Study about community care in Bizkay. 2015

Developed research in 2015

Along the first Months of 2015, a comparative study was conducted in Bizkai, about the situations of community mental health care . They have been taken as references, the practices of countries like Britain , Finland, USA . This is done within the framework of foresight on community care for next decades. It could be emphasize the SWOT analysis with a group of professionals, that has been developed within the study.

One of the key issues that have emerged in the study is that if in the history of the last 35 years of psychiatry in Bizkaia, a major deinstitutionalization occurred along the 80s. In the 1980s, a program of mental health and community psychiatry was proposed and accepted by the Health Commission of the Basque Parliament, which was completed by 1990 in 95% of its objectives. Psychiatric hospitals went from having several thousand patients to having only a few hundred.

  • Multidisciplinary mental health centers were created in this time of the 80, in which there was at least one psychiatrist, a social worker, an occupational therapist, a psychologist and an administrative
  • Perhaps one of the shortcomings in that development, which partly determines the current situation, is that of two gaps, which at that time were given: the impossibility of creating crisis intervention centers, and secondary prevention was not adequately developed . On the other hand, it was not particularly emphasized that mental health centers should be primarily concerned with the psychotic mentally ill, with community-based care.
  • These mental health centers had a drift, which has been described as typical in countries as diverse as the United States, the United Kingdom or Australia. They ended up being primary mental health centers, in which mainly people with first outbreaks who were followed monthly, and little else was done to keep them in the community. The personnel were mainly concerned with attention to milder mental problems and other characteristics than chronic psychotic
  • However specialized institutions for the mentally ill were organized, such as the Eragintza Foundation and the Argia Foundation. But these institutions were organized in the 1990s by NGO´s. Day hospitals organized to treat chronic psychotic patients had major shortcomings.
  • The SWOT analysis suggests that a long-term strategy should be maintained with questions such as : Flexible organization , adaptable to the socio- economic changes ; Continuous assessment of the effectiveness of the programs and their costs; Emphasis on secondary prevention ; Integration of Mental health Promotion Programms ; Assuming the Recovery Model .
  • Finally some recommendations on tactics were made.