How size matters: exploring the association between quality of mental health services and catchment area size

BMC Psychiatry

Research Article

Raija Kontio¹  Minna Kaila²  Kristian Wahlbeck³  Minna Sadeniemi⁴  Olli Oranta⁵  Samuli Saarni⁵  Taina Ala-Nikkola⁶  Grigori Joffe⁷  Sami Pirkola⁸ 

[1] Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, FI-00029, Helsinki, Finland;Department of Public Health, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, FI-000014, Helsinki, Finland;Mental Health Unit, National Institute for Health and Welfare (THL), Mannerheimintie 170, FI-00270, Helsinki, Finland;Mental Health Unit, National Institute for Health and Welfare (THL), Mannerheimintie 170, FI-00270, Helsinki, Finland;Department of Social Services and Health Care, City of Helsinki, FI-00099, Helsinki, Finland;Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, FI-00029, Helsinki, Finland;Turku University Central Hospital and University of Turku, Kiinanmyllynkatu 4-8, 20520, Turku, Finland;University of Helsinki and Helsinki University Hospital, Psychiatry, Välskärinkatu 12, FI-00029, Helsinki, Finland;Mental Health Unit, National Institute for Health and Welfare (THL), Mannerheimintie 170, FI-00270, Helsinki, Finland;University of Helsinki and Helsinki University Hospital, Stenbäckinkatu 9, FI-00029, Helsinki, Finland;University of Tampere and Mental Health Unit, National Institute for Health and Welfare (THL), Mannerheimintie 170, FI-33014, Tampere, Finland;

关键词: Mental health services;    Service providers;    Diversity;    Public corporation;    Third sector;    Private sector;   

DOI  :  10.1186/s12888-016-0992-5

 received in 2016-04-19, accepted in 2016-08-03,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known.Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others.The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers’ contributions are sensitive to population size.MethodsTo map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors.ResultsThe diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services.The third sector and public corporations each provided 44 % of the service units.Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units.ConclusionsSignificant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services.Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system.

【 授权许可】

CC BY   
© The Author(s). 2016