Health services research on people with menatl disorders in the integrated care system

Introduction: Mental disorders are a rising issue for the health care systems worldwide. In Europe, 20- 25% of the burden of diseases is caused by these illnesses. In Germany, the prevalence pertains 31% and the most frequent diagnoses are anxiety, substance misuse and affective disorders. Still stigmatized, the level of health care for mentally ill people is inadequate. In many cases the illness is not discovered. However, diagnosed patients are treated with delay or never. In addition, ambulatory treatment places are insufficient and the lack of a holistic approach across the different medical sectors is causing challenges for the patients. This thesis will identify different innovative models which provide a higher level of attention to mentally ill patients and at the same time strengthen the outpatient care. Models of integrated care are one option to overcome the barriers of the divided medical sectors with the objective to accomplish improved care quality with an optimized treatment process while keeping the economic aspects in sight as well. Methods: An adapted health needs assessment is conducted for people with mental disorders based on literature research and an analysis of routine data in the integrated care system ‘Gesundes Kinzigtal’. The appraisal of the innovative approaches of the outpatient care is done through a focus group discussion with experts from ‘Gesundes Kinzigtal’. Results: The comparative analysis of data from Germany and ‘Gesundes Kinzigtal’ shows several similarities, for instance a prevalence of mental disorders of around 30% and several parallel diagnoses exist. There are multiple approaches in Germany for a strengthened outpatient care available, but quite often with missing transparency and evaluation processes. The experts in the focus group discussion made two suggestions for an enhanced care of mentally ill people. Conclusion: The different approaches of ambulatory care illustrate the awareness of health care providers and policy that innovative projects are necessary for a better health care of people with mental disorders and for a handling of the rising demand