[Service structure and cooperation in mental health care].
BACKGROUND
This study assesses exemplarily the regional structure of mental health services and the practice of cooperation of mental health service providers. The aim is to identify starting points for improving mental health care.


METHODS
(1) Mapping of mental health services in four exemplary regions (urban/rural, East/West Germany) using the European Service Mapping Schedule. (2) Analysis of the practice of cooperation in mental health care using focus groups and a postal survey of psychiatrists and psychotherapists working in private practice.


RESULTS
All surveyed regions have a well-developed and complex service system available. Cooperation in mental health care takes place in flexible networks rather than in fixed relationships. An explicit concept of cooperation does not exist. Time and resources promote cooperation. Psychiatrists and psychotherapists working in outpatient care mainly cooperate among themselves and rarely on an interdisciplinary basis. In particular psychotherapists are usually not part of cooperation networks.


CONCLUSIONS
Improvements in mental health care are more likely to be achieved through improving cooperation rather than just developing additional services. Starting points for improvements include-beyond the increase of resources for cooperation - the training of medical students and psychiatrists in cooperation practice, reimbursement of cooperation and coordination and the implementation of systematic coordination of service networks.
Klinik und Poliklinik für Psychiatrie, Universitätsklinikum Leipzig, Semmelweisstr. 10, 04103 Leipzig, Deutschland. carsten.ungewitter@notraces.net
C
C
Ungewitter
D
D
Böttger
J
J
El-Jurdi
R
R
Kilian
C
C
Losert
K
K
Ludwig
V
V
Steinkohl
A
A
Bramesfeld
D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007373:Interinstitutional Relations; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D017146:Models, Organizational; D015995:Prevalence