title: [Care programmes at mental health centres: the degree of adherence in the first phase of treatment].
abstract: BACKGROUND
  Most mental health providers in the Netherlands have implemented programmes of care. However, little is known about the extent to which care programmes are adhered to in routine clinical practice.
  
  
  OBJECTIVE
  To investigate the extent to which care programmes are adhered to in routine clinical practice.
  
  
  METHODS
  For three consecutive years we randomly selected 100 patients with a unipolar mood disorder, anxiety disorder or somatoform disorder and investigated retrospectively the extent to which care programmes were actually implemented in the first phase of treatment. We used a set of clinical process indicators based on the care programmes. The investigation took place on the premises of one of the 'Rivierduinen' mental health providers. We used patient records and data collected by means of routine outcome monitoring (ROM).
  
  
  RESULTS
  Over the three years under study scores for most of the indicators ranged from fair to good. Scores were lower for the indicators 'ROM follow-up measurements' and 'frequency of psychotherapy'. Only the number of routine measurements of the severity of the psychopathology in the diagnostic phase appeared to have increased significantly over the three years under study.
  
  
  CONCLUSIONS
  On the premises of the mental health care provider Rivierduinen where the study was conducted, care programmes during the first phase of treatment for mood disorder, anxiety disorder and somatoform disorders were adhered to reasonably well. Further research will have to concentrate on the subsequent phases of treatment. Another important matter that requires investigation is the relationship between the use of care programmes in daily practice and treatment outcomes.
authors.affiliation: afdeling Psychiatrie, Leids Universitair Medisch Centrum (LUMC), Leiden. e.m.vanfenema@lumc.nl
authors.forename: E M
authors.initials: EM
authors.lastname: van Fenema
authors.forename: N J A
authors.initials: NJ
authors.lastname: van der Wee
authors.forename: E
authors.initials: E
authors.lastname: Onstein
authors.forename: F G
authors.initials: FG
authors.lastname: Zitman
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011787:Quality of Health Care; D016896:Treatment Outcome