World Health Organization World Health Organization Collaborating Center for Training and Research in Mental Health and in the Prevention of Substance Abuse

Mental Health Projects

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WHO Coordinated Multi Center Study of the Course and Outcome of Schizophrenia

The Center, in collaboration with WHO Geneva and Collaborating Centers in 17 countries, is participating in a follow-up study of patients whohad been in previous research studies of schizophrenia, such as the International Pilot Study of Schizophrenia (IPPS), the study on the Determinants of Outcome of Severe Mental Disorder (DOSMeD), and the study on Reduction and Assessment of Psychiatric Disability (RAPyD). In this study of the course and outcome of schizophrenia, patients have been assessed in their second decade after onset of psychosis. Key areas of this research have been the development of assessment instruments suitable for cross-cultural research and the continuing development of statistical methods for analyzing the data. Analysis of the data will focus primarily on cross national variation in etiology and course that are consistently apparent across nations.

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WHO Collaborative Project on Health and Social Services Utilization by the Mentally Ill

In an effort to assist mental health authorities within a wide range of infrastructures, socioeconomic conditions and technological resources, the Center has developed an approach to obtaining data on the characteristics of the health, mental health and social service networks in a defined area and on the patients with mental health problems who use these services. The methodology includes a survey to be conducted over a short time period during which data are collected on patients seen in a typical week in each setting. The purposes of the methodology are to:

  1. collect a standard set of data that describes each provider in an area who serves persons with mental health problems;
  2. collect a standard set of data that describes persons with mental health problems;
  3. provide an annualized estimate of the number and proportion of persons in the service system that have mental health problems and assess the costs to the services of dealing with such patients;
  4. generate information useful for planning, resource allocation, research and reporting to governing, regulatory and funding bodies. ]

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NKI/WHO Mental Health Information System

The WHO Center at NKI has developed and disseminates a microcomputer-based mental health information system designed to be used for planning, managing, evaluating, and delivering mental health services. The purposes of the system are to:

  1. collect a standard minimum data set on each patient that can provide a balanced picture of the population in treatment,
  2. generate information for planning, resource allocation, reporting to governing, regulatory and funding bodies, and
  3. provide the clinician or treatment team with basic information about a patient.

The System is designed to be used by personnel with limited familiarity with data processing technology and to be adaptable to local situations.The System collects data from individual facilities and allows for the aggregation of data to regional and national levels. Tracking of patients is possible in cases where individuals can be identified by a unique number such as a system-wide case number or a national identification number. The System has been translated into Chinese, Czech, Japanese and Spanish.

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Collaboration with the Pan American Health Organization (the WHO Regional Office for the Americas, AMRO)

Consultative visits and information/technology transfer activities with countries in the Americas are ongoing. Information management technologies, in general, and the information system developed by the Center, in particular, have been of interest to the governments and universities in the region.

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Collaboration with the People's Republic of China

Since 1993, the Center has been collaborating with the PeopleOs Republic of China in the development of a national mental health information system. These efforts included adapting the NKI/WHO Mental Health Information System to the needs of China, training visiting scientists, and providing continuous support to the project. In January, 1995, the Center was notified that the System has been approved by the Ministry of Health for use nationwide.

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Cost Effectiveness Analysis

Consultation on methods of conducting cost-effectiveness analysis is ongoing. Costing approaches are being adapted for application to countries with highly diverse economic profiles. A method for studying the cost-effectiveness of the treatment of depression in primary care settings has been proposed and has been circulated for review. Already developed is a research protocol that would refine the methodology which could then be applied to intervention studies for the purpose of assessing alternative treatment programs of depression in primary care settings. This observation/naturalistic study will help estimate the prevalence of depression and will assess the rate at which primary care physicians identify depression, the adequacy of treatment, the prognoses, the consequences of morbidity on public cost and the burden of depression. Also, the study aims to describe variations in service organization and pathways to care for depressive patients across countries.

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