The journal of mental health policy and economics
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J Ment Health Policy Econ · Mar 2005
Implementation of social services for the chronically mentally ill in a Polish mental health district: consequences for service use and costs.
In accordance with the mental health reform in Poland, from 1970 to 1980 the following mental health facilities were established within the general health system in the Warsaw District of Targowek: general hospital psychiatric ward, day hospital, outpatient clinic (OC), and community mobile team (CMT) with some procedures of assertive community treatment (ACT). In 1998 (according to the Mental Health Act of 1994), within the social welfare system, new community facilities were established in this district with psychosocial rehabilitation programs for the chronically mentally ill. These new social welfare facilities were a vocational rehabilitation center (VCR), community center of mutual help (CCOMH), and specialized social help services at client homes (SSHS). ⋯ The activity of the new social welfare facilities (VRC, CCOMH, SSHS) seems to reduce both full time and partial hospitalizations. Despite the increasing costs of medication reimbursement, and the increased use of CMT and OC, the overall costs for the mental health system were substantially reduced. The decrease in day hospital use is probably due to the large amount of daily social support and home services offered in VRC, CCOMH and SSHS. The results emphasize the importance of evaluating the coordination of care for chronically mentally ill patients in the mental health and social welfare systems.
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J Ment Health Policy Econ · Mar 2005
Health status and access to care for children with special health care needs.
About 11-14% of children with special health care needs (CSHCN) have unmet needs during a given year. Little is known about the determinants of unmet health care needs for CSHCN. ⋯ Future research should determine the causal relationship between mental health problems of CSHCN and their caregivers and the level unmet health care needs.
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J Ment Health Policy Econ · Dec 2004
Randomized Controlled Trial Clinical TrialEconomic evaluation of treatments for children with severe behavioural problems.
Disruptive behaviour disorders, including conduct disorder, affect at least 10% of children and are the most common reasons for referral to children's mental health services. The long-term economic impact on society of unresolved conduct disorder can exceed pound sterling 1 million for one individual over their lifetime. ⋯ It would be of interest for further research to continue to follow up the work done in this study with a larger cohort of subjects to further establish the effective components of parenting programmes and their relative costs and benefits both at intervention and over time.
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J Ment Health Policy Econ · Jun 2004
Comparative StudyCost-effectiveness of interventions for depressed Latinos.
Depression is a leading cause of disability worldwide, but treatment rates are low, particularly for minority patients. ⋯ Latinos benefit from improved care for depression, and the cost is less than that for white patients. Diverse patients are likely to benefit from improving care for depression in primary care.
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J Ment Health Policy Econ · Dec 2003
Community/hospital indicators in South African public sector mental health services.
The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. ⋯ Further research is needed into the development of mental health information systems, refining service indicators and improving methodologies for assessing the implementation of mental health policies in service delivery.