ABSTRACT
PURPOSE: This study aims to evaluate the quality of the Finnish clinical practice guideline related to schizophrenia care and how it can be utilized in psychiatric services. PARTICIPANTS AND METHODS: The data were collected from one psychiatric ward and seven psychiatric outpatient units situated in two cities in Southern Finland. A total of 49 professionals working in these sites participated in this study. A descriptive study design was adopted. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument with six domains including 23 items was used to assess the quality of the guideline, whereas a vignette was implemented to describe how staff would use the guideline in hypothetical cases in daily practice. The analysis of AGREE II was based on rating each of the 23 items on a seven-point scale and calculating a quality score for the six domains. To describe the utilization of the guideline, eight key recommendations of the guideline were deductively rated out of the respondents' answers. RESULTS: The results showed that the "scope and purpose" of the guideline were well described, but "applicability" was insufficient. The overall quality of the guideline was high (73%). Almost one fifth of the respondents were in agreement with key recommendations. CONCLUSION: The overall quality of Guideline for Schizophrenia was good, but its "applicability" and utilization should be improved.
ABSTRACT
OBJECTIVE: High-quality mental health care requires written strategies to set a vision for the future, yet, there is limited systematic information available on the monitoring and evaluation of such strategies. The aim of this nationwide study is to evaluate local mental health strategies in community-based mental health services provided by municipalities. DESIGN AND SETTING: Mental health strategy documents were gathered through an online search and an e-mail survey of the local authorities of all Finnish mainland municipalities (n = 320). PARTICIPANTS: Out of 320 municipalities, documents for 129 municipalities (63 documents) were included in the study. INTERVENTION: The documents obtained (n = 63) were evaluated against the World Health Organization checklist for mental health strategies and policies. MAIN OUTCOME MEASURES: Evaluation of the process, operations and content of the documents, against 31 indicators in the checklist. RESULTS: Out of 320 Finnish municipalities, 40% (n = 129) had a mental health strategy document available and 33% (n = 104) had a document that was either in preparation or being updated. In these documents, priorities, targets and activities were clearly described. Nearly all (99%) of the documents suggested a commitment to preventative work, and 89% mentioned a dedication to developing community-based care. The key shortfalls identified were the lack of consideration of human rights (0%), the limited consideration of research (5%) and the lack of financial planning (28%) to successfully execute the plans. Of the documents obtained, 60% covered both mental health and substance abuse issues. CONCLUSIONS: This study contributes to the limited evidence base on health care strategy evaluations. Further research is needed to understand the potential impact of policy analysis.
