A follow-up on patients with severe mental disorders in Sardinia after two changes in regional policies: poor resources still correlate with poor outcomes

BMC Psychiatry

Research Article

Anna Pisano¹  Roberto Pirastu²  Francesco Tuligi³  Emanuele Pisanu⁴  Maria Francesca Moro⁴  Elisa Pintus⁴  Mirra Pintus⁴  Giuseppina Trincas⁴  Gisa Mellino⁴  Federica Sancassiani⁴  Davide Massidda⁴  Mauro Giovanni Carta⁴  Matthias C Angermeyer⁵  Dinesh Bhugra⁶ 

[1] Department of Mental Health (DSM)- of Cagliari, Cagliari, Italy;Department of Mental Health (DSM)- of Carbonia-Iglesias, Carbonia, Italy;Department of Mental Health (DSM)- of Lanusei, Lanusei, Italy;Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, via Ospedale, 117, Cagliari, Italy;Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, via Ospedale, 117, Cagliari, Italy;Centre for Public Mental Health, Gösing am Wagram, Austria;HSPRD Institute of Psychiatry (KCL) London, London, UK;

关键词: Quality of care;    Mental health;    Psychosis;    Follow-up;    Social functioning;    Resources;   

DOI  :  10.1186/1471-244X-13-333

 received in 2013-06-27, accepted in 2013-12-02,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThis survey followed a cohort of patients with chronic psychosis recruited from five catchment areas (DSMs) of the Sardinian community mental health services. The objective was to examine whether the amount of resources in the different sites may be a determinant of the outcomes.MethodsNaturalistic follow-up study on 309 consecutive users with diagnosis of schizophrenic disorder, schizoaffective disorder, bipolar affective disorder with psychotic symptoms (DSM-IV TR) of five Sardinian community mental health services. Mental state and clinical symptoms along with functioning were assessed using semi-structured clinical interviews (ANTAS), Clinical Global Impression Severity Scale (CGI-S), Global Assessment of Functioning Scale (GAF) and Health of the Nation Outcome Scales (HONOS). Assessments were conducted at the beginning of the study and after one year.ResultsThe proportion of professionals working in all DSMs participating in the study was found lower than the national Italian standard (0.7 vs 1.0 per 1,500 inhabitants). Follow-up revealed significant differences between DSMs in the improvement of the Honos scores (F = 5.932, p = 0.000). These differences correlate with the improvement of resources in terms of number of professionals during, and one year prior, to the trial.ConclusionsThe study shows that mental health services provided in the public sector in Sardinia are still very resource-poor, at least in terms of human resources. Our findings suggest that mental health service resources influence outcomes as regards the social functioning of users. We urge policy makers to take these observations into account when planning future services.

【 授权许可】

CC BY   
© Carta et al.; licensee BioMed Central Ltd. 2013