Development of a System Dynamic Model of Mental Healthcare Structure in Stockholm

Sammanfattning: Mental illnesses are the leading cause of disability in the world today, affecting nearly a billion people including 14% of the world’s adolescents. Mental illnesses include both psychiatric conditions and inconveniences and is a broad term to describe multiple different conditions in varying severity. Mental healthcare has become one of the most central focuses for the Swedish healthcare system and the need to further explore the mental healthcare system and the effectiveness of it is highly important. System dynamics and simulation modeling is a great tool in understanding the system and its behavior. Therefore, the aim of this thesis is development of a working system dynamic simulation model, that will show how the public healthcare system provides mental healthcare for depression and anxiety in Stockholm to adults. The system should be represented with relevant parameters of the real world to accurately simulate the mental healthcare infrastructure.   A literature review was conducted to gain an understanding of the structure of the system, its challenges and behavior. The literature review also included gathering of data for the model. Due to privacy concerns of the patients and regulations some of the data was not obtainable throughout the process. The unobtainable data was estimated through information from the provided literature review.    The system dynamic model was used to run various possible future scenarios. The scenarios were used to test different real-world situations and analyze the system output and behavior. The system was validated with historical data to estimate the accuracy of the model, and if the model output were in agreement with the real-world data. The system dynamic model was created in an iterative process including adding and removing parameters, stocks and flows throughout the process.   However, to further validate the simulation model and increase the accuracy, further research needs to be performed. These include interviews with experts for further validation and data gathering of parameters that is not available in the public domain but will not violate privacy or ethics of patients. The result was a system dynamic model of the mental healthcare system and structure in Stockholm. The system dynamic model showed that it keeps up with the increasing demand for mental healthcare and that primary care was the department that was the most effective in treating its patient when having additional resources.