ArticleBMC psychiatry2016
An international comparison of the deinstitutionalisation of mental health care: Development and findings of the Mental Health Services Deinstitutionalisation Measure (MENDit).
Article in BMC psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Transition of Mental Health Services from Institutional to Community-Based Care Abroad and Its Context for Slovenia-Advantages and Risks.International journal of environmental research and public health · 2025Pooled it
- Meta-analysis of suicide rates in the first week and the first month after psychiatric hospitalisation.BMJ open · 2019Pooled it
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- Delivery and delay of guideline pharmacological, psychological, and social interventions for adults with complex psychosis in Dutch inpatient rehabilitation units: A retrospective study.The International journal of social psychiatry · 2026Article
- Putting mental health deinstitutionalisation back on track: a scoping review of what empirically hinders and drives deinstitutionalisation of adults who experience mental illness.BMC public health · 2025Article
- Differences in Personal Recovery Among Individuals with Severe Mental Disorders in Private and Supported Accommodations: An Exploratory Study.International journal of environmental research and public health · 2025Article
- The key pillars of psychosocial disability: a European perspective on challenges and solutions.Frontiers in psychiatry · 2025Article
- An integrated knowledge translation (iKT) approach to advancing community-based depression care in Vietnam: lessons from an ongoing research-policy collaboration.BMC health services research · 2024Article
- Schizophrenia and schizoaffective disorder: Length of stay and associated factors.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2024Article
- Addressing Challenges in Residential Facilities: Promoting Human Rights and Recovery While Pursuing Functional Autonomy.Psychiatric research and clinical practice · 2024Article
- Needs for care of residents with schizophrenia spectrum disorders and association with daily activities and mood monitored with experience sampling method: the DIAPASON study.Epidemiology and psychiatric sciences · 2023Article
- Quality of residential facilities in Italy: satisfaction and quality of life of residents with schizophrenia spectrum disorders.BMC psychiatry · 2022Article
- Parity of esteem and systems thinking: a theory informed qualitative inductive thematic analysis.BMC psychiatry · 2022Article
- Types of Community Support Services and Self-Efficacy for Continuous Community Living among Individuals with Disabilities and Caregivers.International journal of environmental research and public health · 2022Article
- Performance and effectiveness of step progressive care pathways within mental health supported accommodation services in Italy.Social psychiatry and psychiatric epidemiology · 2022Article
- Factors Affecting Treatment Regress and Progress in Forensic Psychiatry: A Thematic Analysis.Frontiers in psychiatry · 2022Article
- Stakeholder Coalitions and Priorities Around the Policy Goals of a Nation-Wide Mental Health Care Reform.Administration and policy in mental health · 2021Article
- Improving Care for Deinstitutionalized People With Mental Disorders: Experiences of the Use of Knowledge Translation Tools.Frontiers in psychiatry · 2021Article
- Recommendations for Mental Health Reforms in Uzbekistan: A Policy Report.Central Asian journal of global health · 2020Review
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3 authors.
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Abstract
backgroundDespite its inclusion as a key aspect of successful mental health care service provision by the World Health Organization, there exists a lack of consensus regarding the definition, key components and implementation of deinstitutionalisation. This lack of consensus has also contributed to subjectivity in assessments of countries' progress towards deinstitutionalisation which act as a barrier to its evaluation and success. In order to provide for reliable within and cross country evaluations of the success of deinstitutionalisation we aimed to develop a quantitative measure of country-level progress towards deinstitutionalisation through the (1) identification of key markers of deinstitutionalisation; (2) development of an assessment tool based on the identified markers; (3) evaluation of the tool's psychometric properties; and (4) comparison of progress towards deinstitutionalisation across Europe.
methodsNational care standards from 10 European countries and World Health Organization recommendations were used to identify items for the tool. A draft version was reviewed by an international expert panel and assessed for test-retest reliability and internal consistency. Once a final version had been agreed, progress towards deinstitutionalisation was assessed for 30 European countries. We used this opportunity to test convergent validity through comparison with local experts' assessments. Country total as well as individual item scores were described and compared.
resultsThe five-item Mental Health Services Deinstitutionalisation Measure (MENDit) is an objective tool with moderate to very good test-retest reliability (Kappa range: 0.46-1.00) and internal consistency (α = 0.70, 95 % CI 0.25, 0.92). A statistically significant difference between groups was found by one-way ANOVA (F(3,26) = 6.77, p = 0.002). Post-hoc testing found significant differences between MENDit scores of countries categorised as having advanced levels of deinstitutionalisation and not started or just started. Across Europe, MENDit scores suggest substantial variety in progress towards deinstitutionalisation.
conclusionsThe MENDit has good psychometric properties which support its use in research and as a benchmarking tool to measure national progress towards deinstitutionalisation by policy makers. Across Europe a high proportion of psychiatric beds are still located in psychiatric hospitals. Additionally, low numbers of mental health professionals in many countries may hinder further deinstitutionalisation. These findings corroborate previous mental health systems research and highlight some of the difficulties of deinstitutionalisation.
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