ESAMEN: Descripción y medida de la estructura de los servicios de atención comunitaria en salud mental
2019
The basic structure of community-oriented mental health services consists
of four types of facilities: mental health units in general hospitals, day hospitals, mental
health centres, and psychosocial rehabilitation centres, complemented by social support
provided by specialized social services. Due to the fact that these facilities can host very
diverse health activities that may involve several sectors of the Administration and the
Third Sector, simultaneously or successively, and also due to their irregular geographical
implementation, the management of mental health services is a complex issue on which
no agreement has yet been reached. At present, we have several instruments for measuring and classifying services to facilitate their management, but none of them has become
popular.
The aim of this work is to report on ESAMEN, a tool to classify and measure the structure
of community mental health services, and to subject it to a feasibility study. This instrument is not based on the classification of facilities as has been done so far, but on the
classification of the 32 activities or modules of care that are practiced in them.
For this feasibility study, a survey was sent to the coordinators of 380 mental health faci-
ESAMEN 61
lities from Andalusia, Euskadi and Madrid, requesting information on the area of coverage
and the number of professionals in each of the modules dispensed in their facility. With
these data, indicators of capacity (expressed as the maximum time of professional dedication per inhabitant and unit of time) and scope (proportion of the total number of inhabitants who are potentially beneficiaries of the module) were elaborated.
Results tables show with clarity and simplicity the structure of the services, evaluating
each module according to its capacity and population scope, showing imbalances in its
distribution, allowing comparisons between areas and Communities, and leaving the door
open to the refinement of the indicators and the inclusion of new activity modules that
may be developed in the future.
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