Background: Mozambique has gradually changed its action on mental health (MH) from an asylum-centric care with long-term hospitalization to an innovative approach to community and primary care. Objective: To collect essential information on Mozambique's MH system for decision making, to improve quality of services delivered, update MH Strategy and Action Plan. Method: The study used the WHO-AIMS to assess MH systems including policy and legislation, organization of services, MH in primary care, human resources, public education and link with other sectors, monitoring and research. A comparative analysis was conducted to present the evolution of relevant data from 2010 to 2014. Results: There are two psychiatric hospitals in the country and beds in general hospitals. In the period, the number of beds in general hospitals remained stable (203), and the beds in psychiatric hospitals increased from 173 to 298. Mental health outpatient facilities have increased from 83 to 152. The number of psychiatrists (9 in 2010, and 10 in 2014) remained very low, with a significant increase in the number of psychologists (56-109) and occupational therapists (2-23). The number of Psychiatric Technicians has increased from 66 in 2010, to 241 in 2014. This increase allowed the mental health network to expand from 60 to 135 Districts, meaning an increase of coverage from 44 to 100 % of the country districts. Conclusion: The task-shifting strategy focused on services delivered in primary care by psychiatric technicians, mid-level professionals, allowed the expansion of mental health services for all the country districts and the reduction of treatment gap in Mozambique. ; WHO ; Ministry of Health of Mozambique ; NIMH-Fogarty grant [D43TW009675] ; New York State Psychiatric Institute-Columbia University Department of Psychiatry ; Eduardo Mondlane University Medical School ; Federal University of Sao Paulo, Psychiatry Department ; Mental Health Department, Center for Applied Psychology and Psychometric Tests, Ministry of Health, Rua de Nachingwea No 486, Maputo, Mozambique ; New York State Psychiatric Institute, Columbia University, New York, USA ; Lisbon Institute of Global Mental Health, Universidade Nova de Lisboa, Lisbon, Portugal ; Lisbon Institute of Global Mental Health, Lisbon, Portugal ; Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil ; Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil ; NIMH-Fogarty: D43TW009675 ; Web of Science
In: Killaspy , H , White , S , Wright , C , Taylor , T , Turton , P , Schuetzwohl , M , Schuster , M , Cervilla , J A , Brangier , P , Raboch , J , Kalisova , L , Onchev , G , Alexiev , S , Mezzina , R , Ridente , P , Wiersma , D , Visser , E , Kiejna , A , Adamowski , T , Ploumpidis , D , Gonidakis , F , Caldas-de-Almeida , J , Cardoso , G & King , M B 2011 , ' The development of the Quality Indicator for Rehabilitative Care (QuIRC) : a measure of best practice for facilities for people with longer term mental health problems ' , BMC Psychiatry , vol. 11 , 35 . https://doi.org/10.1186/1471-244X-11-35
Background: Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at most risk of potential abuses of care and exploitation. This study aimed to develop an international, standardised toolkit to assess the quality of care in longer term hospital and community based mental health units, including the degree to which human rights, social inclusion and autonomy are promoted. Method: The domains of care included in the toolkit were identified from a systematic literature review, international expert Delphi exercise, and review of care standards in ten European countries. The draft toolkit comprised 154 questions for unit managers. Inter-rater reliability was tested in 202 units across ten countries at different stages of deinstitutionalisation and development of community mental health services. Exploratory factor analysis was used to corroborate the allocation of items to domains. Feedback from those using the toolkit was collected about its usefulness and ease of completion. Results: The toolkit had excellent inter-rater reliability and few items with narrow spread of response. Unit managers found the content highly relevant and were able to complete it in around 90 minutes. Minimal refinement was required and the final version comprised 145 questions assessing seven domains of care. Conclusions: Triangulation of qualitative and quantitative evidence directed the development of a robust and comprehensive international quality assessment toolkit for units in highly variable socioeconomic and political contexts.
In: Killaspy , H , White , S , Wright , C , Taylor , T L , Turton , P , Schuetzwohl , M , Schuster , M , Cervilla , J A , Brangier , P , Raboch , J , Kalisova , L , Onchev , G , Alexiev , S , Mezzina , R , Ridente , P , Wiersma , D , Visser , E , Kiejna , A , Adamowski , T , Ploumpidis , D , Gonidakis , F , Caldas-de-Almeida , J , Cardoso , G & King , M B 2011 , ' The development of the Quality Indicator for Rehabilitative Care (QuIRC) : a measure of best practice for facilities for people with longer term mental health problems ' , BMC Psychiatry , vol. 11 , 35 . https://doi.org/10.1186/1471-244X-11-35 ; ISSN:1471-244X
Background: Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at most risk of potential abuses of care and exploitation. This study aimed to develop an international, standardised toolkit to assess the quality of care in longer term hospital and community based mental health units, including the degree to which human rights, social inclusion and autonomy are promoted. Method: The domains of care included in the toolkit were identified from a systematic literature review, international expert Delphi exercise, and review of care standards in ten European countries. The draft toolkit comprised 154 questions for unit managers. Inter-rater reliability was tested in 202 units across ten countries at different stages of deinstitutionalisation and development of community mental health services. Exploratory factor analysis was used to corroborate the allocation of items to domains. Feedback from those using the toolkit was collected about its usefulness and ease of completion. Results: The toolkit had excellent inter-rater reliability and few items with narrow spread of response. Unit managers found the content highly relevant and were able to complete it in around 90 minutes. Minimal refinement was required and the final version comprised 145 questions assessing seven domains of care. Conclusions: Triangulation of qualitative and quantitative evidence directed the development of a robust and comprehensive international quality assessment toolkit for units in highly variable socioeconomic and political contexts.