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Medical Practice Variations in Mental Health and Addictions Care

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Medical Practice Variations

Part of the book series: Health Services Research ((HEALTHSR))

Abstract

This chapter provides an overview of the practice variations in care delivery for mental health and addictive disorders and some of the system-level funding and structural factors that contribute to such variation. Practice variations are described for five populations, along with their expected clinical picture and service needs:

  • Children and adolescents

  • The elderly

  • Severe mental illness

  • Mild/moderate illness

  • Substance use disorders

These variations occur in a system-level climate which has been transformed over the past decades because of a fundamental change in how appropriate care is defined. Specifically, Western countries have been shifting from institutional to more community-based care – a process labeled “deinstitutionalization.” National differences in how services are funded and organized in light of deinstitutionalization are described. Pending gold-standard outcome indicators such descriptions allow more in-depth examination of what the potential drivers for system change are and how different funding and structure configurations might be compared and evaluated.

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Authors and Affiliations

  1. Institute for Clinical Evaluative Sciences, Toronto, Canada

    Elizabeth Lin

  2. Provincial System Support Program, Centre for Addiction and Mental Health, 33 Russell Street, Room 4075, M5S 2S1, Toronto, ON, Canada

    Elizabeth Lin

  3. Institute for Research and Information in Health Economics, 10 rue Vauvenargues, 75018, Paris, France

    Zeynep Or & Magali Coldefy

  4. Health Systems Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada

    Karen Urbanoski

  5. Providence Care – Mental Health Services, Geriatric Psychiatry, Queen’s University, Kingston, Canada

    Dallas Seitz

  6. Youth Addiction & Concurrent Disorders, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada

    Corine Carlisle

  7. Child and Youth Mental Health Collaborative, Centre for Addiction and Mental Health, Hospital for Sick Children, and University of Toronto, Toronto, Canada

    Peter Szatmari

  8. Health Systems Research, Centre for Addiction and Mental Health, Institute for Clinical Evaluative Sciences, 250 College Street, 4th Floor, M5T 1R8, Toronto, ON, Canada

    Paul Kurdyak

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    Ana Johnson

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    Thérèse Stukel

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Lin, E. et al. (2015). Medical Practice Variations in Mental Health and Addictions Care. In: Johnson, A., Stukel, T. (eds) Medical Practice Variations. Health Services Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7573-7_78-1

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