title: Size matters - determinants of modern, community-oriented mental health services.
abstract: Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule-Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data, local data on unemployment rate, length of education, age of retirement, proportion of single households, alcohol sales and a composite mental health index were used as indicators of population mental health needs. Population size correlated strongly with service diversity, explaining 84% of the variance. Personnel resources did not associate with diversity or community orientation. The indicators of mental health services need did not have the expected association with quality and quantity of services. In terms of service organization, the results may support larger population bases, at least 150,000 adult inhabitants, when aiming for higher diversity.
authors.affiliation: Department of Psychiatry, University Hospital Region, Hospital District of Helsinki and Uusimaa, Välskärinkatu 12, FI-00029 HUS, Finland. taina.ala-nikkola@hus.fi.
authors.forename: Taina
authors.initials: T
authors.lastname: Ala-Nikkola
authors.affiliation: Department of Psychiatry, University Hospital Region, Hospital District of Helsinki and Uusimaa, Välskärinkatu 12, FI-00029 HUS, Finland. sami.pirkola@uta.fi.
authors.forename: Sami
authors.initials: S
authors.lastname: Pirkola
authors.affiliation: Department of Psychiatry, Hyvinkää Hospital Region, Hospital District of Helsinki and Uusimaa, Vanha Valtatie 198, FI-04500 Kellokoski, Finland. raija.kontio@hus.fi.
authors.forename: Raija
authors.initials: R
authors.lastname: Kontio
authors.affiliation: Department of Psychiatry, University Hospital Region, Hospital District of Helsinki and Uusimaa, Välskärinkatu 12, FI-00029 HUS, Finland. grigori.joffe@hus.fi.
authors.forename: Grigori
authors.initials: G
authors.lastname: Joffe
authors.affiliation: Department of Mental Health and Substance Abuse Service, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland. maiju.pankakoski@thl.fi.
authors.forename: Maiju
authors.initials: M
authors.lastname: Pankakoski
authors.affiliation: Department of Mental Health and Substance Abuse Service, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland. maili.malin@thl.fi.
authors.forename: Maili
authors.initials: M
authors.lastname: Malin
authors.affiliation: Department of Mental Health and Substance Abuse Service, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland. minna.sadeniemi@hus.fi.
authors.forename: Minna
authors.initials: M
authors.lastname: Sadeniemi
authors.affiliation: Hjelt Institute, Medical Faculty, University of Helsinki, FI-000014 Helsinki, Finland. minna.kaila@helsinki.fi.
authors.forename: Minna
authors.initials: M
authors.lastname: Kaila
authors.affiliation: Department of Mental Health and Substance Abuse Service, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland. kristian.wahlbeck@thl.fi.
authors.forename: Kristian
authors.initials: K
authors.lastname: Wahlbeck
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration / Q000592:standards; D005387:Finland; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data