ASSESSING THE IMPACT OF MENTAL-HEALTH-PROGRAMS UPON COMMUNITY - THE PERSPECTIVES OF PRIMARY CAREGIVERS AND CONSUMERS

Since 1985, there has been a significant movement in Spanish mental he alth services away from provision of care in psychiatric hospitals and toward a community mental health model (CMMH). This reform has ushere d in changes not only for the patients but also for both their relativ es and their primary caregivers. However, no survey has ever been carr ied out to obtain these parties' perceptions of the CMMH. Two studies have now been designed to describe the acceptability of the CMMH to th ese two key groups. The goals of the two projects were, firstly, to as sess the opinions of primary care professionals about CMMH and, second ly, to sample the opinions of the patients' relatives regarding mental health care. In the first survey, 884 primary caregivers (general pra ctitioners (GPs), pediatricians, nurses and social workers) filled out a 14-item questionnaire with a five-point response scale. Several asp ects of care were evaluated: accessibility, referral facilities, thera peutic support, training or teaching activities, communication between primary care and mental health professionals for their mutual collabo ration, and appropriateness of resources. Most of the primary caregive rs reported that the community psychiatric model improved accessibilit y, treatment and communication between the different levels. Nurses an d pediatricians reported dissatisfaction with the CMMH. In the second survey, the satisfaction of patients' relatives with the services prov ided by the therapists was assessed, using the Satisfaction with Thera pist Questionnaire (STQ). The STQ consists of 15 items with a three-po int response scale. Amount and adequacy of the information provided, a ccessibility, and style of conducting the appointment were assessed as measures of satisfaction. A sample of relatives of schizophrenic pati ents was surveyed by mail (76 relatives answered, a response rate of 3 1.13%). In summary, relatives were satisfied with therapists' competen ce but dissatisfied with their communication skills. (C) 1997 Elsevier Science Ltd.