Use of the European Classification of Services ‘DESDE-LTC 2.0’ for mapping and planning mental care in two areas of Spain (Gipuzkoa and Bizkaia)

Abstract

Background/Objectives PSICOST in cooperation with the Mental Health Departments of Gipuzkoa and Bizkaia produced the first Mental Health Atlas in these areas based on the DESDE-LTC 2.0 classification system. The toolkit allowed for the collection of exhaustive and standardized information on the typology and functioning of services based on the territory. This information is essential for the evaluation and planning of mental health care based on evidence-informed knowledge and useful for national and international comparisons. Methods DESDE-LTC 2.0 together with geographical techniques have been used to assess availability, accessibility, adequacy of provision and use of mental health care services for all age groups (child/adolescents, adults, elderly) provided by different departments (Health, Social, Justice, Education). Information was gathered through a template to be filled by services and available health databases. Results The Atlas includes a standardized service inventory with 152 entries for Bizkaia and 139 for Gipuzkoa mainly focused on community care. Furthermore, it has been possible to identify other units of analysis that lack organization stability such as long term or short term programs that were not included in previous versions of the classification system and provide useful information about the organization of the services in the area. A set of maps with services distribution and zoning, utilization of mental health centres and hospital services, and accessibility has also been included. Results show a tendency of services clustering in high density areas in Bizkaia, unlike Gipuzkoa that shows a more spread out provision. Finally, comparisons with other territories in Spain have been carried out reflecting an adequate availability of different types of care except for an excess of long term hospitalization care. Discussion/Conclusion DESDE-LTC 2.0 was useful for the development of an integral Mental Health Atlas in Gipuzkoa and Bizkaia, as it was possible to assess mental care services offered by different providers and not only by the health system. There was an identification of standardized types of care independently of the official name of the service. It was also possible to identify different units of analysis not assessed previously. The Atlas provides useful information for decision making in health policy based on evidence-informed.