| Summary: | The purpose of this report was to provide an overview of systematic reviews on the effects of interventions to organize services for children, youth and adults with mental disorders. We identified 17 systematic reviews of interventions to organize services for people with mental illness. In terms of content the various organizational interventions complemented each other by having different purposes, covering topics such as multidisciplinary teams, treatment setting, integrated care and continuity of care.1. Intensive coordination of psychosocial work compared with standard therapy possibly led to slightly less number of days in hospital, some more users who maintained contact with mental health care, higher functional score, a few more living independently and possibly slightly higher user satisfaction.2. Use of community multidisciplinary teams versus hospital-based services may lead to slightly fewer hospitalizations3. Day hospitals versus hospitalisation probably led to longer duration for index admission but also probably a slightly better score for social function.4. For all the other interventions with more restricted purposes, the quality of the documentation was either too low, the results had wide confidence intervals or showed inconsistent effects across studies, making it difficult to draw meaningful conclusions about efficacy. Of the identified organizational interventions, intensive case management compared with standard therapy appears to be the intervention with positive effects on more outcomes. The quality of the evidence for these results was low. Overall, the scientific evidence for the effect of organisational interventions is generally of low and very low quality. The main part of the studies was of an earlier date. The scientific evidence appears to be a rather inadequate basis for decisions on future organisation of mental health care
|
|---|