2. Minimum Psychiatric Summary Ministry of Social Affairs, Public Health & Environment. Belgium Ph. Corten, P. Gerits, JP Gorissen, M. Sueten

3. MPS: Aims & context Since: 1996 July 1st Who: –All Belgian psychiatric institutions –All hospitalized patients Records: –Continue –Discontinue Aims: –inventory of provided care –to develop Public Health policy –stimulate evaluation of Quality of Care

4. Belgium 10 million inhabitants Hospitals: –62 psychiatric units of general hospitals (PUGH) –72 psychiatric hospitals (PH) Number of beds: –19 261

5. MPS Content Admission Life Unit Discharge file 1: How? file 2: Who? file 3: Diagnosis? file 4: admission at the unit Problems & Objectives? file 9: temporary discharge Why & Length ? files 5, 6, 7, discharge of the unit Care & Control ? Cure & Evaluation? Diagnosis ? file 10: Problems? Follow-up ? Objectives ? Where?

6. MPS: first national feedback Data: –from July 1, 1996 –to December 31, 1996 Report: –part 1: Prevalence all patients hospitalized the 31 of December –part 2: Incidence all patients discharged during the period

7. Part 1: Prevalence day (12/31/96) 19.116 patients –1–19 261 beds –(–(99% occupation) 32% not planned mean of age: –4–48 years (+ 18) gender: –5–53% women, 47% men

8. Who intervenes for the hospitalization? Professional same institution –Psychiatric units of General Hospitals (PUGH): 41% –Psychiatric hospitals (PH): 18%

9. Prevalence day: DSM IV Schizophrenia Mood disorders Substance related disorders Personality disorders = 82% PH= Schizophrenia PUGH = Mood disorder = 1/2 GAF-score: –1/2 patients < 40 –median: PUGH: 43 PH: 38

10. Part 2: Incidence 38.990 hospitalizations –42% depression –27% alcohol –24% anxiety –27% partner rel. prob. –21% work prob. –21% spare-time prob. Care: –31% stimulate to wake- up / sleep –25% stimulate to hygiene –> 75% no direct help

11. Discharged patients Controls: –48.5% basic functions –47% exit control –32% exit forbidden –26% use of substances Risk situation: 22,4% –3.5% individual control –3% separation –4% contention –4% isolation room

12. Discharged patients Evaluations –82% nursing eval. –82% team meeting –66% somatic ex. –61% mental ex. –58% biological –57% social –50% coordination –45% neurophysiological –20% psychological tests –13% others –9% protocol –6% justice –2% orthophonist eval.

13. Discharged patients Relational treatments (at least 1/week) –7–77% counseling –4–41% occupational therapy –3–34% socio-cultural activities –3–34% cognitive training –3–32% psychotherapy –3–31% psychomotricity 31% Community –2–26% DLA training –2–23% group therapy –1–18% family therapy –6–6% sheltered workshop –3–3% psychopedagogy –1–1% orthophonist

14. Psychotropic drugs in 85%. > 50% –anxiolytics –antidepressive drugs –neuroleptics –hypnotics –somatic medication < 10% –long acting neuroleptics –thymostabilizators

15. Conclusions quality of data: –diagnosis –cares in general: –control –psychotropic drugs relational treatment: –counseling –occupational