Abstract

ARANDA REGULES, José Manuel et al. Collaborative models for mental health care in Andalusia: an assessment after 9 years of implementation. Rev. Asoc. Esp. Neuropsiq. [online]. 2012, vol.32, n.113, pp.09-28. ISSN 2340-2733.  https://dx.doi.org/10.4321/S0211-57352012000100002.

Introduction: The implementation of the Integrated Care Process of Anxiety, Depression and Somatization (ICPADS; a collaborative care model) began in Andalusia in 2002. Data presented correspond to an assessment after 9 years of implementation Material and methods: Telephone questionnaire were carried out to 380 Health Centers (HC) and 76 Community Mental Health Units (CMHU) from November 2008 to May 2009. This was completed with a qualitative analysis for an urban HC (in depth interviews, document analysis) which introduced the ICPADS in 2002. We used descriptive statistics of frequencies and univariate analysis (SPSS software) Results: Qualitative analysis revealed four stone corners of a successful implementation: a two-way communication between institutions and professionals, an organization of shared consultation, a filter function and an inclusion of mental health objectives in the management contract. Response rate to the questionnaire was 68.9% in HCs and 78.9% in the CMHUs. ICPADS was fully implanted in 2.3% of HCs. However, a partial implantation was observed in 88.2% of the units on specific aspects as the existence of a person in charge of the program, periodic visits from mental health specialists to HCs, continued education, protocols, specific mental health consultation from family physicians and psychoeducational groups offered in the HCs. Analyses revealed that a higher job satisfaction and minor delays for a first specialist visit were associated with the implementation of ICPADS (shared consultation, continued education and protocols). In addition, an increased number of referrals were associated with a less overcrowded consultation and a lack of both psychoeducational groups offer and periodic visits from mental health specialists. Conclusions: The ICPADS showed the capacity to solve and manage mental health demands of these pathologies in the HCs without medicalize them and generates job satisfaction without added costs of implementation or maintenance. However, further research would be desirable in order to assess the benefits of the program on patients' mental health.

Keywords : collaborative care; mental health services; primary health care.

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