Anna García-Altés, Head of the Catalan Health System Observatory
This report presents the results of all SISCAT mental health centres for 2014. This year, the structure of the report is slightly different from previous years. It deals with fewer topics but in a more concrete, in depth manner. A special effort has been made to include new indicators such as the age of the first visit, or the percentage of patients with Severe Mental Disorders (SMD) in the AMHC requiring hospitalization during the year. However, The tables with the values of all indicators centre by centre -the distinguishing feature of the Results Centre- remain. As in previous years, all reports include innovative experiences that provide good care results, included in the Observatori d’Innovació en Gestió de la Sanitat in Catalonia as well as the experts’ opinions.
During 2014 the Adult Mental Health Centres (AMHC) have treated 169,919 people, representing 2.5% of the total population of Catalonia. The average number of visits per beneficiary was 6.5. From this total, 55,963 patients are new cases, representing 0.9% of the Catalan population. All these indicators remain without any significant changes during the last 3 years. Patients with SMD represent one third of the attended people and almost half of the total number of visits. The percentage of SMD in AMHC requiring hospital admission during the year went from 10% in 2012 to 8% in 2014. This result suggests a marked improvement in the overall functioning of mental health facilities, especially with regard to AMHC. However, the percentage of hospitalized patients who have been treated at an AMHC during the year of hospitalization, one of the new indicators in this report, is 70% and should be close to 100%. The reasons that could explain this 30% would be the referral to the private network, deficiencies in the referral system between hospitals and AMHC or the existence of a more fragmented system with zoning issues. 1.5% of patients suffering from schizophrenia have been prescribed multiple medications detected in the previous report. 88.8% of patients with bipolar disorder have been prescribed mood stabilizers during 2014; professionals showed a good adherence to treatment guidelines and good pharmacological management.
As for the hospitalization services for adults patients with mental health problems, in 2014 the psychiatric hospitals and psychiatric services for adults registered a total of 16,449 patients, a value almost identical to 2013. Readmissions at thirty days remain low but rose from 5.3% to 7.0%. As for the subacute, in 2014 there have been 2,998 admissions, with an average stay of 63.2 days, instead of the 67.2 days of 2013. The 30-day readmissions have been 3.6%.
The Children and Youth Mental Health Centres (CYMHC) in 2014 attended to 59,570 people, 7% more than last year. This volume of attended people represents 3.9% of the Catalan population under the age of 18, who averaged 6.2 visits per year. Of the total population treated, 25,136 patients correspond to new cases, 1.8% of the Catalan population of this age group. In the last six years, the total number of people served in CYMHC has grown by 27.6%. One out of every 8 patients attended in a CYMHC suffers from a serious mental disorder, 53% more than in 2009. The increase in the number of SMD treated in CYMHC suggests better detection and better prognosis. Meanwhile, ADHD is the most common diagnosis and is present in one out of every four patients treated. Among the prioritized emerging diseases, the autistic spectrum disorders are notable, accounting for 8.4% of attended children (which is an increase of 12% compared with 2013). The child and youth area is where family treatment is necessary and effective. In this sense, 50.1% of the families of patients attending CYMHC have assisted the visits specified as familiar treatment during 2014. However, the variability between centres suggests that some of them routinely incorporate such intervention in their treatment plans, while others still have room to increase the percentage of this type of intervention.
In 2014, the psychiatric hospitals and psychiatric services in acute hospitals performed a total of 1,331 admissions of patients under the age of 18. 17.1% of hospitalizations were SMD (16.1% in 2013), 12.3% for eating behaviour disorder (12.3% in 2013) and 9.3% for behaviour disorders (9.3% in 2013). The percentage of emergency admissions rose from 53.1% in 2013 to 58.5% in 2014.
Similarly to last year, the analysis of the results of this report can be deepened by the Results Centre application and by the dynamic calculation sheets available on the Observatory’s website (http://observatorisalut.gencat.cat), as well as by consulting open data files that meet the W3C international standards available to public on the Generalitat de Catalunya website: http://dadesobertes.gencat.cat/ca).
This report, and all the presented data, can be found on the Observatory’s website: http://observatorisalut.gencat.cat