| Title | The Mental Health Care Gap in Intellectual Disabilities in Spain: Impact Analysis and Knowledge-to-Action Plan |
|---|---|
| Authors | Salvador-Carulla, Luis , Martinez-Leal, Rafael , Poole, Miriam , SALINAS PÉREZ, JOSÉ ALBERTO, Tamarit, Javier , Garcia-Ibanez, Jose , Almenara-Barrios, Jose , ÁLVAREZ GÁLVEZ, JAVIER |
| External publication | No |
| Means | J. Ment. Health Policy Econ. |
| Scope | Article |
| Nature | Científica |
| JCR Quartile | 3 |
| SJR Quartile | 2 |
| JCR Impact | 1.406 |
| SJR Impact | 0.649 |
| Publication date | 01/09/2013 |
| ISI | 000324362200005 |
| Abstract | Background: Intellectual developmental disorder or Intellectual disability (ID) is a prevalent condition with a high impact along the life-span particularly when associated to other mental disorders (MD).\n Specific Aim: To estimate the unmet needs and to design a knowledge to action plan to reduce the care gap in ID-MD in Spain.\n Method: We followed a 5-step \'maxi\' impact assessment and a mixed qualitative/quantitative design including expert panels, secondary analysis of databases and a prospective survey in the 17 regions in Spain. Schizophrenia was used as comparator due to similar prevalence rates and burden.\n Results: Persons with ID-MD had ten times less outpatient contacts and hospital admissions than patients with schizophrenia. The outpatient case load was 2.31% in ID and 14.6% in schizophrenia. ID had the lowest hospitalization rate amongst all mental disorders but the highest length of stay. The expert panel estimated that half of persons with ID-MD are not adequately assessed and 95% do not receive the required care in Spain. Basic care needs include 6.5 beds and an ID-MD outpatient service per 1 million population. At least 134 specialized psychiatrists and psychologists and 277 beds are needed to reach the minimum standards in Spain.\n Conclusion: This study quantifies the ID-MD care gap in Spain and the basic specialized services needed. In spite of the societal and health implications of ID-MD the knowledge-to-action plan had a modest impact limited at the regions where ID-MD programmes were already implemented.\n Implications for Health Policy: Specific priority setting on ID-MH should be incorporated to mental health strategy at the Ministry of Health within a broader health and ID plan. National and regional policies should incorporate an integrative care approach through the life cycle. The development of excellence centers on ID-MD and a national observatory on this topic should be encouraged. |
| Universidad Loyola members |