ACTIVA′T PER LA SALUT MENTAL: patients and caregivers as managers for integration of care and services in Mental Health

摘要

Activa′t per la salut mental : patients and caregivers as managers for integration of care and services in Mental Health The main goal of project ACTIVA’T PER LA SALUT MENTAL(“Get active for mental health””) is to promote people with mental disorders and caregivers as managers of own integrated care. It’s apilot project for three years to address the gaps identified in order to consolidate a specific service in the portfolio of public services. The project is a partnership formed by professionals, family members and people with severe mental disorders, developed jointly by the Catalan Federation of Mental Health and the Health Department of the Catalan Government, in collaboration with 12 local mental health services and12 families and users associations. In Catalonia 54 714 people with severe mental disorders have been attended in 2014, 32.2% of the total care at mental health centers for adults. Mental disorders influence in on all family members: between 40% and 90% of people with mental disorders live in or have frequent and close contact with their families, who provide physical and emotional support at long term. The Catalan government prioritizes public policies for family care and empowerment in Mental Health from the regulatory framework (PINSAP - Interministerial Public Health Plan; PIAISS - Interdepartmental Plan for Care and Social and Health Interaction; Health Plan 2011-15; Plan for Mental Health and Addictions; and Integral Mental Health Plan), and from studies that recognize deficiencies: "The relationship between users and professionals in the field of mental health" (2007); "Needs of family care" (Dep. Health, 2009); "Itineraries in mental health: needs of users and their families in the therapeutic process" (Health Department 2010). Aims : - Provide useful tools for the daily management of mental disorders for families and people with mental health problems and promoting their own mental health. - Increasing the degree of influence and control that families and people with mental health problems play on their own lives and processes of recovery, and their participation in the Health System. - Develop spaces that improve social cohesion as a tool to reduce vulnerability for families and people with mental health problems, through the establishment of peer support iniciatives. - Encourage joint action of health, social, advocacy and other networks to ensure the adequacy and continuity of care. - Assess the results and measure the impact of the program in relation to its objectives. Methodology : A common circuit is developed with a continuum of services from the health vision to the social-based community approach: - Psychoeducative training for people with mental health problems (Klau de Re) and family (PROENFA), by mental health services. - Training on empowerment (PROSPECT) for people with mental health problems, families, and health and social care professionals, by the advocacy groups. - Participation in peer support groups for people with mental health problems and their families, by the advocacy groups A shared professional, integrated in care networks, coordinates the circuit. He acts as a referent for information on mental health issues on the basis of a comprehensive vision, accessibility and active listening. All support tools used at the project are validated (training programs, brochures, guides...) The evaluation strategy focuses on outcomes at three levels: the family, the person with mental health problems and the impact on the system,. Key findings : - Implementation has started in 12 Catalan cities in partnership with mental health centers and associations of users and families, and the centralized information service at the Federation. - 220 people ( 110 families) have been surveyed. - More than 500 inquiries have been attended from February 2015. Highlights : - Great interest among the different stakeholders - Difficulties during the recruitment process to attract participants respecting strict criteria. - The great need identified is not associated with a sign of commitment and availability for training. - Integrating social local networks and health system has been difficult but successful in all pilot locations. - Integration of diferent information sources (administrative data bases and outcomes surveys) allow a precise diagnosis of the situation of family units Conclusions : - Results available in September 2016. - The project is deployed in 12 different municipalities, but the results are transferable since it works with approved materials. - It is sustainable because it reduces public costs, addressing individual needs as a group, and, improving the tools to be autonomous in recovery, reduce the need for care. Collaboratos : The "Active for mental health" project recieves the support of the four Catalan Province Councils, the Barcelona City Council, the Ministry of Health, Social Services and Equality, and Ivàlua; and it’s has also private financingt by Obra Soci