(The consequences of avoiding the quality evaluation in mental health. A case study.

Quality gap in the public primary mental health services in Chile. Examples from a service data
analysis.

(The Paper Outline)

MsC. Jorge Luis Crespo Suarez

Dr. Raudelio Machin Suarez

Theoretical Discussion of background:

 The relevance of measurement of quality in mental health services.

o Problems of measurement. Advantages and promises of the measurement of the
quality.
o Measurement in primary health services. Measurement in public system services
of mental health.
o The consequences of avoiding the quality evaluation I mental health.

Case Study.

 To illustrate different problems using a few cases or partial data.

o Early medicalisation:
 Quick diagnosis (misdiagnosis, multiple diagnosis).
 Users are diagnosed at the very first encounter.
 Patients tend to receive multiples diagnoses during the treatment
time.
 Hasty pharmacotherapy.
 Most patients are prescribed medication.
 Most of them at the very first encounter.
o Long-term treatments and pharmacotherapies.
 Insufficient frequency of medical interventions.
 Patients sticks to services for long periods.
 Fulfilling the treatment as a goal, instead of accomplishing a goal through
a treatment: prescriptions never end.
o Uncontrolled control
 A massive and authoritarian service:
 Automatic entry to the mental health program.
 Lack of negotiation, acceptance and agreement with patients on
intervention modalities, characteristics and regimen. (Users
participation).
 So, what’s going on:
  Lack of systematic data on the program population
 Lack of systematic data on the program interventions
 Lack of information on individual treatments
 Lack of follow-ups.
 The massive way out: to dropout.