Treating mental diseases is a serious challenge, and some patients should receive long-term hospitalization and ongoing support. However, treatment procedures are constantly changing; for example, mental health questions have shifted from institutional to community settings. Moreover, the allocation of resources shifts to a format of payment for a unit of service instead of a charge for results. Such changes have a substantial impact on the deinstitutionalized severely mentally ill patients.
Transferring the patient from long-term hospitals to community care may be necessary during treatment. This process, known as deinstitutionalization, aims to enhance patients’ quality of life and promote their social integration (Fulone et al., 2021). At the same time, deinstitutionalization leads to negative consequences without properly established programs that support people, such as psychoeducation or combating stigma. Patients can face problems of homelessness, marginalization, risk of entering prisons, and similar issues (Fulone et al., 2021). The negative impact may increase due to the transition to a different resource allocation method.
Paying for the number of units of the service instead of the result can shift the focus to the quantity of work done rather than its quality. The pay-for-result method is designed to make sure that patients can have quality services that lead to improved health (Diaconu et al., 2021). Moreover, problems may arise if patients receive services unevenly, as various areas have contrasting conditions (Fulone et al., 2021). Employees have the opportunity to manipulate the number of services provided without regard for equal access.
Thus, changes to the approach to addressing mental diseases may not always have positive consequences. If care is transferred to the circumstances of communities and funding changes for the number of services, there is a risk for patients, including seriously ill individuals. They can become homeless or end up in correctional facilities without suitable treatment. As a result, additional assistance tools and programs are needed for patients with mental health problems in community settings.
References
Diaconu, K., Falconer, J., Verbel, A., Fretheim, A., & Witter, S. (2021). Paying for performance to improve the delivery of health interventions in low- and middle-income countries. The Cochrane Database of Systematic Reviews, 5(5), 1-44.
Fulone, I., Barreto, J. O. M., Barberato-Filho, S., Bergamaschi, C. D. C., Silva, M. T., & Lopes, L. C. (2021). Improving care for deinstitutionalized people with mental disorders: Experiences of the use of knowledge translation tools. Frontiers in Psychiatry, 12, 1-10.