Sur model with spatial effects: an application to mental health expenditure

2007 ◽  
Vol 16 (12) ◽  
pp. 1403-1408 ◽  
Author(s):  
Francesco Moscone ◽  
Elisa Tosetti ◽  
Martin Knapp
Keyword(s):  
Mental Health ◽  
Health Expenditure ◽  
Spatial Effects ◽  
Mental Health Expenditure

scholarly journals Relationship between national mental health expenditure and quality of care in longer-term psychiatric and social care facilities in Europe: cross-sectional study

2017 ◽  
Vol 211 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Tatiana Taylor Salisbury ◽  
Helen Killaspy ◽  
Michael King
Keyword(s):  
Mental Health ◽  
Quality Of Care ◽  
Service User ◽  
Health Expenditure ◽  
Multilevel Models ◽  
Service Users ◽  
Cross Sectional ◽  
National Mental Health ◽  
Mental Health Expenditure

BackgroundIt is not known whether increased mental health expenditure is associated with better outcomes.AimsTo estimate the association between national mental health expenditure and (a) quality of longer-term mental healthcare, (b) service users' ratings of that care in eight European countries.MethodNational mental health expenditure (per cent of health budget spent on mental health) was calculated from international sources. Multilevel models were developed to assess associations with quality of care and service user experiences of care using ratings of 171 facility managers and 1429 service users.ResultsSignificant positive associations were found between mental health spend and (a) six of seven quality of care domains; and (b) service user autonomy and experiences of care.ConclusionsGreater national mental health expenditure was associated with higher quality of care and better service user experience.

scholarly journals Expenditure on mental health care by English health authorities: A potential cause of inequity

2000 ◽  
Vol 177 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Jonathan Bindman ◽  
Gyles Glover ◽  
David Goldberg ◽  
Daniel Chisholm
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Expenditure ◽  
Local Level ◽  
Regression Modelling ◽  
Health Authorities ◽  
London Health ◽  
Mental Health Expenditure ◽  
Deprived Areas

BackgroundThe York resource allocation formula includes a calculation of the amount needed to purchase mental health services equitably in each health authority in England. However, the amount which is actually spent on services is at the discretion of the authority.AimsTo compare expenditure on mental health services with allocation, and test the hypothesis that differences between them are to the disadvantage of services in deprived areas.MethodA comparison of routine expenditure and allocation data, and linear regression modelling of the ratio of expenditure to allocation.ResultsThe ratio of expenditure to allocation varies widely. Relative underspending occurs more frequently in deprived areas, although not in the four inner-London health authorities.ConclusionsThe intentions of the York formula are not achieved in practice. The implications of the formula for mental health should be made explicit to health authorities, and shortfalls in mental health expenditure relative to allocation should be justified at a local level.

Mental health expenditure in England: A spatial panel approach

2007 ◽  
Vol 26 (4) ◽  
pp. 842-864 ◽  
Author(s):  
Francesco Moscone ◽  
Martin Knapp ◽  
Elisa Tosetti
Keyword(s):  
Mental Health ◽  
Health Expenditure ◽  
Spatial Panel ◽  
Mental Health Expenditure

scholarly journals Community Mental Health Care in Italy: Basaglia’s ashes in the wind of the crisis of the last decade

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Carta
Keyword(s):  
Mental Health ◽  
Health Expenditure ◽  
Psychiatric Hospitals ◽  
Community Services ◽  
Cultural Expression ◽  
South Italy ◽  
The North ◽  
Key Points ◽  
National Mental Health ◽  
Mental Health Expenditure

Abstract Introduction In 1978, Italy approved the Law 180, which required the closure of all psychiatric hospitals. The three key points were: 1) A ban on the building of new psychiatric hospitals; 2) The principle that prevention, treatment, and rehabilitation have to be provided in community services; 3) The reason for requiring involuntary treatments was no longer dangerousness: involuntary treatments could only be required if a person needed an urgent treatment and he or she did not have - in that particular moment - the capacity for taking a decision. Discussion Regional differences. The 1978 law has been “translated” into regional policies. The resources allocated to implement these policies were higher in the North and lower in the South Italy. The access to services and, thus, the health outcomes were found to be related to the availability of resources. Decreases in resources Furthermore, the total amount of resources for the national mental health system in Italy shows a constant decrease from 2001 to date. Considering the percentage of mental health expenditure on the total public health expenditure, today the European countries with an income similar to Italy spend 10% of their health budget for mental health; Italy spends half of it. In this new scenario, the Italian associations of users and families have denounced abuses during involuntary health treatments and in the so-called shelter-houses. Lack of a scientific approach. Another critical point of the reform is the poor scientific testimony of what has been done. Conclusions Italy created a revolutionary approach to mental illness in a historical framework in which this country was in economic expansion and produced a great cultural expression. At that time, we were accustomed to ‘believing and doing’ rather than to questioning results. With the economic and cultural crisis, Italy has guilty neglected mental health. Any future humanitarian approach to mental health should take this experience into account.

scholarly journals Mental Health and the City in the Post-COVID-19 Era

2021 ◽  
Vol 13 (14) ◽  
pp. 7533
Author(s):  
Jakub Bil ◽  
Bartłomiej Buława ◽  
Jakub Świerzawski
Keyword(s):  
Mental Health ◽  
Spatial Structure ◽  
Urban Sprawl ◽  
Mental Health Treatment ◽  
Interpersonal Relations ◽  
Urban Structure ◽  
Spatial Effects ◽  
Development Goals ◽  
The City

The article describes the risks for the mental health and wellbeing of urban-dwellers in relation to changes in the spatial structure of a city that could be caused by the COVID-19 pandemic. A year of lockdown has changed the way of life in the city and negated its principal function as a place of various meetings and social interactions. The danger of long-term isolation and being cut-off from an urban lifestyle is not only a challenge facing individuals, but it also creates threats on various collective levels. Hindered interpersonal relations, stress, and the fear of another person lower the quality of life and may contribute to the development of mental diseases. Out of fear against coronavirus, part of the society has sought safety by moving out of the densely populated city centres. The dangerous results of these phenomena are shown by research based on the newest literature regarding the influence of COVID-19 and the lockdown on mental health, urban planning, and the long-term spatial effects of the pandemic such as the urban sprawl. The breakdown of the spatial structure, the loosening of the urban tissue, and urban sprawl are going to increase anthropopressure, inhibit access to mental health treatment, and will even further contribute to the isolation of part of the society. In addition, research has shown that urban structure loosening as a kind of distancing is not an effective method in the fight against the SARS-COV pandemic. Creating dense and effective cities through the appropriate management of development during and after the pandemic may be a key element that will facilitate the prevention of mental health deterioration and wellbeing. It is also the only possibility to achieve the selected Sustainable Development Goals, which as of today are under threat.

scholarly journals Mental health system costs, resources and constraints in South Africa: a national survey

2019 ◽  
Vol 34 (9) ◽  
pp. 706-719 ◽  
Author(s):  
Sumaiyah Docrat ◽  
Donela Besada ◽  
Susan Cleary ◽  
Emmanuelle Daviaud ◽  
Crick Lund
Keyword(s):  
Public Health ◽  
Mental Health ◽  
South Africa ◽  
Health System ◽  
National Survey ◽  
Mental Health System ◽  
Scale Up ◽  
Health Spending ◽  
Mental Healthcare ◽  
Mental Health Expenditure

Abstract The inclusion of mental health in the Sustainable Development Goals represents a global commitment to include mental health among the highest health and development priorities for investment. Low- and middle-income countries (LMICs), such as South Africa, contemplating mental health system scale-up embedded into wider universal health coverage-related health system transformations, require detailed and locally derived estimates on existing mental health system resources and constraints. The absence of these data has limited scale-up efforts to address the burden of mental disorders in most LMICs. We conducted a national survey to quantify public expenditure on mental health and evaluate the constraints of the South African mental health system. The study found that South Africa’s public mental health expenditure in the 2016/17 financial year was USD615.3 million, representing 5.0% of the total public health budget (provincial range: 2.1–7.7% of provincial health budgets) and USD13.3 per capita uninsured. Inpatient care represented 86% of mental healthcare expenditure, with nearly half of total mental health spending occurring at the psychiatric hospital-level. Almost one-quarter of mental health inpatients are readmitted to hospital within 3 months of a previous discharge, costing the public health system an estimated USD112 million. Crude estimates indicate that only 0.89% and 7.35% of the uninsured population requiring care received some form of public inpatient and outpatient mental healthcare, during the study period. Further, mental health human resource availability, infrastructure and medication supply are significant constraints to the realization of the country’s progressive mental health legislation. For the first time, this study offers a nationally representative reflection of the state of mental health spending and elucidates inefficiencies and constraints emanating from existing mental health investments in South Africa. With this information at hand, the government now has a baseline for which a rational process to planning for system reforms can be initiated.

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