Skip to main content

Table 3 Overview of organisation-related and environment-related factors in treatment (dis)continuation decisionsa

From: Decision making on (dis)continuation of long-term treatment in mental health services is an interpersonal negotiation rather than an objective process: qualitative study

Organisation-related factors

Citation

Environment-related factors

Citation

Internal capacity

The degree to which treatment options are available within the service

‘She has not shown up in our program, the DRG has ended and we are not going to open a new one. So let’s quit’ (PSO, TeamMeeeting4)

External capacity

The degree to which treatment options are available outside the service

‘This is highly complex care. If the patient has five contacts per year we may keep him stable. This does not have to be in our service – if the primary care physician has a mental health nurse it may be done there’ (PSA, TeamMeeeting7)

Financial incentives

The degree to which financial reimbursement of services influences decisions

‘Limitations play no role. If there is still is a need for treatment, another DRG [financial treatment episode] is started’ (CMHN, Interview8)

  
  

Support

The degree to which the patient has social support, or is able to organize practical support

‘The biggest problem was her housing. Once she got another house, things were already a lot better. When her financial situation got better also, we were able to terminate treatment’ (SW, TeamMeeeting8)

  

Resistance

The degree to which others (e.g. family, neighbours, other institutions) are willing to care for the patient

‘This is an annoying guy but if we terminate treatment there will be trouble that will reflect on us’ (CMHN, TeamMeeeting11)

  1. aPlease note that not all cells are filled, since in the analysis not every factor was found to apply to both the organisation and the environment