Is the performance of an Integrated Mental Health Network related to its readiness for chronicity and/or structures?

Mental health is one of the areas in which integrated care is so relevant due to the great number of organisations that are involved in its provision: primary care, acute care, mental health centres, psychiatric hospitals, NGOs, social organisations,...Evaluation is key in order to know whether structures and processes are well coordinated among all the agents and patients are adequately approached and cared. The Bizkaia Mental Health Network (BMHN) has designed its Atlas of the mental health care system of Bizkaia (Basque Country) using the DESDE-2.0 methodology[1] so that all services for persons with mental health have been mapped. Structure and capacity are necessary but not enough inputs when it comes to achieving proactive, efficient and coordinated care. For that reason, the information stemming from the Atlas should be combined with information about its readiness to undertake processes to provide integrated care to cope with the challenge of mental health chronicity and with information on the expected outcomes for its patient populations so that an integral vision of the organisation can be drawn. Objective: To undertake a comprehensive evaluation scheme in the four geographical areas that make the Bizkaia Mental Health Network following the Donabedian evaluation principles based on structure, processes and outcomes. Methods: “Structure” is going to be assessed with the information provided by the Atlas based on DESDE-2.0 methodology for each geographical area. To get information about “Processes” and readiness to provide integrated care, the ARCHO-IEMAC [2,3] instrument will be used. ARCHO (Assessment of Readiness for Chronicity in Health Care Organisations)-IEMAC is based on the "Chronic Care Model” and allows self-assessment of healthcare organisations with respect to their degree of readiness to provide integrated care; it has proven to work adequately in the mental