Evaluating complex mental health care in outpatient care in rural Lower Saxony: an ecologic study

Background/Objectives: Health care reforms in 2004 in Germany financially promoted the establishment of integrated care models. At the same time and due to a pilot project sponsored by the Ministry of Health, the German federal state of Lower Saxony had a relatively well developed structure of outpatient psychiatric nursing services working as independent enterprises. Office-based psychiatrists, who are the main source for outpatient mental health care in Germany, allied with these psychiatric nursing services in order to providing complex and outreaching care with the aim to reduce the need for hospital admissi…