Detailed Analysis of Champus Per Capita Mental Health Expenditures for Beneficiaries Ages 18 through 64, Health Services Command Catchment Areas Fiscal Years 1988-1993

1994 ◽  
Author(s):  
Barbara E. Wojcik ◽  
Scott A. Optenberg
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Detailed Analysis ◽  
Health Expenditures ◽  
Catchment Areas ◽  
Per Capita

scholarly journals Management of mental health services in Malawi

2008 ◽  
Vol 5 (2) ◽  
pp. 29-30 ◽  
Author(s):  
Felix Kauye
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Gross Domestic Product ◽  
Sub Saharan Africa ◽  
Gdp Per Capita ◽  
Domestic Product ◽  
Per Capita ◽  
Sub Saharan

Malawi is a country in sub-Saharan Africa bordering Mozambique, Tanzania and Zambia. It has an area of approximately 118000 km2 and is divided into northern, central and southern regions. It has an estimated population of 13 million, 47% of whom are under 15 years of age and just 5% over 60 years. Its economy is largely based on agriculture, with tobacco being the main export. The projected growth in gross domestic product (GDP) for 2007 was 8.8%; GDP per capita was $284 per annum.

scholarly journals Changes in community mental health services availability and suicide mortality in the US: A retrospective study

2020 ◽  
Author(s):  
Peiyin Hung ◽  
Susan Busch ◽  
Yi-Wen Shih ◽  
Alecia McGregor ◽  
Shi-Yi Wang
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
The United States ◽  
Suicide Mortality ◽  
Per Capita

Abstract Background: Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States. Methods: Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state. Results: From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3,406 to 2,920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (-0.52, 95% CI -1.08 to 0.03; p=0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths. Conclusions: State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts. Keywords: Suicide, Deinstitutionalization, Access to mental health care, Community mental health

Description and classification of mental health services: a European perspective

1998 ◽  
Vol 13 (7) ◽  
pp. 333-341 ◽  
Author(s):  
S Johnson ◽  
L Salvador-Carulla
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Use ◽  
Validity And Reliability ◽  
Programme Implementation ◽  
Services Research ◽  
Similar Treatment ◽  
Catchment Areas

SummaryWhilst steady progress has been made in the development and dissemination of valid and reliable instruments for evaluation of patient outcomes, progress in establishing standard methodologies for description and classification of mental health services has been limited. Valid and reliable methods of describing and classifying services are needed in mental health services research for purposes including; i) comparison of levels of provision between catchment areas and countries; ii) reaching an understanding of the relationship between socio-demographic indicators and service use; iii) investigation of the degree to which one service may be substituted for another; iv) evaluating programme implementation; and v) understanding why different outcomes are observed from apparently similar treatment programmes. Where programmes of research encompass different countries, the need for methods of comparing the local service contexts is particularly acute. In this paper, the various contributions which have been made to the somewhat fragmented body of research in this area are reviewed, and the problems which have hampered the development of satisfactory instruments are discussed. A set of criteria for satisfactory service measurement methodologies is proposed: these include development of standard nomenclature and operational definitions of service types; clear demonstration of validity and reliability; comprehensiveness; and applicability and similar interpretation in a range of countries.

scholarly journals Outer-context determinants in the sustainment phase of a reimbursement-driven implementation of evidence-based practices in children’s mental health services

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Joyce H. L. Lui ◽  
Lauren Brookman-Frazee ◽  
Teresa Lind ◽  
Kenny Le ◽  
Scott Roesch ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Health Expenditures ◽  
Regulatory Compliance ◽  
State Mental Health ◽  
System Level ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Ebp Implementation ◽  
State Mental

Abstract Background Although there is increasing investment to implement evidence-based practices (EBPs) in public systems across the USA, continued or sustained use of EBPs after initial implementation remains a challenge. The low integration of EBPs in routine practice severely limits their public health impact, highlighting the need to understand factors that affect the return on costly investments in EBP implementation. This study aims to (1) characterize trajectories of EBP delivery volume through a reimbursement-driven implementation and (2) examine impacts of system-level policy regulatory activity and state-level mental health services funding on the implementation reimbursement strategy. Methods This study involved secondary data analyses. Psychotherapy administrative claims and regulatory site visit data from the Los Angeles County Department of Mental Health and California state mental health expenditures were extracted from 2010 to 2017. Multilevel regression examined EBP claims volume over time with state expenditures and regulatory compliance as predictors. Results EBP claims volume trajectories demonstrated a rapid initial increase, followed by a period of decrease, and a small increase in the final year. State mental health expenditures increased across time reflecting increased funding availability. State mental health expenditures and system regulatory compliance were inversely related to EBP claims volume. Conclusions The impact of reimbursement-driven EBP implementation strategy is sensitive to multiple outer-context determinants. At the system level, commitment to fidelity of implementation regulations resulted in reduced use of the reimbursement strategy. Alternative reimbursement streams not tied to EBPs coupled with an expanded array of reimbursable services also impacted the use of the reimbursement strategy to implement EBPs.

Estimates of global spending and financing of mental health

2011 ◽  
Vol 08 (01) ◽  
pp. 05-08 ◽  
Author(s):  
R. M. Scheffler
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Capita Income ◽  
Health Spending ◽  
The United States ◽  
Health Care Spending ◽  
Per Capita Income ◽  
Per Capita

SummaryThis paper illustrates the wide variation in the spending and financing of mental health services around the globe. As would be expected, mental health spending in high-income countries is a larger percent of overall health care spending, which in the United States, United Kingdom, and France is about 10% of health care spending, compared to countries such as Japan, Portugal, the Czech Republic, and Hungary, where the spending is around 6%. In OECD countries, mental health spending is approximately 7.4% of total health care spending. Our analysis of the relationship between per capita spending on mental health and per capita income shows that the elasticity of mental health spending is 0.49, suggesting that a 10% change in per capita income produces a 4.9% increase in mental health spending per capita. In LMIC, we found that the spending levels for mental health was approximately 1–2% of the total health care budget. The dominant payer for mental health services throughout the globe still appears to be that of the government sector. The case studies that we present in Korea, Spain, and Ghana show dramatically different approaches to the financing and spending of mental health.

scholarly journals Changes in community mental health services availability and suicide mortality in the US: A retrospective study

2020 ◽  
Author(s):  
Peiyin Hung ◽  
Susan Busch ◽  
Yi-Wen Shih ◽  
Alecia McGregor ◽  
Shi-Yi Wang
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Professionals ◽  
Low Income ◽  
Mental Health Center ◽  
The United States ◽  
Suicide Mortality ◽  
Per Capita

Abstract Background: Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States.Methods: Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state.Results: From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3,406 to 2,920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (-0.52, 95% CI -1.08 to 0.03; p=0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths. Conclusions: State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts.

scholarly journals Socio-economic disadvantage and resource distribution for mental health care: a model proposal and example application for Victoria, Australia

2020 ◽  
pp. 103985622096392
Author(s):  
Graham Meadows ◽  
Frances Shawyer ◽  
Shrinkhala Dawadi ◽  
Brett Inder ◽  
Joanne Enticott
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Mental Health Services ◽  
Health Services ◽  
Resource Distribution ◽  
Royal Commission ◽  
Economic Disadvantage ◽  
Local Health ◽  
Mental Health Resource ◽  
Catchment Areas

Objective: A spreadsheet-based model for supporting equitable mental health resource distribution in Australia was developed, based on the Australian Health Survey (AHS) psychological distress findings associated with area socio-economic disadvantage (SED). An illustrative application is presented. Method: Stratum-specific psychological-distress rates for area SED quintiles are applied to local government areas, catchment areas and local health networks (LHNs). A case study applies the model to Victoria, including examining recommendations in the Royal Commission into Victoria’s Mental Health Services (RCVMHS) 2019 interim report for increases to bed stock in two LHNs. Results: Need-adjusted demand estimates considered as a ratio of raw population proportions for catchments range between 0.6 to 1.4 in Victoria. Applying the formula to the Royal Commission recommendations suggests the proposed distribution of beds is a reasonable correction for these two LHNs and indicates next expansion priorities for more equitable distribution to other LHNs. Conclusions: The spreadsheet, adaptable for other states and territories, could complement National Mental Health Services Planning Framework outputs and assist in evaluation, for instance, determining potential supply shortages in the tele-mental-health response to COVID-19. We outline research directions including consideration of the moral bases of value judgements and identification of other variables including their use in parameterisation and calibration.

scholarly journals The case for catchment areas for mental health services

1995 ◽  
Vol 19 (6) ◽  
pp. 343-345 ◽  
Author(s):  
Graham Thornicroft ◽  
Geraldine Strathdee ◽  
Sonia Johnson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Community Mental Health Services ◽  
Companion Paper ◽  
Community Services ◽  
Planning Service ◽  
The Past ◽  
Audit Commission ◽  
Catchment Areas

The establishment of mental health teams which take responsibility for small geographical catchment areas has been a fundamental element in the planning of community services in most Western European countries over the last decade. This idea is challenged in the companion paper in this issue of Psychiatric Bulletin which refers to catchment areas as a “relic of the past”. The case is put for catchment areas in terms of their planning, service delivery and quality advantages for the development of comprehensive inter-agency mental health services. In brief, it is argued that community mental health services are still in many areas poorly developed (Audit Commission, 1994; Faulkner et al, 1994), and that catchment areas are necessary but not sufficient for their fuller realisation.

scholarly journals Service Characteristics and Geographical Variation in Compulsory Hospitalisation: An Exploratory Random Effects Within–Between Analysis of Norwegian Municipalities, 2015–2018

2021 ◽  
Vol 12 ◽  
Author(s):  
Tore Hofstad ◽  
Jorun Rugkåsa ◽  
Solveig Osborg Ose ◽  
Olav Nyttingnes ◽  
Solveig Helene Høymork Kjus ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
General Practitioners ◽  
Random Effects ◽  
Geographical Variation ◽  
Health Workers ◽  
Health Centre ◽  
Mental Healthcare ◽  
Service Characteristics ◽  
Catchment Areas

Background: Compulsory hospitalisation in mental healthcare is contested. For ethical and legal reasons, it should only be used as a last resort. Geographical variation could indicate that some areas employ compulsory hospitalisation more frequently than is strictly necessary. Explaining variation in compulsory hospitalisation might contribute to reducing overuse, but research on associations with service characteristics remains patchy.Objectives: We aimed to investigate the associations between the levels of compulsory hospitalisation and the characteristics of primary mental health services in Norway between 2015 and 2018 and the amount of variance explained by groups of explanatory variables.Methods: We applied random-effects within–between Poisson regression of 461 municipalities/city districts, nested within 72 community mental health centre catchment areas (N = 1,828 municipality-years).Results: More general practitioners, mental health nurses, and the total labour-years in municipal mental health and addiction services per population are associated with lower levels of compulsory hospitalisations within the same areas, as measured by both persons (inpatients) and events (hospitalisations). Areas that, on average, have more general practitioners and public housing per population have lower levels of compulsory hospitalisation, while higher levels of compulsory hospitalisation are seen in areas with a longer history of supported employment and the systematic gathering of service users' experiences. In combination, all the variables, including the control variables, could account for 39–40% of the variation, with 5–6% related to municipal health services.Conclusion: Strengthening primary mental healthcare by increasing the number of general practitioners and mental health workers can reduce the use of compulsory hospitalisation and improve the quality of health services.

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