Community-based Mental Healthcare: A Case Study in a Cross-border Region of Germany and the Netherlands

Abstract

Background Community-based mental healthcare (CBMH) aims at supplying psychiatric patients with rehabilitative care outside the hospital. The aim of this study was to compare the organization of CBMH in a cross-border region of Germany and the Netherlands.

Method Semi-structured interviews gave insight into characteristics of CBMH approaches applied in the German region of Aachen (IHP) and the Dutch Province of Limburg (FACT). We applied a Delphi technique to select a performance indicator (PI) set for CBMH, which served as a conceptual model to allow comparison.

Results Both approaches are flexible, patient-centred and include the evaluation of quality. Both provide financial and administrative support for the access.

Conclusion CBMH approaches appear to be equally valid from several perspectives even if they revealed, at the same time, important differences related to scope, integration with non-CBMH care resources and geographic coverage. Secondarily, the study provides a contribution to the development of a PI set to compare and evaluate CBMH approaches.

Zusammenfassung

Hintergrund Gemeindebasierende psychiatrische Versorgung (GPV) zielt darauf ab, Patienten außerhalb des Krankenhauses mit Rehabilitationsmaßnahmen zu versorgen. Ziel dieser Studie war es, die Organisation von GPV-Ansätzen im Grenzgebiet Aachen zur Provinz Limburg zu vergleichen.

Methode Interviews gaben Einblicke in die Merkmale der beiden GPV Ansätze. Wir verwendeten Delphi-Verfahren, um ein Leistungsindikatorenset auszuwählen, das als Konzeptmodell diente. Wir verglichen 1) Stärkefallmanagement mit seinem individuellen Hilfeplan in der deutschen Region mit 2) funktioneller konsequenter Gemeinschaftsbehandlung mit seinem intensiven Fallmanagement in der niederländischen Region.

Ergebnisse Beide Ansätze sind flexibel, patientenorientiert und beinhalten die Bewertung von Qualität. Beide Ansätze bieten finanzielle und administrative Unterstützung für den Versorgungszugang.

Fazit GPV-Ansätze scheinen aus vielerlei Hinsicht gleichermaßen gültig zu sein, auch wenn sie gleichzeitig wichtige Unterschiede in Bezug auf Umfang, Integration mit Nicht-GPV-Betreuungsressourcen und der geografischen Abdeckung aufzeigen. Sekundär liefert die Studie einen Beitrag zur Entwicklung eines Leistungsindikatorensets, um GPV-Ansätze zu bewerten und zu vergleichen.

Key words

community-based care - performance indicators - mental health - case management

Schlüsselwörter

gemeindebasierte Betreuung - Leistungsindikatoren - psychische Gesundheit - Fallmanagement

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