Development of a health registry for service recipients with substance use and mental health problems (Userplan)

Background

Municipalities offer services to people with substance use and/or mental health problems, here referred to as service recipients. High quality data are needed to understand the needs of service recipients, evaluate the quality of care and guide further development of the services. The health registry Userplan has been developed in Norway to meet the need for high quality data. The register is a collaboration between hospitals, municipalities and financed by the Directorate of Health since 2013. Userplan collects data on demographics, quality of life, and public services are provided to service recipients. 

Method

In 2020, about 38 000 service recipients were registered in Brukerplan with the following inclusion criteria: 

•       16 years of age.

•       Have a mental health and/or substance use problem that severely affects their daily functioning and/or relationship with others.

•       Have received at least one public service in the past 12 months.

•       Service recipients did not opt out.

Daily functioning in eight areas is measured: housing, work and related activities, economic situation, physical and mental health, substance use, social functioning, and social life. Daily functioning is categorized as high (green), middle (yellow) or low (red). An overall daily functioning score is calculated based on the rating of each item. Additionally, current use and future needs of public services are registered.

Municipal services covered by Userplan include public services in health and care services, social welfare, and childcare protection. National identity numbers are used in the collection of data. Data is pseudonymized when transferred to Stavanger University Hospital. From 2024 data is available for research. The Centre for Alcohol and Drug Research at Stavanger University Hospital manages the registry. 

Results

In 2020 service recipients average age was 45 and were predominantly male (67%). The majority were born in Norway (90%). Service recipients are categorized in three groups; those dealing with substance use problems (5%), mental health problems (68%), and both (27%). A large proportion had a lack of meaningful activity (63%), while the majority maintained satisfactory financial stability (61%) and permanent housing situation (81%). The majority exhibited either no or minor physical health issues (86%). The majority displayed significant substance use (71%), which was associated with middle or low on overall functioning (65%) and restricted social interactions (67%). 

Conclusion

Userplan has contributed to reduce the information gap on service recipients receiving public services in Norway. Results from Userplan have been included in the evaluation of the escalation plan for the drug field in Norway, contributing to better national guidelines for this group.