Beijing's Mental Health Workers' Perceptions of the Severe Mental Illness Reporting System

Abstract

Background The Severe Mental Illness Reporting System (SMIRS) has been operated for many years as an important part of mental health monitoring, but its effectiveness needs to be further explored. Objective To analyze the perceptions of mental health workersfrom municipal-, district- and community-level hospitals in Beijing regarding the importance, main role, effects and problems during the implementation, and improvement measures concerning the SMIRS, providing suggestions facilitating the improvement of the system. Methods From March to June 2019, a survey was conducted among a convenient sample of 234 mental health workers from municipal-level psychiatric hospitals, and two stratified samples of 397 mental health workers (one sample of 183 cases from district-level psychiatric hospitals, and the other sample of 214 cases from community-level hospitals) , using a questionnaire named Status of the Rule of Mental Health Laws in Beijing for understanding these workers' general information and their perceptions of the SMIRS. Results The SMIRS was assessed as "very important" by 56.3% (103/183) of the mental health workers from district-level hospitals and 54.7% (117/214) of those from community-level hospitals, and as "relatively important" by 66.7% (156/234) of those from municipal-level hospitals.The major role of the SMIRS was assessed as "risk warnings for mental illnesses" by 76.9% (180/234) of the mental health workers from municipal-level hospitals and 82.7% (177/214) of those from community-level hospitals, and as facilitating community-based management of mental illnesses by 80.9% (148/183) of those from district-level hospitals. The implementation effectiveness of the SMIRS was evaluated as "relatively good" by 44.4% (104/234) of mental health workers from municipal-level hospitals, 50.3% (92/183) of those from district-level hospitals, and 50.9% (109/214) of those from community-level hospitals. And the number of workers choosing "relatively good" accounted for the highest percentage of the total workers from each kind of hospitals. The major problem during the implementation of the SMIRS was assessed as "involving patient privacy" by 77.8% (182/234) of the mental health workers from municipal-level hospitals, 78.1% (143/183) of those from district-level hospitals, and 83.2% (178/214) of those from community-level hospitals. And the number of workers choosing "involving patient privacy" accounted for the highest percentage of the total workers from each kind of hospitals. "Standardizing the system of information entry, registration, correction, and summary" was chosen as a measure for improving the implementation of the SMIRS by 73.5% (172/234) of the mental health workers from municipal-level hospitals, and 76.6% (164/214) of those from community-level hospitals, while "standardizing the system of information sharing and protection of patients' privacy" was chosen by 68.9% (126/183) of those from district-level hospitals. Conclusion The role and implementation effectiveness of the SMIRS have won the approval of mental health workers from municipal-, district- and community-level hospitals. To further improve the implementation of SMIRS with a dual emphasis on risk containment and privacy protection and consideration for patient management services, we put forward the following recommendations: detailing relevant legal provisions; insisting on ensuring patients access to relevant services (including management) , improving the mental health service system, and implementing the essential and major public health service programs; increasing policy publicity to improve the recognition of the system by patients and their families.

Keywords

• mental disorders, severe|medical staff|severe mental illness reporting system|beijing