2228 – Unmet Needs Of Mental Health Services In Portugal: Comparing Outpatient Versus Inpatient Units

Abstract

Introduction

Although some improvements during the last decade, Portuguese mental health services still bear substantial shortages, in terms of accessibility, equity and quality of care. A new National Mental Health Plan with a community model has been launched in 2007.

Objectives

To assess unmet needs at public mental health services in Portugal.

Methods

Cross-sectional study, steering all the public mental health services throughout the country, both for adults (39 units) and children/adolescents (11 units). Evaluation was done by means of the WHO “Quality Assurance in Mental Health Care” tool, which includes dimensions such as physical environment, administrative arrangements, care process, interaction with families, outreach, discharge and follow-up.

Results

The quality of services, according to the assessment made with the participation of professionals, did not reach the “Good level” (> 80% met needs). Level of unmet needs was worse in adult outpatient services (35%) than in inpatient units (27%, despite the relevance of the former. Most critical areas of unmet needs included human resources (only 44% met needs, concerning provision, distribution, interdisciplinary composition of the staff) and administrative arrangements (66% met needs). Regarding the child/adolescent units, the weighted level of quality of outpatient services (67% met needs) was similar to that of inpatient units (68%).

Conclusions

The implementation of the mental health plan has to tackle some of the unmet needs present in mental health services in Portugal. Special attention should be given to the outpatient facilities, in order to undertake with the community philosophy of the National Mental Health Plan.