[The third pillar of psychiatric health care reform].
OBJECTIVE
Coordination of all psychiatric services is essential for the successful implementation of community oriented services, particularly in a decentralised health system like the one in Germany. This study investigates which mechanisms are implemented for coordinating and planning psychiatric services throughout the 16 German States (Länder).


METHODS
Analysing mental health legislation and policy documents of the States. Guided expert interviews with the psychiatry departments of the State governments.


RESULTS
Coordinating and planning panels exist in all States on district level and in most States on State level for various tasks. Most of these mechanisms are implemented without legal obligation. 4 States have a mental health evaluation panel, which scrutinises all psychiatric services once a year and reports publicly to the government. 12 States have a mental health legislation and 13 States published a central psychiatric planning document.


CONCLUSIONS
The continous implementation of mechanisms for coordinating and planning psychiatric services in the German States represent the dynamics of psychiatric reforms there. The effect of these mechanisms on the implementation of community oriented psychiatric care should be subject to further research.
Bramesfeld
Anke
A
Abteilung Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Germany. bramesfeld.anke@mh-hannover.de
Wismar
Matthias
M
D005544:Forecasting; D005858:Germany; D018166:Health Care Reform / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006285:Health Planning / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006286:Health Planning Councils / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006291:Health Policy / Q000331:legislation & jurisprudence; D006301:Health Services Needs and Demand / Q000331:legislation & jurisprudence / Q000639:trends; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008605:Mental Health Services / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D009313:National Health Programs / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010348:Patient Care Team / Q000331:legislation & jurisprudence / Q000458:organization & administration; D011057:Politics; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence / Q000639:trends
Das dritte Standbein der Psychiatriereform - Strukturen der Koordinierung und Planung der psychiatrischen Versorgung in Deutschland -