Mental Health Expenditure in England: A Spatial Panel Approach

2006 ◽  
Author(s):  
Francesco Moscone ◽  
Martin Knapp ◽  
Elisa Tosetti
2007 ◽  
Vol 26 (4) ◽  
pp. 842-864 ◽  
Author(s):  
Francesco Moscone ◽  
Martin Knapp ◽  
Elisa Tosetti

2007 ◽  
Vol 16 (12) ◽  
pp. 1403-1408 ◽  
Author(s):  
Francesco Moscone ◽  
Elisa Tosetti ◽  
Martin Knapp

2017 ◽  
Vol 211 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Tatiana Taylor Salisbury ◽  
Helen Killaspy ◽  
Michael King

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.


2000 ◽  
Vol 177 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Jonathan Bindman ◽  
Gyles Glover ◽  
David Goldberg ◽  
Daniel Chisholm

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.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Carta

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.


2019 ◽  
Vol 34 (9) ◽  
pp. 706-719 ◽  
Author(s):  
Sumaiyah Docrat ◽  
Donela Besada ◽  
Susan Cleary ◽  
Emmanuelle Daviaud ◽  
Crick Lund

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.


2002 ◽  
Vol 180 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Harvey Whiteford ◽  
Bill Buckingham ◽  
Ronald Manderscheid

BackgroundAustralia commenced a 5-year reform of mental health services in 1993.AimsTo report on the changes to mental health services achieved by 1998.MethodAnalysis of data from the Australian National Mental Health Report 2000 and an independent evaluation of the National Mental Health Strategy.ResultsMental health expenditure increased 30% in real terms, with an 87% growth in community expenditures, a 38% increase in general hospitals and a 29% decrease in psychiatric hospitals. The growth in private psychiatry, averaging 6% annually prior to 1992, was reversed. Consumer and carer involvement in services increased.ConclusionsMajor structural reform was achieved but there was limited evidence that these changes had been accompanied by improved service quality. The National Mental Health Strategy was renewed for another 5 years.


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