Department of Mental Health - Manzoni Hospital,Lecco,Italy.
Centre de recherche de l'Institut Universitaire en Santé Mentale,Université de Montréal,Montreal,Canada.
Epidemiol Psychiatr Sci. 2017 Aug;26(4):383-394. doi: 10.1017/S2045796016000743. Epub 2016 Oct 26.
Information is crucial in mental healthcare, yet it remains undervalued by stakeholders. Its absence undermines rationality in planning, makes it difficult to monitor service quality improvement, impedes accountability and human rights monitoring. For international organizations (e.g., WHO, OECD), information is indispensable for achieving better outcomes in mental health policies, services and programs. This article reviews the importance of developing system level information with reference to inputs, processes and outputs, analyzes available tools for collecting and summarizing information, highlights the various goals of information gathering, discusses implementation issues and charts the way forward.
Relevant publications and research were consulted, including WHO studies that purport to promote the use of information systems to upgrade mental health care in high- and low-middle income countries.
Studies have shown that once information has been collected by relevant systems and analyzed through indicator schemes, it can be put to many uses. Monitoring mental health services, represents a first step in using information. In addition, studies have noted that information is a prime resource in many other areas such as evaluation of quality of care against evidence based standards of care. Services data may support health services research where it is possible to link mental health data with other health and non-health databases. Information systems are required to carefully monitor involuntary admissions, restrain and seclusion, to reduce human rights violations in care facilities. Information has been also found useful for policy makers, to monitor the implementation of policies, to evaluate their impact, to rationally allocate funding and to create new financing models.
Despite its manifold applications, Information systems currently face many problems such as incomplete recording, poor data quality, lack of timely reporting and feedback, and limited application of information. Corrective action is needed to upgrade data collection in outpatient facilities, to improve data quality, to establish clear rules and norms, to access adequate information technology equipment and to train health care personnel in data collection. Moreover, it is necessary to shift from mere administrative data collection to analysis, dissemination and use by relevant stakeholders and to develop a "culture of information" to dismantle the culture of intuition and mere tradition. Clinical directors, mental health managers, patient and family representatives, as well as politicians should be educated to operate with information and not just intuition.
信息在精神卫生保健中至关重要，但利益相关者对其重视不足。信息的缺失破坏了规划的合理性，使得服务质量改进的监测变得困难，阻碍了问责制和人权监测。对于国际组织（例如世卫组织、经合组织）而言，信息对于在精神卫生政策、服务和规划方面实现更好的结果是不可或缺的。本文参考投入、过程和产出，审查了开发系统级信息的重要性，分析了收集和总结信息的现有工具，突出了信息收集的各种目标，讨论了实施问题，并为未来指明了方向。
查阅了相关出版物和研究，包括世卫组织旨在促进使用信息系统来提升高收入和中低收入国家精神卫生保健的研究。
研究表明，一旦相关系统收集了信息并通过指标计划进行了分析，就可以将其用于多种用途。监测精神卫生服务是使用信息的第一步。此外，研究还指出，信息是许多其他领域的主要资源，例如对照循证护理标准评估护理质量。在可能将精神卫生数据与其他健康和非健康数据库联系起来的情况下，服务数据可以支持卫生服务研究。需要信息系统来仔细监测非自愿入院、约束和隔离情况，以减少护理机构中的侵犯人权行为。信息还被决策者用于监测政策的实施、评估其影响、合理分配资金和创建新的融资模式。
尽管信息系统有多种应用，但目前仍面临许多问题，例如记录不完整、数据质量差、缺乏及时报告和反馈以及信息应用有限。需要采取纠正措施来升级门诊设施的数据收集、提高数据质量、建立明确的规则和规范、获取足够的信息技术设备并培训医疗保健人员进行数据收集。此外，需要将信息从单纯的行政数据收集转变为相关利益攸关方的分析、传播和使用，并培养一种“信息文化”，以打破凭直觉和传统行事的文化。临床主任、精神卫生管理人员、患者和家属代表以及政治家都应该接受教育，用信息而不是直觉来进行操作。
