Transferring psychiatric specialist services to local authorities - Characteristics of the patients
involved
Sammanfattning
Background: To obtain more co-ordinated services, better co-operation between the services and
more efficient use of resources, a pilot project for transferring some district psychiatric centres
(DPCs) to large municipalities is planned by the Norwegian government. Systematic knowledge about
the patients involved is needed when clinical needs and standards, funding, and political agendas
are discussed. This study identifies the clinical, socio-demographic, and behavioural characteristics
of patients who need services from both the municipality and the DPC.
Method: A national mapping of patients in specialist mental health services was conducted in
2012/2013, including 65% of all inpatients (n = 2358) and 60% of all outpatients (n = 23-124). The need
for services was assessed by each patient’s clinician.
Results: It was found that 74% of inpatients and 43% of outpatients needed one or more services from
the municipality, usually involving housing, mental health treatment/therapy, or economic support
according to their clinicians. These were typically patients with severe mental illness, young
inpatients, older outpatients and persons with low education and weak social networks. Only small
differences in the need for municipal services were found between patients in hospitals and DPCs.
Conclusions: Many of the patients in specialist mental health services, especially the inpatients,
needed services from municipal social and health services. Because these patients had the most
severe mental illnesses and were the most socially deprived, a stronger integration of service levels
would potentially benefit these patients most. The pilot project should be evaluated to identify the
consequences for patients, staff, quality of services, and costs of transferring services to a lower
system level.