A comprehensive review of ecosystem research and context analysis in mental health care

Abstract

The role of context is critical in health services research. In health care, “context” could be defined as all sources of evidence of the local system: geographic, social and demographic factors, other environmental factors, service availability and scope, capacity, use, costs and the historical development of the health care system. The analysis of context of care of “healthcare ecosystem research” is an emerging discipline that should play a critical role in implementation sciences [1] and in the analysis of complex interventions [2, 3]. “Contextual evidence” has recently been identified as a major source of knowledge in health systems research together with experimental, observational, expert and experiential knowledge [4]. In spite of its relevance, the need for context analysis in health services and delivery research has not been sufficiently recognised [1, 2, 4]. One of the most widely used instrument in context analysis providing data on service availability is ESMS/DESDE (Description and Evaluation of Services and Directories for Long Term Care. This piece of research aims 1) to analyse available methods of context analysis and healthcare ecosystem research for standard description of mental health (MH)