The Evaluation Indicators Building For Community Mental Health Service

BackgroundWith the development of the society and the severity of competition, more and more people are living in stressful situations, which bring negative influence on their physical and mental health. Depression is among the leading causes of disability and affecting about121million people worldwide.45percent to75percent suicidal people are under depression. According to the China Association for Mental Health: There are currently over26million people are suffering from depression in our country, which brought about62billion financial burden each year. Besides, the harmful use of alcohol kills2.5million people each year. It was responsible for almost4%of all deaths in the world, according to the estimates for2004.Community is the place where people live and establish communication with each other. Developing community mental health service is important to the community residents for their adapting ability and the improvement of their mental health. We are still on the primary stage of the delivery community mental health service, and the national and local governments are seeking a variety of effective forms of community mental health service right now.However, there are still some questions need to answer during the development of community mental health service, such as whether the organization and mechanism is efficient, how’s the service is delivering and whether it works. At present, we has yet not establish a scientific, feasible evaluation indicator system for community mental health services, that will be an obstruction to the standardization and further development of the community mental health service.ObjectivesTo form a scientific, reasonable and systematic evaluation indicator system for community mental health services, so as to promote the standardization of the community mental health service and provide scientific basis and technical supports. MethodsLiterature ReviewRelevant literatures were collected, reviewed and summarized.Expert counseling method During establishing process of the evaluation framework and initial indicators set, experts were organized to conduct comprehensive discussion. The experts are from fields as diverse as community health, health management and mental health.Delphi methodDelphi method was used to screen the indicators from the initial indicators set according to their importance and feasibility. Positive coefficient, Kendall coefficient and authoritative coefficient were adopted to test the credibility of this study. Critical value method and experts meeting consultation were used to screen indicators.ResultsThe evalution indicator system is established based on the theory of Donabedian. Appropriate indicators were used to evaluate the community mental health service from three aspects:framework, process and outcome. The evaluation of framework is relating to "Government Support and Coordination","Network Building" and "CHS Support". The evaluation of process is relating to six aspects, while the evaluation of outcome is relating to "INDICATORSMental Health Condition" and "Mental Health Cognition".28experts were participating in the Delphi consultations. Positive coefficients of two expert consultations were87.5%and100%. Both Kendall coefficients of two expert consultations were showed significant differences, and the Kendall coefficient of the second expert consultation was0.466, which much higher than that of the first expert consultation. Authoritative coefficient of this study was0.7279.12indicators were excised, names of4indicators were changed, categories of2indicatores were changed and explanation of11indicators were perfected after the first expert consultation. After the second expert consultation,11indicators were excised. Finally, there are49indicators were left in the evalution indicator system for community mental health services, which includes3first-grade indicators,11second-grade indicators and35third-grade indicators.ConclusionIn accordance with the principles of establishing indicator system, this indicator system was established with theory analysis, expert counseling method, and Delphi method. The experts chosen from multiple disciplines were representative authoritative. After two times of counseling, they were reaching almost unanimity. Based on the high credibility, we can make the conclusion that the result of this study is rational and reliable.The evaluation indicator system for community mental health services, which were mainly composed of structural and process indicators, supplemented by appropriate outcome indicators, is set up and the indicators of this system is well-defined, hierarchy and comprehensive. According to this indicator system, an comprehensive and systematic evaluation on the current community mental health services can be conducted.