A preliminary taxonomy and a standard knowledge base for mental-health system indicators in Spain

A qualitative method with two experts panels was used to develop a framing document, a preliminary taxonomy with a conceptual map of health indicators, and a knowledge base consisting of key documents, glossary and database of indicators with an evaluation of their relevance for Spain.A total of 661 indicators were identified and organised hierarchically in 4 domains (Context, Resources, Use and Results), 12 subdomains and 56 types. Among these the expert panels identified 200 indicators of relevance for the Spanish system.The classification and hierarchical ordering of the mental health indicators, the evaluation according to their level of relevance and their incorporation into a knowledge base are crucial for the development of a basic list of indicators for use in mental health planning.Health indicators are tools designed to measure the health status of people and the functioning of health services through the various factors that influence them (demographic, economic, social) [1,2]. These provide the basic information for system analysis and decision-making in policies, planning and health management. The area of mental health presents added difficulties for the development of a useful list of health indicators for a variety of reasons. Firstly, this is a complex area in which health, social, educational and criminal and justice services coexist, where the care teams are multidisciplinary, and in which an integral care focus should be adopted [3]. Secondly, there are no reliable biological indicators for either the disorders assessed or the results, which complicates epidemiological and outcome research. Thirdly, mental health has been included late into the general health system (in Spain from 1986), it presents problems of under-financing and the lack of national data bases which exists in other disciplines (e.g. Oncology or AIDS) [4].The instruments which compile indicators are rarely organised as a knowledge-base and they lack adequate semantic interoperab