TY - JOUR
T1 - On the roller coaster
T2 - An abridged history of mental health planning in Spain. SESPAS Report 2020
AU - Salvador-Carulla, Luis
AU - Almeda, Nerea
AU - Álvarez-Gálvez, Javier
AU - García-Alonso, Carlos
N1 - Publisher Copyright:
© 2020 SESPAS
PY - 2020/1
Y1 - 2020/1
N2 - Effective mental health change in Spain started in 1985 with the Report of the Ministerial Commission for the Psychiatric Reform that recommended integrating psychiatric care into the general health system, providing care in the patient's context and for specific diagnoses. The SESPAS 2002 Report carried out an analysis of this reform and recommended the creation of a permanent ministerial commission, the design of a national map of socio-sanitary mental health services, the creation of a coordination and promotion agency for and carrying out a financial analysis of resource provision and research. Since 2004, the Technical Committee for the Mental Health Strategy boosted the elaboration of a theoretical and normative framework that unfortunately did not lead to a road map for the improvement of the system. After 2011, during the financial crisis, the Ministry of Health lost the opportunity to lead a second phase of change of the mental health care, which was evidence-based: no key technical reports were published nor was an action plan based on data developed. Currently, the 1985 community mental health model is still the general framework of mental health care with the addition of aspects related to the recovery model and the balance of care model. Significant progress has been made in developing care systems assessment methods and data-based models that could advance mental health planning. The gap between general health attention and mental health care has increased and the expected reform of the mental health system will not take place in the near future.
AB - Effective mental health change in Spain started in 1985 with the Report of the Ministerial Commission for the Psychiatric Reform that recommended integrating psychiatric care into the general health system, providing care in the patient's context and for specific diagnoses. The SESPAS 2002 Report carried out an analysis of this reform and recommended the creation of a permanent ministerial commission, the design of a national map of socio-sanitary mental health services, the creation of a coordination and promotion agency for and carrying out a financial analysis of resource provision and research. Since 2004, the Technical Committee for the Mental Health Strategy boosted the elaboration of a theoretical and normative framework that unfortunately did not lead to a road map for the improvement of the system. After 2011, during the financial crisis, the Ministry of Health lost the opportunity to lead a second phase of change of the mental health care, which was evidence-based: no key technical reports were published nor was an action plan based on data developed. Currently, the 1985 community mental health model is still the general framework of mental health care with the addition of aspects related to the recovery model and the balance of care model. Significant progress has been made in developing care systems assessment methods and data-based models that could advance mental health planning. The gap between general health attention and mental health care has increased and the expected reform of the mental health system will not take place in the near future.
KW - Evidence-informed
KW - Integrated model
KW - Mental health care
KW - Mental health services
KW - Planning
KW - Provision
UR - http://www.scopus.com/inward/record.url?scp=85089729286&partnerID=8YFLogxK
U2 - 10.1016/j.gaceta.2020.06.009
DO - 10.1016/j.gaceta.2020.06.009
M3 - Review article
SN - 0213-9111
VL - 34
SP - 3
EP - 10
JO - Gaceta Sanitaria
JF - Gaceta Sanitaria
ER -