{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T19:33:50Z","timestamp":1777750430920,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Soc Psychiatry"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>In Portugal, a reform to implement Long-term mental health care (LTMHC) started in 2017 allowing patients with severe mental illness receiving psychosocial rehabilitation to regain their autonomy and be reintegrated into their communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To describe the first steps of the Portuguese LTMHC implementation and to assess the relationship between the LTMHC\u2019s demand (referrals) and supply (vacancies and occupancy).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a national retrospective observational study to analyse the LTMHC referrals, vacancies and occupancy between mid-2017 (LTMHC establishment) and December 2022. We described and analysed the associated indicators through time and geography, as well as performed a simultaneous regression model to evaluate the relationship between supply and demand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 1,192 referrals to the LTMHC, of which 99 (8.3%) were made for childhood and adolescence structures. The maximum support residence (RAMa, \u2018Resid\u00eancia de apoio m\u00e1ximo\u2019), designed for patients with higher disabilities, had the highest number of referrals. Additionally, since the opening of vacancies in different institutions, residential structures became quickly saturated. On the other hand, domiciliary services were those with the lowest occupancy. Our estimates support that the vacancies (supply) are induced by the referrals (demand), and referrals are also related to the location of LTMHC facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>LTMHC is still in the initial stage of development in Portugal, and it is expected to receive financial support through the Recovery and Resilience Programme. According to the occupancy rates and referrals made, residential structures seem to be a priority, being also important to explore the partial use of domiciliary services. The geographical distribution of vacancies can also be a concern, considering the important proximity to the community in LTMHC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00207640231168026","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T08:16:28Z","timestamp":1682324188000},"page":"1605-1616","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term mental health care in Portugal: A portrait of the first years of activity"],"prefix":"10.1177","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6220-3124","authenticated-orcid":false,"given":"Filipa","family":"Santos Martins","sequence":"first","affiliation":[{"name":"Psychiatry and Mental Health Department, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o (CHUSJ), Porto, Portugal"},{"name":"CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Tallys","family":"Feldens","sequence":"additional","affiliation":[{"name":"CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal"},{"name":"Federal University of Paran\u00e1, Paran\u00e1, Brazil"}]},{"given":"C\u00e1tia","family":"Guerra","sequence":"additional","affiliation":[{"name":"Psychiatry and Mental Health Department, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o (CHUSJ), Porto, Portugal"},{"name":"Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Porto (FMUP), Porto, Portugal"}]},{"given":"Jo\u00e3o Vasco","family":"Santos","sequence":"additional","affiliation":[{"name":"CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal"},{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Public Health Unit, ACES Grande Porto V \u2013 Porto Ocidental, Porto, Portugal"}]}],"member":"179","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"bibr1-00207640231168026","unstructured":"ACSS. (2017). Guia de referencia\u00e7\u00e3o de utentes para as unidades e equipas de sa\u00fade mental da RNCCI (in Portuguese). Retrieved June, 2022, from https:\/\/www.acss.min-saude.pt\/wp-content\/uploads\/2016\/07\/Guia_Referenciacao_Final.pdf"},{"key":"bibr2-00207640231168026","unstructured":"ACSS. (2020a). Relat\u00f3rio das Experi\u00eancias-piloto de Cuidados Continuados Integrados de Sa\u00fade Mental (in Portuguese). Retrieved June, 2022, from https:\/\/www.acss.min-saude.pt\/wp-content\/uploads\/2016\/07\/Relatorio-CCISM-2020.pdf"},{"key":"bibr3-00207640231168026","unstructured":"ACSS. (2020b). Monitoriza\u00e7\u00e3o da Rede Nacional de Cuidados Continuados Integrados 2019 (in Portuguese). Retrieved June, 2022, from https:\/\/www.acss.min-saude.pt\/wp-content\/uploads\/2020\/08\/Relatorio_-Monitorizacao_RNCCI-2019.pdf"},{"key":"bibr4-00207640231168026","unstructured":"ACSS. (2022). 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