Models of mental health care in psychiatry across sectoral borders

Since 2004, article 140 of the fifth German Social Code Book (SGB V) provides the opportunity for developing and implementing models of Integrated Care (IC). The main aim of integrated care projects is to improve the quality and efficiency of health care in Germany by ameliorating the cooperation between the different sectors hospitals, ambulatory and rehabilitative care. As an example of implementing an integrated care network in the psychiatric sector, the first local network for integrated care in psychiatry in Aachen is described. It was founded in 2006 by the department of Psychiatry and Psychotherapy of the University Hospital Aachen, the DGPPN (German Association of Psychiatry and Psychotherapy) and the BVDN (Professional Association of German Neuropsychiatrists). The present interface problem between the separated sectors of medical care in Germany is being solved by evidence-based therapy, coordinated treatment between the different sectors, a standardised documentation and advanced training for all clinical participants. Early diagnosis and treatment of depression are improved by integrating clinical diagnostics, acute therapy, maintenance therapy, prophylaxis of relapse and after-care within one network. By the end of 2008, 1,081 patients have been treated within the integrated care network in Aachen by 56 ambulant general practitioners and psychiatrists and by 3 local psychiatric hospitals. Currently the network is going to be enlarged by integrating the diagnosis of schizophrenia. Following this, other mental illnesses should be integrated. The aim is to create a nationwide integrated care network across all diagnostic borders of mental illnesses.