[Evidence based community psychiatric community health care services in Germany: taking inventory].
OBJECTIVE
One of the outcomes of reforming mental health care in Germany has been the establishment of a range of community mental health services. However, current evidence for the effectiveness of these services is slight. Based on a literature search this article provides a systematic overview of empirical research in this sphere. In detail, social psychiatric services, crisis centres, psychosocial contact points, day care centres, and various models of supported housing and work/employment are assessed. Available results on effectiveness are classified according to their level of scientific evidence.


RESULTS
The current state of research is characterised by the situation that effectiveness of the care approach provided by social psychiatric services and some types of supported housing and work/employment has been demonstrated at a medium level of scientific evidence. In contrast, the evidence level of mental health care provided in crisis centres, psychosocial contact points, and day care centres is poor.


CONCLUSIONS
The major reasons for this lack of research are: heterogeneity of care models and staffing levels in the different community mental health services, lack of standardised documentation and reporting system in these services, and lack of research culture to utilise routine outcome data. The consequences of aiming at increasing the level of scientific evidence in this sphere would be to intensify funding of research projects and to implement high quality research designs such as randomised controlled trials.
Kallert
T W
TW
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden. thomas.kallert@mailbox.tu-dresden.de
Leisse
M
M
Kulke
C
C
Kluge
H
H
D002986:Clinical Trials as Topic / Q000379:methods*; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012107:Research Design