The use of indicators for the management of Mental Health Services

Lima, Inacia Bezerra de; Bernadi, Filipe Andrade; Yamada, Diego Bettiol; Vinci, Andre Luiz Teixeira; Rijo, Rui Pedro Charters Lopes; Alves, Domingos; Furegato, Antonia Regina Ferreira

doi:10.1590/1518-8345.4202.3409

Inacia Bezerra de Lima

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.

Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.

http://orcid.org/0000-0003-3580-3244

Filipe Andrade Bernadi

Universidade de São Paulo, São Carlos, SP, Brazil.

http://orcid.org/0000-0002-9597-5470

Diego Bettiol Yamada

Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.

http://orcid.org/0000-0001-6221-722X

Andre Luiz Teixeira Vinci

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.

http://orcid.org/0000-0003-3743-0250

Rui Pedro Charters Lopes Rijo

Instituto Politécnico de Leiria, Escola de Tecnologia e Gestão, Leiria, Leiria, Portugal.

http://orcid.org/0000-0002-9348-0474

Domingos Alves

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.

http://orcid.org/0000-0002-0800-5872

Antonia Regina Ferreira Furegato

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.

http://orcid.org/0000-0002-7901-2965

Corresponding author: Inacia Bezerra de Lima. E-mail: lima.inacia@gmail.com

Associate Editor: Sueli Aparecida Frari Galera

Authors’ Contribution:

Study concept and design: Inacia Bezerra de Lima, Filipe Andrade Bernadi, Domingos Alves. Obtaining data: Inacia Bezerra de Lima, Filipe Andrade Bernadi, Diego Bettiol Yamada, Andre Luiz Teixeira Vinci, Rui Pedro Charters Lopes Rijo, Domingos Alves, Antonia Regina Ferreira Furegato. Data analysis and interpretation: Inacia Bezerra de Lima, Filipe Andrade Bernadi, Diego Bettiol Yamada, Andre Luiz Teixeira Vinci, Rui Pedro Charters Lopes Rijo, Domingos Alves, Antonia Regina Ferreira Furegato. Drafting the manuscript: Inacia Bezerra de Lima, Filipe Andrade Bernadi, Diego Bettiol Yamada, Andre Luiz Teixeira Vinci, Rui Pedro Charters Lopes Rijo, Domingos Alves, Antonia Regina Ferreira Furegato. Critical review of the manuscript as to its relevant intellectual content: Inacia Bezerra de Lima, Filipe Andrade Bernadi, Diego Bettiol Yamada, Andre Luiz Teixeira Vinci, Rui Pedro Charters Lopes Rijo, Domingos Alves, Antonia Regina Ferreira Furegato.

All authors approved the final version of the text.

Conflict of interest: the authors have declared that there is no conflict of interest.

Study	Study Objective	Territorial dimension	Implementation of indicators
Psychosocial well-being and psychiatric care in the European Communities: analysis of macro indicators(19)	To review macro indicators capable of providing a synthetic description of mental health status and the availability of psychiatric care in European countries	Europe (OECD, EUROSTAT^‡ ‡ EUROSTAT = Statistical Office of the European Communities; and IMS^§ § IMS = Intercontinental Marketing Services )	The authors do not report the experience of using the indicators in the management
New perspectives of mental health service(20)	The study searches methodologies for the use of health indicators, based on characteristics of the users of health services	Italy, Austria, Estonia, Finland, France, Italy, Spain, Norway, Romania and UK (England, Scotland, Wales and Northern Ireland)	The authors do not report the experience of using the indicators in the management
Monitoring of mental health care at the system level: country profiles and EU^* * EU = European Union; country status(21)	To provide a descriptive overview of Quality Monitoring Programs status in European countries	England, Denmark, France, Germany, Italy, Netherlands, Portugal, and Sweden	Partial implementation
Reporting and use of OECD^† † OCDE = Organization for Economic Cooperation and Development; Quality Indicators for Health Care at the national and regional levels in 15 countries(22)	To explore reports on the use of quality indicators in OECD member countries	Belgium, Canada, Czech Republic, France, Germany, Ireland, Israel, Latvia, Netherlands, Norway, New Zealand, Slovakia, Sweden, United States and UK (England, Scotland, Wales and Northern Ireland)	Partial implementation
UK Quality Indicator Project^® (UK QIP) and the UK (England, Scotland, Wales and Northern Ireland) independent health care sector: a new development(23)	To describe the implementation of the UK Quality Indicators Project in the health sector	UK (England, Scotland, Wales and Northern Ireland)	Implementation in use

Study	Study Objective	Territorial dimension	Implementation of indicators
Overview of the healthcare system in the Czech Republic⁽²⁴24 Kinkorová J, Topolcan O. Overview of healthcare system in the Czech Republic. EPMA J. 2012;3(1). doi: 10.1007/s13167-012-0139-9 https://doi.org/10.1007/s13167-012-0139-... ⁾	To describe the Czech mental health system through population indicators	Czech Republic	The authors do not report the experience of using the indicators in the management
Development of Mental Health Indicators in Korea⁽²⁵25 Han H, Ahn DH, Song J, Hwang TY, Roh S. Development of Mental Health Indicators in Korea. Psychiatry Invest. 2012;9(4):311. doi: 10.4306/pi.2012.9.4.311 https://doi.org/10.4306/pi.2012.9.4.311... ⁾	To develop ways to measure the state of mental health in Korea by analyzing indicators in other regions	Korea South	Indicators were only selected
Call for information, call for quality in mental health care⁽²⁶26 Lora A. Call for information, call for quality in mental health care. Epidemiol Psychiatr Sci. 2012;22(1):9-13. doi: 10.1017/s2045796012000716 https://doi.org/10.1017/s204579601200071... ⁾	To build a model to improve the quality of mental health services mediation system at regional and local levels	Italy	The authors do not report the experience of using the indicators in the management
Size Matters - Determinants of Modern, Community-Oriented Mental Health Services⁽²⁷27 Ala-Nikkola T, Pirkola S, Kontio R, Joffe G, Pankakoski M, Malin M, et al. Size Matters - Determinants of Modern, Community-Oriented Mental Health Services. Int J Env Res Pub Health. 2014;11(8):8456-74. doi: 10.3390/ijerph110808456 https://doi.org/10.3390/ijerph110808456... ⁾	To explore the quality and quantity of substance abuse-related mental health services, and evaluate the correlation between the needs of the population and the availability of those services	Finland	Implementation in use
Quality indicators for the referral process from primary to specialized mental health care: an explorative study in accordance with the RAND^* * RAND = The RAND/UCLA Appropriateness Method (RAM) was developed in the mid-1980s, as part of the RANDCorporation/University of California Los Angeles (UCLA) Health Services Utilization Study, primarily as an instrument to enable the measurement of the overuse and underuse of medical and surgical procedures appropriateness method⁽²⁸28 Hartveit M, Vanhaecht K, Thorsen O, Biringer E, Haug K, Aslaksen A. Quality indicators for the referral process from primary to specialised mental health care: an explorative study in accordance with the RAND appropriateness method. BMC Health Serv Res. 2017 Mar;17(1). doi: 10.1186/s12913-016-1941-1 https://doi.org/10.1186/s12913-016-1941-... ⁾	To develop quality indicators to detect the impact of quality of primary care referral information to specialized mental health care has on the quality of mental health services	Norway	The authors do not report the experience of using the indicators in the management
Mental health quality, outcome measurement, and improvement in Germany⁽²⁹29 Gaebel W, Janssen B, Zielasek J. Mental health quality, outcome measurement, and improvement in Germany. Curr Opin Psychiatry. 2009;22(6):636-42. doi: 10.1097/yco.0b013e3283317c00 https://doi.org/10.1097/yco.0b013e328331... ⁾	To describe the most recent results of quality assurance programs for mental health services in Germany	Germany	Implementation in use
Composing a Core Set of Performance Indicators for Public Mental Health Care: A Modified Delphi Procedure⁽³⁰30 Lauriks S, Wit MASD, Buster MCA, Arah OA, Klazinga NS. Composing a Core Set of Performance Indicators for Public Mental Health Care: A Modified Delphi Procedure. Admin Policy Ment Health. 2014 Sep;41(5):625-35. doi: 10.1007/s10488-013-0506-4 https://doi.org/10.1007/s10488-013-0506-... ⁾	To describe the development of a set of performance indicators that are feasible, meaningful and useful for assessing the quality of the public mental health system in Amsterdam	Netherlands	Pilot implementation

Study	Study Objective	Territorial dimension	Implementation of indicators
Financing mental health services in low- and middle-income countries⁽³¹31 Dixon A, Mcdaid D, Knapp M, Curran C. Financing mental health services in low- and middle-income countries. Health Policy Plan. 2006;21(3):171-82. doi: 10.1093/heapol/czl004 https://doi.org/10.1093/heapol/czl004... ⁾	To evaluate the impact of health care financing deals on the efficient and equitable use of mental health services	Azerbaijan, Bulgaria, Georgia, Lithuania, Kyrgyzstan, Pakistan, Nepal, Thailand, Malaysia, Chile, Kenya, Zambia	The authors do not report the experience of using the indicators in the management
Scale up services for mental disorders: a call for action⁽³²32 Lancet Global Mental Health Group. Scale up services for mental disorders: a call for action. Lancet. 2007;370(9594):1241-52. doi: 10.1016/s0140-6736(07)61242-2 https://doi.org/10.1016/s0140-6736(07)61... ⁾	To improve mental health services through the search for financing and monitor this improvement through indicators	Chile, Albania, Ethiopia, Thailand, China (Hunan Province), Iran, Nepal, Morocco, Nigeria, Ukraine, Vietnam, Paraguay	Partial implementation
Mental health systems in countries: where are we now?⁽³³33 Jacob K, Sharan P, Mirza I, Garrido-Cumbrera M, Seedat S, Mari J, et al. Mental health systems in countries: where are we now? Lancet. 2007;370(9592):1061-77. doi: 10.1016/s0140-6736(07)61241-0 https://doi.org/10.1016/s0140-6736(07)61... ⁾	To analyze ways to improve health systems in low- and middle-income countries	Brazil, India and South Africa	Partial implementation
Three models of community mental health services in low-income countries⁽³⁴34 Cohen A, Eaton J, Radtke B, George C, Manuel B, Silva MD, et al. Three models of community mental health services in low-income countries. Int J Ment Health Syst. 2011;5(1):3. doi: 10.1186/1752-4458-5-3. https://doi.org/10.1186/1752-4458-5-3... ⁾	To compare three models of community mental health services in low-income settings	Nigeria, Philippines, and India	The authors do not report the experience of using the indicators in the management
Situational analysis: preliminary regional review of the Mental Health Atlas 2014⁽³⁵35 R G, Chew Z, Saeed K. Situational analysis: preliminary regional review of the Mental Health Atlas 2014. Eastern Mediterr Health J. 2015 Jan;12(7):467-76. doi: 10.26719/2015.21.7.467 https://doi.org/10.26719/2015.21.7.467... ⁾	To consolidate the data provided for the Atlas 2014 questionnaire by the Member States of the Eastern Mediterranean region	22 Member States of the Eastern Mediterranean Region	Partial implementation
Indicators for routine monitoring of effective mental health coverage in Low- and Middle-Income Countries (LMIC) environments: a Delphi study⁽³⁶36 Jordans MJD, Chisholm D, Semrau M, Upadhaya N, Abdulmalik J, Ahuja S, et al. Indicators for routine monitoring of effective mental healthcare coverage in low- and middle-income settings: a Delphi study. Health Pol Plan. 2016;31(8):1100-6. doi: 10.1093/heapol/czw040 https://doi.org/10.1093/heapol/czw040... ⁾	To identify indicators for the measurement of effective coverage of mental health treatment through a Delphi Study	Ethiopia, India, Nepal, Nigeria, South Africa and Uganda	The authors do not report the experience of using the indicators in the management
Evaluating capacity-building for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners and researchers⁽³⁷37 Hanlon C, Semrau M, Alem A, Abayneh S, Abdulmalik J, Docrat S, et al. Evaluating capacity-building for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners and researchers. Epidemiol Psychiatr Sci. 2017;27(1):3-10. doi: 10.1017/s2045796017000440 https://doi.org/10.1017/s204579601700044... ⁾	To evaluate the impact of human resources training in low- and middle-income countries	Ethiopia, India, Nepal, Nigeria, South Africa and Uganda	The authors do not report the experience of using the indicators in the management

Study	Study Objective	Territorial dimension	Implementation of indicators
Public sector mental health systems in South Africa: Inter-provincial comparisons and policy implications(38)	To document current levels of provision of public health mental health services in South Africa and to compare services between provinces	South Africa	Implementation in use
Evaluation of results and impact of the first phase of a community based mental health model in localities in Bogotá, D.C.(39)	To evaluate the impact of the Community Based Mental Health Model through indicators	Colombia	Implementation in use
Development of mental health indicators at the district level in Madhya Pradesh, India: mixed methods study(40)	To develop a basic set of indicators to monitor mental health in primary care settings through a Mixed Methods Study	India	Implementation in discussion

[1] Corresponding author: Inacia Bezerra de Lima. E-mail: lima.inacia@gmail.com

Brasil

Brasil

The use of indicators for the management of Mental Health Services

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