The journal of mental health policy and economics
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J Ment Health Policy Econ · Jun 2008
Caring for children with mental disorders: do state parity laws increase access to treatment?
High prevalence rates of mental health disorders in childhood have garnered increased public attention in recent years. Yet, among children diagnosed with serious mental health problems, a majority receive no treatment. Improving access to mental health services for children with behavioral and emotional disorders constitutes an important policy concern. ⋯ Since other research has shown that state parity laws are helpful in reducing the family financial burden of caring for a mentally ill child and do not drive up total health care costs, these policies serve a vital function. However, given persistent access problems in the child population, research aimed at increasing rates of mental health services use is needed. In addition, future research on parity laws should consider whether, conditional on having a visit, children in parity states are likely to have more visits compared with other children.
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J Ment Health Policy Econ · Jun 2007
Cost-effectiveness analysis in severe mental illness: outcome measures selection.
Most economic evaluations conducted in mental healthcare did not include widely recommended preference-based health outcomes like the QALY (Quality-Adjusted Life Years). Instead, studies have mainly been designed as cost-effectiveness analyses that include single outcome measures aimed at a (disease) specific aspect of health. ⋯ Decision-makers in the field of mental healthcare should be careful when interpreting results of economic studies that included outcome measures aimed at a specific aspect of health. Such instruments may provide too narrow a view on relevant changes in health and findings may be difficult to generalise. Due to current reservations on the use of QALYs in mental healthcare, QALY outcomes should be considered in the context of the results of additionally assessed health outcomes.
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Despite the wide-ranging financial and social burdens associated with schizophrenia, there have been few cost-of-illness studies of this illness in the UK. ⋯ Better measurement of criminal justice services costs, private expenditures borne by families and valuation of lost quality of life could improve the estimates further.
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J Ment Health Policy Econ · Dec 2006
Health care resource use associated with integrated psychological treatment.
Mental health policies, advocating outpatient as well as community mental health care for the severely mentally ill, are aiming towards health system cost containment and patient quality of life. Programs with cognitive behavioral therapy, such as the Integrated Psychological Therapy (IPT), added to standard medical therapy for patients with schizophrenia have been associated with improved outcomes. A Quebec version of the IPT program was integrated in outpatient clinics and improvements were observed in overall symptoms, subjective experiences, cognitive and social functioning, and quality of life. In light of these results we deemed it relevant to describe the health system cost and patient resource use associated with the program. The costs related to IPT have not been previously reported and this study will elucidate on effective health services and budget allocation needed to include IPT. ⋯ Additional research is needed to examine in parallel the long-term clinical and cost impact of the IPT program in different clinical settings (young adults to long term mentally ill). This will elucidate to which patient population IPT is most cost-effective.
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J Ment Health Policy Econ · Jun 2006
Income and employment of people living with combined HIV/AIDS, chronic mental illness, and substance abuse disorders.
This paper examines the labor market outcomes of HIV triply-diagnosed adults having a combination of HIV, mental illness and substance abuse problems. ⋯ Future research should determine the marginal contribution of mental health conditions or substance abuse on income or labor market outcomes relative to individuals having only HIV/AIDS. This would allow policymakers to better understand how much of income and employment can be attributed to HIV/AIDS, mental health or substance abuse. Future work also should examine the impact of integrated treatment services on income and employment for this population.