THERAPEUTIC LANDSCAPES: ROUTES AND CARE GAPS
Barcelona, October 26, 2012
Organize:
Catalan Association of Mental Health Professionals (AEN-Catalonia)
Catalan Congress of Mental Health Foundation (FCCSM)
Summary document: 6A. THE NETWORK IN DEBATE
The Congrés Català de Salut Mental Foundation (FCCSM) and the Catalan Association of Mental Health Professionals – Spanish Association of Neuropsychiatry (ACPSM-AEN), organizers of this Conference, which is part of the Networks in Debate cycle, want to emphasize this year the care gaps that arise in mental health networks and facilitate a debate that allows for the identification of improvement actions for the care pathways that patients follow.
La Jornada aims to highlight the vision of assistance based on user needs, and therefore, comprehensive care that considers the importance of continuity and consistency in care interventions throughout their journey in mental health networks.
In the first part of the day, Dr. Carles Constante, Director General of Regulation, Planning, and Health Resources of the Department of Health, emphasized these same points, highlighting the commitment of the administrations to the development of community resources, care for chronic conditions, increased primary care resolution, complementary service portfolios, the fight against stigma, and cited the success of the Eixample suicide prevention program as an example.
The Event has subsequently been structured around two panels: the first concerning care organizations, and the second, specific experiences of continuity of care in our environment.
Dr. Claudi Camps, Medical Director of the Girona Health Assistance Institute, in the first round table, commented on the importance of integrating child and adult services, transparency in service management, and his commitment to family involvement on the Board, as well as the increase achieved in the number of supported housing units and the positive experience of the “pis-escola” (school-apartment) in the Girona network. He particularly emphasized the necessary comprehensive training of residents to facilitate high-quality care.
Dr. Charles Alezrah, Head of Service at the Centre Hospitalier Spécialisé de Thuir (France), noted chronicity as inherent to all mental suffering, the commitment to strict territorialization, and in the case of Northern Catalonia, without differentiation between admission for acute, subacute, and chronic cases. He emphasized continuity of care based on the therapeutic plan versus through the psychiatric reference who follows the patient across different network facilities (French sector). He highlighted the importance of the mobile team, as a pilot program, which admits and guides pathology not initially linked to the network. During the discussion, it was highlighted how here, care in acute units is excessively focused on symptomatic reduction at the moment, without considering the medium- and long-term treatment plan, leading to premature discharges and a revolving door effect.
On the second table, Mr. Daniel Cruz, coordinator of CSMIJ Granollers at Hospital Sant Joan de Déu, highlights the importance of the Primary Healthcare Support Program (PSP), which can foster a comprehensive and preventive approach to child issues. He also underscores the lack of recognition by health authorities of non-direct care tasks, which are essential for good mental health care for the population, the importance of strengthening family health, and overall, the significant health and social return on investment in the PSP.
Dr. Jordi Blanch, Head of the CSM-CCEE Section, Psychiatry and Psychology Service at the Hospital Clínic, highlights the increase in pathology detected in pre-adults, the significant lack of resources in this area, and the importance of defining clear benchmarks for this age group. He also explains the experience initiated by the HCP with a Young Adult Service that facilitates the diagnosis and follow-up of patients with a proven tendency to disengage from services.
Mr. Víctor Martí, coordinator of CAS Rubí, Ferran Salsas i Roig Mental Health Services, Terrassa Health Consortium, believes that organizational structures are needed to facilitate the integration process of different resources for children, adults, and drug dependency, as well as the importance of structured inter-institutional work between health, social, educational, and other networks. Flexibility and coherence of approaches need to be increased, avoiding service duplication. He notes increased user and professional satisfaction, improved adherence, reduced hospitalizations, and better quality of life when care interventions are coherent and continuous. For all these reasons, we need strong leadership from organizations and public administrations based on this integrated, patient-centered approach and strong professional involvement in the comprehensive project.
Finally, Dr. Paloma Lago, Director of Mental Health Centers in 9 Barris, highlights the importance of considering others, teamwork, and the need for a team. She also comments on the importance of the expert patient and group work both inside and outside the care setting, in clubs, etc.
