Mental health care in Madrid.
OBJECTIVE
To describe principles and characteristics of mental health care in Madrid.


METHODS
Based on existing data, service provision, number of professionals working in services, funding arrangements, pathways into care, user/carer involvement and specific issues are reported.


RESULTS
In Madrid, mental health services are organized into 11 zones/areas, divided into 36 districts, where there is a mental health outpatient service with a multi-disciplinary team. Home treatment and psychosocial rehabilitation services have been developed. Specialist programmes exist for vulnerable client groups, including Children and Adolescents, Addiction/Alcohol and Older People. The Madrid Mental Health Plan (2003-2008) is regarded as the key driver in implementing service improvement and increased mental health and well-being in Madrid. It has a meant global budget increase of more than 10% for mental health services. Results of the first 2 years are: an increase in mental health staff employed (17%), four new hospitalization units, 50% increase in places for children and adolescents Day Hospitals, 62 new beds in long care residential units, development of specific programmes for the homeless and gender-based violence, a significant investment in information systems (450 new computers) and development of best practice and operational guidelines. Mental health system was put to the test with Madrid's March 11th terrorist attack. A Special Mental Health Plan for Affected people was developed.


CONCLUSIONS
Unlike some European countries, public mental health service is the main heath care provider. There are no voluntary agencies bcollaborating with mental health care. Continuity of care and coordination between all mental health resources is essential in service delivery. Increased demand of care for minor psychiatric disorders, children and adolescent mental health care, and implementation of rehabilitation and residential facilities for chronic patients are outstanding challenges similar to those in other European capitals. Overall, the mental health system had successfully coped with last year's increased care demand after March 11th terrorist attack in Madrid.
Ferre Navarete
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Officini Regional de Coordinacion de Salud mental, Consejeria de Sanidad de la Communidad de Madrid, Madrid, Spain. fferre.scsm@salud.madrid.org
Palanca
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D000293:Adolescent; D000328:Adult; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D002648:Child; D002947:Cities; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data / Q000639:trends; D019538:Health Care Surveys; D006291:Health Policy / Q000639:trends; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D010348:Patient Care Team; D011567:Psychiatric Department, Hospital / Q000639:trends; D011635:Public Health Administration; D013030:Spain; D019037:Urban Health Services / Q000458:organization & administration*