The Mental Health Services Research (MHSR) group is dedicated to research into the organisation of mental-health care delivery and services. Under the academic responsibility of Pr. V. Lorant and Pr. V. Dubois, it is co-ordinated by Pablo Nicaise, PhD. It is composed of members of the IRSS and of external scientific collaborators.
The MHSR group is also acknowledged as « Contact Group » by the FNRS, chaired by Prs. Lorant (UCL), Dubois (UCL) and Ansseau (Ulg). It organises an annual seminar as to favour collaboration and exchange between researchers and field professionals about research and evidence, in Belgium and elsewhere, on mental-health care organisation and delivery.
As a university team, it also centrally acts as a tool for knowledge and good-practice dissemination to all stakeholders in the field: researchers and teachers, clinicians, policy-makers, users and their relatives.
The group meets once a month.
• Mental-health inequalities,
• The resort to involuntary treatment and alternatives,
• Community-based psychiatric care
• Recovery-oriented care, social rehabilitation
• Support to employment, housing, and social relationships of mentally-ill people
• Development aid in mental health
• Care integration and service coordination in the field of mental health
• Care continuity and the use of services
• Social support networks of mentally-ill patients
• The place and involvement of users in the organisation and delivery of mental-health care
• Outreach and mobile teams
International research project funded by the FP7 UE framework, coordinated by the Unit of Social and Community Psychiatry of the Queen Mary University of London (Pr. S. Priebe) (2014-2018). The main aim of the research is to compare two systems for providing continuity of care in the transition between inpatient and outpatient care for chronic and Severe Mentally-Ill (SMI) patients. The integrated system supports the personal continuity of care, with at least one clinician involved in inpatient and subsquent outpatient care, whereas the functional system, involving different teams, facilitates specialised care continuity. These two systems coexist in five European countries (United Kingdom, Belgium, Germany, Italy, and Poland). However, these countries differ greatly in terms of health systems, funding schemes, and care provision. Data on more than 7,500 hospitalised psychiatric patients have been collected between October 2014 and December 2015, among whom more than 1,000 in Belgium. A follow-up data collection is currently ongoing in order to assess the subsequent use of care during the year after the hospital stay. Clinical and social outcomes will be assessed, as well as measurements on the use of services, quality of care, quality of life, and satisfaction with care. Comparative analyses across systems will be carried out nationally and internationally. Specific work packages of the project also address systems of care, the cost-effectiveness of the two systems, and a qualitative appraisal of clinicians' and patients' views.
The IRSS team is work package leader regarding care system assessment and care pathways. Academic supervision is provided by Pr. V. Lorant. The research is coordinated in Belgium by P. Nicaise. Researchers involved in the project are: F. Wyngaerden, H. Zabeau, D. Bourmorck, M. Molera Gui, L. Borremans, P. Smith and C. Walker.
Publications:
- D. Giacco, V. Bird, P. McCrone, V. Lorant, P. Nicaise, A. Pfennig, M. Bauer, M. Ruggeri, A. Lasalvia, J. Moskalewicz, M. Welbel, S. Priebe. Specialised teams or personal continuity across inpatient and outpatient mental health care? Study protocol for a natural experiment. BMJ Open, 2015;5:e008996. doi:10.1136/bmjopen-2015-0089962015 : http://hdl.handle.net/2078.1/167547
-G. Dimitri, D.Giacco, M. Bauer, V.J. Bird, L. Greenberg, A. Lasalvia, V. Lorant, J. Moskalewicz, P. Nicaise, A. Pfennig, M. Ruggeri, M. Welbel, S. Priebe. Predictors of length of stay in psychiatric inpatient units: Does their effect vary across countries?. European Psychiatry (2018), 48, 6-12 : http://hdl.handle.net/2078.1/190496
-Bird, V.J. ; Giacco, D. ; Nicaise, P. ; Pfennig, A. ; Lasalvia, A. ; Welbel, M. ; Priebe, S. In-patient treatment in functional and sectorised care: patient satisfaction and length of stay. British Journal of Psychiatry (2018),212 (2), 81-87: http://hdl.handle.net/2078.1/194334
- For-Care Study on care pathways and settings for detained mentally disordered offenders ("internees") in Belgium
National research project funded by the Federal Ministry of Public Health, coordinated by the VUB (Pr. M. Leys) and the IRSS (2016-2018), and carried out with the UGent and the University of Liège. The research is a processual, realist evaluation of the current reform policy aiming at providing a better care access to the "internees", i.e. detained mentally disordered offenders. New legal and care facilities are being implemented within the broader framework of the generic mental-health care provision reform. The research project is grounded in implementation science, and evaluates these new settings in a realist perspective (“What works for whom, in what circumstances, in what respects, and how?”) and within an international benchmark. The IRSS team is specifically involved in the assessment of care pathways and the development of a monitoring system for routine assessment.
Under the academic responsibility of Pr. V. Lorant, the research is supervised by P. Nicaise and carried out by D. Bourmorck and M. Molera Gui .
- Morpheus: "MObilisation du REseau par les USagers" (Mobilising users’ networks)
Morpheus is a study on social support networks of psychiatric patients, and their influence on continuity of care. Networking data have been collected between 2012 and 2015 on 380 psychiatric users in three sites (Brussels, Namur, and Manage) with the help of a participant-assisted sociogram technique. Data are currently analysed with Social Network Analysis. The study assesses several hypotheses on the influence of patients' social support network structure on continuity of care capacities of the care system, in particular the involvement of the patient in his/her own network. The tool also facilitates social and psychological interventions with the patients.
This research has been funded by the FNRS, the Scientific Funds of the 'Frères de la Charité', the Epsylon Group, and the 'Hôpital psychiatrique du Beau-Vallon'. Under the academic responsibility of Pr. V. Lorant and Pr. V. Dubois, the research is currently carried out by F. Wyngaerden.
- Organisation of mental health for adults in Belgium: advantages, barriers, gaps, and overlaps in the current supply of mental health care services, project with the KCE
The main objective of this research carried out by the KCE is to assess the advantages and shortcomings of the organisation of mental health care services in Belgium and how they will hinder or enhance the transition to the model of care in networks that give priority to social inclusion, recovery, and reintegration of patients in the community. A part of this research is outsourced to the MHSR group of the IRSS, in consortium with LUCAS at the KULeuven (Pr. C. Van Audenhove). This part is focussing on the advantages, barriers, gaps, and overlaps in the current mental health care service supply as implemented locally in the 22 areas that were determined within the mental health care reform (2010-2016). This research is mainly based on a qualitative data collection about the views of stakeholders in the local areas, and a confirmatory study based on potential scenarios of future developments (2017-2018)
Under the responsibility of Pr. V. Lorant, Dr. P. Nicaise , and Pr. Sophie Thunus, the research is carried out at the IRSS by C. Walker et P. Smith.
- Parcours@bxl : qualitative study of mental-health users' care trajectories in Brussels
The main aim of this study is to describe the care trajectories and experience of mental health users in Brussels, and to identify organisational aspects that are likely to optimalise such trajectories (January-June 2018).
This study completes the abovementioned KCE project, and is funded by the 'Commission Communautaire Commune' of the Brussels Region. Under the responsibility of Pr.Sophie Thunus, the study is carried out by C. Walker with the support of P. Nicaise.
- Egonet: "Promoting social support network mapping with severe mentally ill patients to improve care coordination, patient involvement, and personalised care"
- Appropriate care delivery for users with complex, long-term needs combining health, mental health, and social issues, require coordination across care providers, individualised care, and the involvement of the user and his/her social support network. The knowledge and understanding of the social support network of patients is often lacking. Following the "Morpheus" project, this study aims to develop, facilitate, and assess a computer tool to collect, describe, visualise, and analyse patients' social support network in routine practice.
Under the responsibility of Pr. V. Lorant, the research is coordinated by Dr. P. Nicaise and F. Wyngaerden and carried out in partnership with the Institute Paul Lambin and the CERDECAM. The research is funded by the programme "Bridge" of Innoviris (Brussels Region) and sponsored by Epsylon, psychiatric care network, and the network of outpatient health and social services Conectar (2018-2020).
- CAPP: "Continuity of care for socially deprived groups with a chronic disorder in the Brussels-Capital Region", INNOVIRIS project
Socially deprived people are vulnerable groups at risk of developing chronic mental disorders. Risk is increased by accessibility barriers to appropriate services and the lack of coordination, in particular regarding the collaboration between primary care and specialised inpatient institutions. New mechanisms facilitating care access and continuity are implemented. However, the feasibility and impact of these mechanisms are still unclear within the specific institutional context of the Brussels Region and target-group specificities. Based on a mixed-methods design, combining qualitative interviews and stakehoders’ analysis, the main aim of this research project is to identify the most adapted mechanisms to this context. This research project is funded by the Brussels-Capital Region and carried out by M. Dauvrin (2014-2016).
Recently terminated projects:
-Scientific evaluation of the national reform of mental-health care provision "Towards better mental health care" (Title 107).
This national research project has been carried out between 2011 and 2015 by the IRSS, LUCAS (KULeuven) and the VUB. The main aim of the reform was the establishement of networks of services providing community, integrated, and recover-oriented care. This research project is still being exploited for analyses and publications.
Publications:
- P. Nicaise, V. Dubois, V. Lorant. Mental healthcare delivery system reform in Belgium: the challenge of achieving deinstitutionalisation whilst addressing fragmentation of care at the same time. Health Policy 2014, 115(2-3), 120-127 – doi:10.1016/j.healthpol.2014.02.007 : http://hdl.handle.net/2078.1/139794
- A. Grard, P. Nicaise, V. Lorant. Evaluation de la réforme “Vers de meilleurs soins en santé mentale” – Résultats 2014. Acta Psychiatrica Belgica 2015, 115(1), 40-49 : http://hdl.handle.net/2078.1/163886
- V. Lorant, A. Grard, P. Nicaise, & the Title 107 Study Group. Implementing a Nation-Wide Mental Health Care Reform: An Analysis of Stakeholders’ Priorities. Community Mental Health Journal 2016, 53(2), 343-352 – doi:10.1007/s10597-015-9932-y : http://hdl.handle.net/2078.1/165124
- V. Lorant, A. Grard, C. Van Audenhove, E. Helmer, J. Vanderhaegen, P. Nicaise. Assessment of the priority target group of mental health service networks within a nation-wide reform of adult psychiatry in Belgium. BMC Health Services Research 2016, 16(187), 1-9 – doi:10.1186/s12913-016-1434-2. http://hdl.handle.net/2078.1/17402
- V. Lorant, J. Nazroo, P. Nicaise, The Title107 Study Group. Optimal Network for Patients with Severe Mental Illness: A Social Network Analysis. Administration and Policy in Mental Health 2017, online first - doi: 10.1007/s10488-017-0800-7. http://hdl.handle.net/2078.1/183768
-Pr. V. Lorant, J. Nazroo, Dr. Pablo Nicaise. Optimal Network for Patients with Severe Mental Illness: A Social Network Analysis. Administration and Policy in Mental Health 2017. doi:10.1007/s10488-017-0800-7. http://hdl.handle.net/2078.1/183768
- "Psychiatric Advance Directives"
A scenario of intervention to facilitate the use of Psychiatric Advance Directives (PADs) in Belgium has been developed in 2008-2010. PADs are documents that allow patients to declare treatment preferences in advance of crisis events in order to improve crisis care and further recovery. The intervention is still foreseen for future trials.
Publications:
- V. Lorant, C. Depuydt, B. Gillain, A. Guillet, and V. Dubois. Involuntary commitment in psychiatric care: what drives the decision? Social Psychiatry & Psychiatric Epidemiology, 2007, 42(5), 360-365. http://hdl.handle.net/2078.1/10912
- P. Nicaise, C. Geerts, V. Lorant, V. Dubois. Directives Anticipées en Psychiatrie : Analyse des scénarios possibles en Belgique, in coll. La protection de la personne des malades mentaux, Ethique, médecine et Justice, Bruxelles: La Charte, 2011, pp. 251-270 http://hdl.handle.net/2078.1/72207
- P. Nicaise, V. Lorant, V. Dubois. Psychiatric Advance Directives as a complex and multistage intervention: a realist systematic review. Health and Social Care in the Community, 2013, 21(1), 1-14. http://hdl.handle.net/2078.1/109981
- E. Maître, C. Debien, P. Nicaise, F. Wyngaerden, M. Le Galudec, P. Genest, F. Ducrocq, P. Delamillieure, B. Lavoisy, M. Walter, V. Dubois, G. Vaiva. Les directives anticipées en psychiatrie : revue de la littérature qualitative, état des lieux et perspectives. L'Encéphale, 2013, 39(4), 244-251. http://hdl.handle.net/2078.1/127062
- P. Nicaise, V.E. Soto, V. Dubois, V. Lorant. Users' and health professionals' values in relation to a psychiatric intervention: the case of Psychiatric Advance Directives. Administration and Policy in Mental Health 2015, 42(4), 384-393 – doi:10.1007/s10488-014-0580-2. http://hdl.handle.net/2078.1/147034
-PROMO: "Best Practice in Promoting Mental Health in Socially Marginalized People in Europe"
Research project funded by the DG-SANCO of the European Commission and coordinated by the Queen Mary University of London (Pr. S. Priebe) (2008-2010). This research investigated mental-health care delivery for several socially deprived target-groups in 14 European Capitals.
Publications:
-P. Nicaise, S. Tulloch, V. Dubois, A. Matanov, S. Priebe, V. Lorant. Using Social Network Analysis for Assessing Mental Health and Social Services Inter-Organisational Collaboration: Findings in Deprived Areas in Brussels and London. Administration and Policy in Mental Health, 2013, 40(4), 331-33, 9http://hdl.handle.net/2078.1/110712
- S. Priebe, A. Matanov, H. Barros, R. Canavan, E. Gabor, P. Nicaise, A. Gaddini et al. (2013). Mental health-care provision for marginalized groups across Europe: findings from the PROMO study. The European Journal of Public Health, 23(1), 97-103, http://hdl.handle.net/2078.1/109976
- S Priebe, A. Matanov, R. Schor, C. Straßmayr, H. Barros, V. Lorant, A. Gaddini et al. (2012). Good practice in mental health care for socially marginalised groups in Europe: a qualitative study of expert views in 14 countries. BMC Public Health, 12, doi:10.1186/1471-2458-12-248, http://hdl.handle.net/2078.1/132441
- D. Costa, A. Matanov, R. Canavan, E. Gabor, T. Greacen, P. Vondrácková, U. Kluge, P. Nicaise, S. Priebe et al. (2014) Factors associated with quality of services for marginalized groups with mental health problems in 14 European countries. BMC Health Services Research 2014, 14, http://www.biomedcentral.com/1472-6963/14/49 doi:10.1186/1472-6963-14-49 http://hdl.handle.net/2078.1/139415
- C. Strassmayr, A. Matanov, S. Priebe, H. Barros, R. Canavan, P. Nicaise, H. Katschnig, et al. (2012). Mental health care for irregular migrants in Europe: Barriers and how they are overcome. BMC Public Health, 12,. doi: 10.1186/1471-2458-12-367 http://hdl.handle.net/2078.1/111123
- M. Welbel, A. Matanov, J. Moskalewicz, H. Barros, V. Lorant, S Priebe, et al. (2012). Addiction treatment in deprived urban areas in EU countries: Accessibility of care for people from socially marginalized groups. Drugs: Education, Prevention, and Policy, 1-10, doi: 10.3109/09687637-2012-706757
- R. Canavan, M. Barry, A. Matanov, H. Barros, E. Gabor, P. Nicaise, S. Priebe, et al. (2012). Service provision and barriers to care for homeless. BMC Health Services Research, 12, doi: 10.1186/1472-6963-12-222 http://hdl.handle.net/2078.1/113004
Some other relevant publications:
- V. Lorant. Mortality socio-economic inequalities for small-areas in Belgium: assessing concentration. rev.Epidemiol.Sante Publique 48 (3):239-247, 2000 http://hdl.handle.net/2078.1/43822
- Dubois V, Tonglet R, Hoyois Ph, Ka S, Roussaux JP, Hauff E. Household survey of psychiatric morbidity in Cambodia. International Journal of Social Psychiatry, 2004,50 (2) : 174-185.
- Dubois V, Guha-Sapir D, De Clercq M. Psychiatrie humanitaire et traumatisme de guerre: analyse critique et recommandations pour les projets de santé mentale. Revue Francophone du Stress et du Trauma, 2000; 1(1) : 49-54.
- V. Lorant, D. Deliege, W. Eaton, A. Robert, P. Philippot, and M. Ansseau. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 157 (2):98-112, 2003 http://hdl.handle.net/2078.1/9351
- V. Lorant, D. Kampfl, A. Seghers, D. Deliege, M. C. Closon, and M. Ansseau. Socio-economic differences in psychiatric in-patient care. Acta Psychiatr.Scand. 107 (3):170-177, 2003 http://hdl.handle.net/2078.1/9375
- V. Lorant, A. E. Kunst, M. Huisman, G. Costa, and J. Mackenbach. Socio-economic inequalities in suicide: a European comparative study. Br J Psychiatry 187:49-54, 2005 http://hdl.handle.net/2078.1/22228
- V. Lorant, C. Croux, S. Weich, D. Deliege, J. Mackenbach, and M. Ansseau. Depression and socio-economic risk factors: 7-year longitudinal population study. Br.J.Psychiatry 190:293-298, 2007 http://hdl.handle.net/2078.1/22226
- X. Coton, S. Poly, Ph Hoyois, C. Sophal, V. Dubois. The healthcare-seeking behaviour of schizophrenic patients in Cambodia. International Journal of Social Psychiatry, 2008, 54(4): 328-337 http://hdl.handle.net/2078.1/14179
- X. Coton & V. Dubois. Quel parcours de soins pour le patient schizophrène au Cambodge ? L’Autre, 2008, 9 (2) : 229-237
- Nicaise P. ; Mental Health Service Networks: the Challenge of Articulating Community Care and Integrated Care. Thesis dissertation. Institute of Health and Society, Université Catholique de Louvain, Brussels, 2013. http://hdl.handle.net/2078.1/128269
Pr. Vincent Lorant: Professor of medical sociology, his main research topics are: health inequalities, social health determinants, supply and demand of health human resources, health policy, international comparisons of social policies, care networks, alcohol and tobacco policies.
Pr. Vincent Dubois: Professor of psychiatry, Medical Director of the Epsylon Mental-Health network, his main research topics are: emergency and crisis psychiatry, mental-health care organisation and delivery, involuntary treatment and alternatives.
Dr. Pablo Nicaise: PhD in Public Health Sciences, political sociologist, has an expertise in health policy and systems, evaluation of health services and programmes, particularly in the fields of substance-abuse and mental-health, and network governance.
François Wyngaerden: Sociologist, researcher in the IRSS and scientific collaborator at the Clinique Fond’Roy. He has a specific interest in models for care integration, users’ autonomy and empowerment. He is preparing a PhD on social support networks of patients and their relation to service delivery.
Delphine Bourmorck: Master in Public Health Sciences with a background of nurse in emergency and intensive care. Research assistant, she is preparing a PhD in relation to care access and pathways for vulnerable groups.
Marie Molera-Gui: Master in Public Health Sciences with a background of occupational therapist. Research assistant in the projects COFI and For-Care.
Adeline Grard: Demographer and sociologist. She is preparing a PhD in relation to alcohol and tobacco control policies.
Pierre-Olivier Robert: Sociologist and social worker, teaching assistant.
Héline Zabeau: participated in the COFI project.
Pierre Smith: research assistant in the COFI project.
Carole Walker: psychologist, researcher on the COFI and KCE-Mental Health projects
External members: Marie Tempels, Alina Punga, Dr. J.L. Feys, Dr. Guy Deleu, Pr. M. Ansseau, L. Verhaegen