The third pillar of psychiatric health care reform structures for coordination and planning of psychiatric health care in Germany

Objective: Coordination of all psychiatric services is essential for the successful implementation of community oriented services, particularly in a decentralised health system like the one in Germany. This study investigates which mechanisms are implemented for coordinating and planning psychiatric services throughout the 16 German States (Lender). Method: Analysing mental health legislation and policy documents of the States. Guided expert interviews with the psychiatry departments of the State governments. Results: Coordinating and planning panels exist in all States on district level and in most States on State level for various tasks. Most of these mechanisms are implemented without legal obligation. 4 States have a mental health evaluation panel, which scrutinises all psychiatric services once a year and reports publicly to the government. 12 States have a mental health legislation and 13 States published a central psychiatric planning document. Conclusion: The continous implementation of mechanisms for coordinating and planning psychiatric services in the German States represent the dynamics of psychiatric reforms there. The effect of these mechanisms on the implementation of community oriented psychiatric care should be subject to further research.