Researchers from CINTESIS and the Faculty of Medicine of the University of Porto (FMUP) advocate an increase in the number of vacancies in residential structures for Continuing Mental Health Care, in order to meet the demand, especially from hospitals. The team also alerts to the low use of home care services.
“The number of vacancies in residential homes should increase since the occupation of these structures reaches values of about 90%. Residential facilities seem to be a priority, but it is important to understand why home-based services seem to be underutilized,” indicate the authors of the paper published in the International Journal of Social Psychiatry.
This is the first study to look at the results of the reform in Continued Integrated Mental Health Care, which began in 2017 and is currently ongoing in Portugal. Intended for people with severe mental illness, including schizophrenia and bipolar disorder, this care aims at psychosocial rehabilitation and reintegration of patients into the community.
“The Continued Mental Health Care corresponds to a Community Psychiatry strategy that is expected to grow in the future, given the investment expected through the Resilience and Recovery Program. In fact, one of the goals is to extend the number of Integrated Continued Mental Health Care responses up to 1,000 vacancies and up to 100 vacancies in 10 home-based teams,” note the authors.
The FMUP/CINTESIS research team analyzed the demand and supply of these structures and services, namely residential structures and outpatient services, such as socio-occupational units and home support teams, between 2017 and December 2022.
In all, in these five years, there were 1,192 referrals from hospitals, primary health care, and the social sector to Continuing Mental Health Care, of which 8.3% corresponded to children and adolescents.
“The maximum support residences (RAMa), designed for patients with more disability, had the highest number of referrals and, as soon as vacancies opened, they were quickly saturated,” points out the study.
The residential structures are centers that receive patients with different degrees of psychosocial disability, i.e., greater severity and functional commitment, and who usually cannot be treated at home due to a lack of family or social support.
While residential homes are almost full, home care services are the least sought after, with occupancy rates below 50%. Researchers believe that factors that may be hindering their use, including lack of awareness or redundancy of services, should be investigated.
In addition, this study describes that “the number of referrals assumes a concentric pattern in relation to the availability of vacancies in Continued Mental Health Care. It is also possible to observe that there are regions of the country with low coverage and offer of this type of care, which is an obstacle, taking into account the importance of proximity to the community”.
“Alentejo and Algarve, which correspond to the most underserved regions of the country in terms of Mental Health resources and professionals, are also the regions with the fewest vacancies and structures available”, say the authors.
The authors of this study are Filipa Santos Martins (CINTESIS/Centro Hospitalar Universitário de São João), Tallys Feldens (CINTESIS/Universidade Federal do Paraná), Cátia Guerra (FMUP/CHUSJ) and João Vasco Santos (CINTESIS/FMUP/ACES Grande Porto V – Porto Ocidental).
