since the constitution of its autonomy. Great strides have been made in the approach to MH from primary care and the creation of a network of specialised second and third level facilities. However, there is still room for progress. This study is included in the new regional Strategic Plan for MH and Addictions and is aimed at analysing MH service provision in Andalusia.

             MH services were described and classified based on their main activity (Main Type of Care, MTC). The tool used was the Description and Evaluation of Human Services and Directories, (DESDE) system. The research encompassed a comprehensive evaluation of public MH services from the health, social and Justice sectors. Analyses quantified and compared accessibility, capability and workforce considering both general and specific diagnoses.

             The analysis of MH services provided 518 main DESDE codes and 25 secondary codes. These codes were part of the main activity found in 486 MH Basic Stable Unit of Care (BSIC)(the main unit of analysis comparable to service). Providers included 30 different agencies like MH clinical Management Units (UCG SM), FAISEM for social and dependency services, among others. Most services were classified as residential (47%) according to DESDE, secondly as outpatient (31%), and then as day care (26%). Fifteen different DESDE codes were used to describe services.

              The study offered a precise overview of the MH care provision of Andalusia, useful for strategic decision-making and planning. The analyses showed a diverse and well-balanced health-social system. The analysis of BSICs and MTCs revealed problems of terminology in some resources that required more than one DESDE code to describe them. Additionally, the geographical location of codes made it possible to detect regional differences in access to some of the services.