DEMoBinc
Development of a European Measure of Best Practice for People with Long Term Mental Illness in Institutional Care
Duration in months: 36
Official start date: 01/03/2007
Study Completed: 28/02/2010
Funder: European Commission
Call (part) identifier:
FP6-2006-SSP-5A (8.1.B.2.1) Health determinants and the provision of
high quality and sustainable health care services and pension systems
Activity code: Policy orientated research “policy support anticipating scientific and technological needs”
Research objectives of call:
to develop a methodology for the assessment and review of the living
situations, care and treatment practices in psychiatric and social care
institutions for mentally ill and disabled persons in the European
Union, with a particular focus on human rights, the protection of the
dignity of residents, the use of restraint and the scope for health
promoting measures.
Call topic: human rights and mental well being of people living in psychiatric and social care institutions in Member States.
Call strategic objectives: to improve the understanding of health determinants.
Study abstract
This
study sought to develop a toolkit for assessing the quality of care in
longer term mental health facilities in European countries, based in
hospital and the community. Internationally agreed domains were
developed through a systematic review of the international literature, a
review of national or regional care standards across the ten partner
countries and the results of Delphi exercises with key stakeholder
groups (service users, carers, mental health professionals and
advocates) in partner countries. The toolkit was refined through the
course of the study to maximise a) its reliability b) its usability c)
its ability to deliver assessments that translate into action plans
within each country’s established systems of change at local, regional
and national level. A health economic analysis was conducted to examine
the toolkit’s ability to provide sufficient information for an
assessment of an institution’s “value for money”. The toolkit was also
cross-validated against service users’ quality of life, autonomy and
markers of recovery to test whether it could deliver a proxy-measure of
the promotion of individuals’ human rights and recovery.
The
final product of the project is a web based toolkit called the Quality
Indicator for Rehabilitative Care (QuIRC) which assesses the living
conditions and care that a unit provides and the degree to which it
promotes the human rights and social inclusion of its residents. The
QuIRC is a self-report tool completed by the unit manager. It uses a
computerised algorithm to produce individualised, printed reports which
detail the unit’s performance on seven domains of care (living
environment; therapeutic environment; treatments and interventions;
promotion of service users’ self-management and autonomy; promotion of
service users’ human rights; promotion of service users’ contact with
family and community/social inclusion; the degree of Recovery based
practice). These are plotted on a radar chart and the results for
similar units in the same country are also shown for comparison. Further
text provides more detail about the results and the areas of care the
unit could focus on to improve their results.
Participating centres and research partners
Co-ordinator: Dr Helen Killaspy (University College London, UK)
Principal contractors:
1. Christine Wright (St George’s University, London UK)
2. Professor Dr.Thomas Kallert (Dresden, Germany)
3. Professor Jorge Cervilla (Granada, Spain)
4. Professor Jiri Raboch (Prague, Czech Republic)
5. Dr Georgi Onchev (Sofia, Bulgaria)
6. Professor Giuseppe Dell’Acqua (Trieste, Italy)
7. Professor Durk Wiersma (Groningen, Netherlands)
8. Professor Andrzej Kiejna (Wroclaw, Poland)
9. Associate Professor Dmitris (Athens, Greece)
10. Professor Jose Caldas de Almeida (Lisbon, Portugal)
For more information about this study please contact the Co-ordinator, Dr Helen Killaspy (h.killaspy@medsch.ucl.ac.uk)
Diagrammatic representation of study methodology
Publications:
Killaspy, H., King, M., Wright, C., White, S., et al. Study protocol for the development of a European measure of best practice for people with long term mental illness in institutional care (DEMoBinc). BMC Psychiatry, 2009, 9:36
Taylor, T.L., Killaspy, H., Wright, C., Turton, P., et al. A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problemsStudy protocol for the development of a European measure of best practice for people with long term mental health problems in institutional care (DEMoBinc). BMC Psychiatry 2009, 9:36
Turton, P., Wright, C., White, S., Killaspy, H., et al. Promoting recovery in long term mental health institutional care: an international Delphi study of stakeholder views. Psychiatric Services, 2010, 61(3), 293-299.
Kalisova L., Raboch J., Wright S, Turton P, et al. Which components of care are important for recovery of long term mentally ill patients? Project DEMoBinc. Czech Republic. Proceedings of the XIVth WPA conference, Prague 20-25 September 2008. J Czech Slovac Psychiatry, 2008; 104 (suppl 2): 1349 ISSN 1212-0383
Cardoso G, Coelho C, Caldas de Almeida J. The DEMoBinc Study in Portugal: development and first results. European Psychiatry, 2009; 24/Suppl 1:S171.
Across the consortium there are plans for more than 20 further papers to be prepared for publication in peer reviewed journals. These include the development of the toolkit, reliability testing and factor analysis (Phase 2), the correlation of toolkit domain ratings with service users’ experiences of care (Phase 4), international differences in quality of institutional care (Phase 4), the value for money provided by the institutions assessed in the DEMoBinc study (Phase 5), international differences in human rights and recovery based practice, determinants of social functioning in institutional care, levels of victimisation in institutions across Europe, and the national results of the Delphi exercises, quality of care and service user experiences across each country.
Presentations at conferences
A
number of presentations have been made at national and international
conferences about the DEMoBinc study by members of the consortium:
- European Network for Mental Health Service Evaluation (ENMESH) annual conference, Krakow, Poland, May 2008.
- London Mental Health Research Network annual conference, June, 2008 and January 2010.
- World Psychiatric Association conference, Prague, September 2008
- Royal College of Psychiatrists’ Faculty of Rehabilitation and Social Psychiatry, annual conference, Prague, November 2008
- European Psychiatric Association Congress of Psychiatry, Lisbon, January 2009.
- Expert seminar of WHO, Czech Republic, February 2009
- International seminar for the European Commission and World Health Organisation on “Destigmatisation and Improving the Quality of Care in Psychiatry”, Prague, Czech Republic, May 2009.
- Royal College of Psychiatrists annual conference, Liverpool, UK, June, 2009
- International Mental Health Collaborating Network conference, Copenhagen, October 2009
- Royal College of Psychiatrists Rehabilitation Faculty annual conference, Prague, November 2009.
- Assessment of quality of care in psychiatry in Czech Republic; 1st Congress: Treatment in Psychiatrii, Karlovy Vary, November 2009
- National Conference on Rehabilitation, IV Jornadas sobre Reabilitação, Casa de Saúde do Telhal, Telhal, November 2009.
- Rob Giel Research Center conference. Assen, Netherlands, November 2009
- Annual Conference of the Bulgarian Psychiatric Association (BPA), 2009.
- Hellenic Psychiatric Association, 2009
- International conference on “What is mental health?” Trieste, Italy, February, 2010
- Annual Conference of the Czech Psychiatric Association, Spindleruv Mlyn, Czech Republic, June 2010.
Links to related research:
HELPS - European Network for Promoting the Health of Residents in Psychiatric and Social Care Institutions
http://www.helps-net.eu/
HELPS
is an interdisciplinary European network that aims at (i) gathering
relevant knowledge on physical illness in people with mental illness,
(ii) identifying health promotion initiatives in European countries that
meet country-specific needs, and (iii) at identifying best practice
across Europe. HELPS will develop and implement a "physical health
promotion toolkit", which will provide information to empower residents
and staff to identify the most relevant risk factors and to select the
most appropriate action.
ITHACA - Institutional Treatment, Human Rights and Care Assessment
http://www.ithaca-study.eu/
In
the framework of a European Commission funded project the ITHACA
toolkit was developed by users and professionals in order to provide a
clear and practical way of monitoring human rights and general health
care in psychiatric and social care institutions across Europe. It is
anchored in several recently published international documents. The
ITHACA toolkit covers 30 areas, such as access to and involvement in the
development of care plans, involuntary commitment, correspondence and
visitors, and access to general health care. It is available in 13
languages.
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Phase 1
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Phase 2
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Phase 3 Refinement of toolkit through consensus agreement of international expert panel and researchers in response to:
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Phase 4
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Phase 5
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Phase 6 (ongoing)
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