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Key Strategies for Improving Psychiatric Home-Based Care in Spain: A Modified Delphi Study
Ana María Besoaín-Cornejo1,2,3, Montserrat Gil-Girbau1,2,4, Luisa Baladón Higueras2,4
1Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
Scandinavian Journal of Caring Sciences
|July 17, 2026
Summary
Improving psychiatric home care (CRHT) services in Spain involved prioritizing strategies like better training and communication. This collaborative approach ensures patient-centered improvements for mental health care programs.
Area of Science:
- Psychiatry
- Mental Health Services Research
- Health Services Management
Background:
- Psychiatric home-based care, specifically the Crisis Resolution and Home Treatment (CRHT) intervention in Catalonia, Spain, requires continuous quality improvement.
- Incorporating diverse stakeholder perspectives is crucial for effective enhancement of mental health services.
Purpose of the Study:
- To identify and prioritize key strategies for enhancing the CRHT programme.
- To integrate the views of service users, family caregivers, and healthcare professionals into quality improvement efforts.
Main Methods:
- A modified Delphi method was employed with 130 participants (CRHT service users/caregivers and healthcare professionals).
- Three rounds of online surveys assessed 18 improvement strategies based on problem significance, change agency, and feasibility.
- Qualitative data from open-ended responses were also analyzed.
Main Results:
- Five key strategies were prioritized through consensus: improved training on referral/eligibility, standardized discharge/continuity protocols, enhanced feedback loops, optimized scheduling/communication for visits, and real-time updates on CRHT slots.
- These strategies were highly rated for feasibility and change agency.
- Stakeholder involvement ensured continuity and relevance of input.
Conclusions:
- Collaborative, consensus-based approaches are effective for quality improvement in mental health care.
- The prioritized strategies offer feasible and actionable improvements for CRHT services.
- Involving service users, caregivers, and professionals enhances care relevance, person-centeredness, and effectiveness.
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