mental health expenditure
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2021 ◽  
pp. 1-5
Author(s):  
M. Tasdik Hasan ◽  
Tasnim Anwar ◽  
Enryka Christopher ◽  
Sahadat Hossain ◽  
Md Mahbub Hossain ◽  
...  

Mental health is a significant factor for a sound and productive life; nevertheless, mental disorders do not often receive adequate research attention and are not addressed as a serious public health issue in countries such as Bangladesh. Part 1 of this two-part profile describes the current situation of mental health in Bangladesh in its wider sociocultural context, outlining existing policies and highlighting mental illness as a neglected healthcare problem in the country using a narrative synthesis method. The prevalence of mental disorders is very high and augmented in nature among different population groups in Bangladesh. A lack of public mental health facilities, scarcity of skilled mental health professionals, insufficient financial resource distribution, inadequately stewarded mental health policies and stigma contribute to making current mental healthcare significantly inadequate in Bangladesh. The country has few community care facilities for psychiatric patients. Furthermore, the current mental health expenditure by the Bangladeshi government is only 0.44% of the total health budget. Less than 0.11% of the population has access to free essential psychotropic medications.


2021 ◽  
Author(s):  
Joanne Enticott ◽  
Shrinkhala Dawadi ◽  
Frances Shawyer ◽  
Brett Inder ◽  
Ellie Fossey ◽  
...  

Objectives: To examine trends in psychological distress in Australia between 2001 to 2017-18, including analysis by age, sex, and location. Design, setting and participants: Secondary analysis of six successive national health surveys of representative samples of the working age population (18-64 years). Main outcome measures: Prevalence of psychological distress at very-high symptom level (defined by a Kessler Psychological Distress Scale [K10] score of 30 or more) and combined high/very-high level (K10 score of 22 or more). Results: The latest survey showed 5.1% of Australians reporting very-high level distress and 14.8% combined high/very-high level - both the largest rates recorded this century. The greatest increase from 2001 to 2017-18 was in women aged 55-64 with very-high distress significantly increasing from 3.5% (95% CI: 2.5-4.5%) to 7.2% (5.9-8.5%), and; high/very-high distress from 12.4% (10.5-14.2%) to 18.7% (16.7-20.7%). Men aged 25-34 had very-high distress increase from 2.1% (1.4-2.8) to 4.0% (2.9-5.1%); and combined high/very-high distress remained stable at 10.6% (9.1-12.1%) to 11.5% (9.7-13.3%). In 2017-18, greatest distress was in women aged 18-24 years (very-high 8.0% (5.9-10.2%); high/very-high 22.1% (18.8-25.3%)). Overall, distress was significantly more prevalent in inner regional Australia than elsewhere (very-high level 4.8% (4.4-5.1%); high/very-high 14.4% (13.8-15%)). Conclusions: Australia's annual mental health expenditure over this period has doubled, yet population level psychological distress has increased. A whole of government approach and targeted strategies focusing on groups with the poorest mental health such as older working aged women, younger people, particularly women, and those outside of major cities are indicated.


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.


2019 ◽  
Vol 53 (11) ◽  
pp. 1052-1058 ◽  
Author(s):  
Sebastian Rosenberg ◽  
Ian Hickie AM

Objective: To explore the impact of proposed expansion of Australia’s Better Access Program and alternatives. Method: Australia’s Better Access Program, which costs taxpayers AUD28 million every week, is once again the focus of national political and professional scrutiny. The current Medicare Review calls for a massive expansion. This article reviews its history and context. It challenges the recommendations made by the Review. It also provides three scenarios which model the proposed expansion, with significant implications for consumers, the workforce and taxpayers. Results: The capacity for continued growth of the Program is demonstrated. At the same time. Conclusion: There has been recent evidence suggesting the impact of the programme on key mental health indicators in Australia has been negligible, while also perpetuating social, economic and geographic inequities. While advocacy for increased mental health expenditure is easy, active reform of existing patterns of service is hard. Nonetheless, this article suggests that it is timely to reconsider the structure and scale of this AUD1.5 billion annual investment, which has the potential to grow to up to AUD10 billion per year over the next decade. In our view, it is possible to make the programme fit for purpose in the 21st century. Specifically, the principal focus could be shifted to better support the interdisciplinary, team-based care that responds to the needs of people with more complex mental health problems. An increased role for incorporation of digital technologies alongside clinical services is part of the mix. The combination of changes suggested would suggest that the programme could be rebranded as ‘Better Access and Quality’. This shift in the primary focus of the clinical programme away from brief interventions for those with lower needs to more sustained interventions with those with greater impairment requires new service models, as well as new regionally based health care systems. In addition, we propose specific outcomes that can be measured regionally, and collated nationally, to properly evaluate the impact of the programme and drive systemic quality improvement.


2019 ◽  
Vol 53 (9) ◽  
pp. 844-850 ◽  
Author(s):  
Graham N Meadows ◽  
Ante Prodan ◽  
Scott Patten ◽  
Frances Shawyer ◽  
Sarah Francis ◽  
...  

A doubling of Australian expenditure on mental health services over two decades, inflation-adjusted, has reduced prevalence of neither psychological distress nor mental disorders. Low rates of help-seeking, and inadequate and inequitable delivery of effective care may explain this partially, but not fully. Focusing on depressive disorders, drawing initially on ideas from the work of philosopher and socio-cultural critic Ivan Illich, we use evidence-based medicine statistics and simulation modelling approaches to develop testable hypotheses as to how iatrogenic influences on the course of depression may help explain this seeming paradox. Combined psychological treatment and antidepressant medication may be available, and beneficial, for depressed people in socioeconomically advantaged areas. But more Australians with depression live in disadvantaged areas where antidepressant medication provision without formal psychotherapy is more typical; there also are urban/non-urban disparities. Depressed people often engage in self-help strategies consistent with psychological treatments, probably often with some benefit to these people. We propose then, if people are encouraged to rely heavily on antidepressant medication only, and if they consequently reduce spontaneous self-help activity, that the benefits of the antidepressant medication may be more than offset by reductions in beneficial effects as a consequence of reduced self-help activity. While in advantaged areas, more comprehensive service delivery may result in observed prevalence lower than it would be without services, in less well-serviced areas, observed prevalence may be higher than it would otherwise be. Overall, then, we see no change. If the hypotheses receive support from the proposed research, then implications for service prioritisation and delivery could include a case for wider application of recovery-oriented practice. Critically, it would strengthen the case for action to correct inequities in the delivery of psychological treatments for depression in Australia so that combined psychological therapy and antidepressant medication, accessible and administered within an empowering framework, should be a nationally implemented standard.


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.


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

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