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Breakdown of continuity in public mental healthcare in the Netherlands: a longitudinal case study

Authors:

André Wierdsma ,

Erasmus MC, NL
About André

Assistent professor
O3 Research centre mental healthcare Rijnmond
Department of Psychiatry
Erasmus MC Rotterdam

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Meta van der Schee,

NL
About Meta van der
senior medical nurse and social worker, Municipal Health Department Rotterdam-Rijnmond, PO Box 70032, 3000 LP Rotterdam, the Netherlands
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Cornelis L. Mulder

NL
About Cornelis

MD, PhD, psychiatrist, professor of public mental healthcare, Erasmus MC, teacher in BavoEuropoort Centre for Mental Healthcare, and program coordinator O3 Research Centre Mental Healthcare Rijnmond, PO Box 2040, 3000 CA Rotterdam, the Netherlands

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Abstract

Introduction: Continuity of care for long-term service-dependent patients in the public mental health system requires intensive collaboration between all agencies involved. Understanding the ways in which various aspects of continuity of care interact may reveal help to find out more about how care de­livered over time improves outcomes.

Case study: Based on medical records, an addicted couple was monitored for number and type of contacts with health and social services. Over the years, 81 social workers or nurses, spread over 25 health and social services, have been involved in the rehabilitation process. Breakdown of continuity of care is linked to lack of information, missing procedures and guidelines, fragile relationships with the patient, and a reluctant public health approach.

Conclusion: Prominent among relevant factors is the absence of protocols governing the transfer of patients between the various links in the continuum of mental healthcare services. High-quality follow-up after admission is partly a matter of professional principle in ensuring that problems in the chain of services are discussed. Case presen­tation in psychiatric journals should give syste­matic at­ten­tion to sources of error in continuity of mental health­care.

How to Cite: Wierdsma A, Schee M van der, Mulder CL. Breakdown of continuity in public mental healthcare in the Netherlands: a longitudinal case study. International Journal of Integrated Care. 2011;11(3):None. DOI: http://doi.org/10.5334/ijic.648
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Published on 16 Sep 2011.
Peer Reviewed

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