ArticleSocial psychiatry and psychiatric epidemiology2019
What drives changes in institutionalised mental health care? A qualitative study of the perspectives of professional experts.
Article in Social psychiatry and psychiatric epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- 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
- Article
- Quality in Psychiatric Care in the Community Mental Health Setting from the Perspective of Patients and Staff.International journal of environmental research and public health · 2023Article
- Mental Health Reform Processes and Service Delivery Shift From the Hospital to the Community in Belgium and Hong Kong.Health services insights · 2023Article
- Factors Affecting Treatment Regress and Progress in Forensic Psychiatry: A Thematic Analysis.Frontiers in psychiatry · 2022Article
- Forensic mental health in Europe: some key figures.Social psychiatry and psychiatric epidemiology · 2021Article
- Working on and with Relationships: Relational Work and Spatial Understandings of Good Care in Community Mental Healthcare in Trieste.Culture, medicine and psychiatry · 2020Article
- A qualitative exploration of service users' and staff members' perspectives on the roles of inpatient settings in mental health recovery.International journal of mental health systems · 2020Article
- Violent Behavior During Psychiatric Inpatient Treatment in a German Prison Hospital.Frontiers in psychiatry · 2019Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince 1990, the provision of mental healthcare has changed substantially across Western Europe. There are fewer psychiatric hospital beds and more places in forensic psychiatric hospitals and residential facilities. However, little research has investigated the drivers behind these changes. This study explored qualitatively the perspectives of mental health professional experts on what has driven the changes in Western Europe.
methodsIn-depth interviews were conducted with twenty-four mental health experts in England, Germany and Italy, who as professionals had personal experiences of the changes in their country. Interviewees were asked about drivers of changes in institutionalised mental health care from 1990 to 2010. The accounts were subjected to a thematic analysis.
resultsFour broad themes were revealed: the overall philosophy of de-institutionalisation, with the aim to overcome old-fashioned asylum style care; finances, with a pressure to limit expenditure and an interest of provider organisations to increase income; limitations of community mental health care in which most severely ill patients may be neglected; and emphasis on risk containment so that patients posing a risk may be cared for in institutions. Whilst all themes were mentioned in all three countries, there were also differences in emphasis and detail.
conclusionsDistinct factors appear to have influenced changes in mental health care. Their precise influence may vary from country to country, and they have to be considered in the context of each country. The drivers may be influenced by professional groups to some extent, but also depend on the overall interest and attitudes in the society at large.
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