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Meeting the challenge of funding and allocating resources to mental health across Europe: developing the Mental Health Economics European Network

Published online by Cambridge University Press:  18 May 2011

David McDaid*
Affiliation:
Personal Social Services Research Unit, LSE Health and Social Care, London School of Economics and Political Science, London (United Kingdom) European Observatory on Health Systems and Policies, London School of Economics and Political Science, London (United Kingdom)
Martin Knapp
Affiliation:
Personal Social Services Research Unit, LSE Health and Social Care, London School of Economics and Political Science, London (United Kingdom) Centre for the Economics of Mental Health, Institute of Psychiatry, King's College, London (United Kingdom)
Claire Curran
Affiliation:
Personal Social Services Research Unit, LSE Health and Social Care, London School of Economics and Political Science, London (United Kingdom)
*
Address for correspondence: David McDaid, LSE Health and Social Care, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE (United Kingdom). Fax: +44-020-7955.6803 E-mail: [email protected]

Summary

Aims – There is growing demand for economic analysis to support strategic decision-making for mental health but the availability of economic evidence, in particular on system performance remains limited. The Mental Health Economics European Network (MHEEN) was set up in 2002 with the broad objective of developing a base for mental health economics information and subsequent work in 17 countries. Methods – Data on financing, expenditure and costs, provision of services, workforce, employment and capacity for economic evaluation were collected through bespoke questionnaires developed iteratively by the Network. This was augmented by a literature review and analysis of international databases. Results – Findings on financing alone suggest that in many European countries mental health appears to be neglected while mechanisms for resource allocation are rarely linked to objective measure of population mental health needs. Numerous economic barriers and potential solutions were identified. Economic incentives may be one way of promoting change, although there is no one size fits all solution. Conclusions – There are significant benefits and synergies to be gained from the continuing development of networks such as MHEEN. In particular the analysis can be used to inform developments in Central and Eastern Europe. For instance there is much that can be learnt on both how the balance of care between institutional and non-institutional care has changed and on the role played by economic incentives in ensuring that resources were used to develop alternative community-based systems.

Declaration of Interest: none of the authors have received any financial support that presents a conflict of interest.

Type
Special Articles
Copyright
Copyright © Cambridge University Press 2006

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References

REFERENCES

Barrett, B., Byford, S. & Knapp, M. (2005). Evidence of cost-effective treatments for depression: a systematic review. Journal of Affective Disorders 84, 113.CrossRefGoogle ScholarPubMed
Bijl, R.V., de Graaf, R., Hiripi, E., Kessler, R.C., Kohn, R., Offord, D.R., Üstün, T.B., Vicente, B., Vollebergh, W.A., Walters, E.E. & Wittchen, H.U. (2003). The prevalence of treated and untreated mental disorders in five countries. Health Affairs 22, 122133.CrossRefGoogle ScholarPubMed
Chen, H., Cohen, P., Kasen, S., Johnson, J.G., Berenson, K. & Gordon, K. (2006). Impact of adolescent mental disorders and physical illnesses on quality of life 17 years later. Archives of Pediatrie and Adolescent Medicine 160, 9399.CrossRefGoogle ScholarPubMed
Chisholm, D., Sanderson, K., Ayuso-Mateos, J.L. & Saxena, S. (2004). Reducing the global burden of depression: population-level analysis of intervention cost-effectiveness in 14 world regions. British Journal of Psychiatry 184, 393403.CrossRefGoogle ScholarPubMed
Commission of the European Communities (2004). The State of Mental Health in the European Union. Commission of the European Communities: Luxembourg.Google Scholar
Commission of the European Communities (2005). Improving the Mental Health of the Population: Towards a Strategy on Mental Health for the European Union. Health and Consumer Protection Directorate, European Commission: Brussels.Google Scholar
Eibner, C., Sturn, R. & Gresenz, C.R. (2004). Does relative deprivation predict the need for mental health services? Journal of Mental Health Policy and Economics 1, 167175.Google Scholar
Fryers, T., Melzer, D., Jenkins, R. & Brugha, T. (2005). The distribution of the common mental disorders: social inequalities in Europe. Clinical Practice and Epidemiology in Mental Health 1, 14.CrossRefGoogle ScholarPubMed
Gabriel, P. & Liimatainen, M.-R. (2000). Mental Health in the Workplace. International Labour Organisation: Geneva.Google Scholar
Glover, G. (2004). Mental Health Care Funding in England. Centre of Public Mental Health, Durham University: Durham.Google Scholar
Harris, E.C. & Barraclough, B. (1998). Excess mortality of mental disorder. British Journal of Psychiatry 173, 1153.CrossRefGoogle ScholarPubMed
Henderson, G., Henderson, J., Lavaikainen, J. & McDaid, D. (2004). Actions against Depression: Improving Mental Health and Well Being by Combating the Adverse Health, Social and Economic Consequences of Depression. Commission of the European Communities, Health and Consumer Protection Directorate General: Luxembourg.Google Scholar
Jane-Llopis, E. & Anderson, P. (2005). Mental Health Promotion and Mental Disorder Prevention. A Policy for Europe. Radboud University Nijmegen: Nijmegen.Google Scholar
Kessler, R.C., Walters, E.E. & Forthofer, M.M. (1998). The social consequences of psychiatric disorders, III: Probability of marital stability. American Journal of Psychiatry 155, 10921096.CrossRefGoogle ScholarPubMed
Knapp, M., McCrone, P., Fombonne, E., Beecham, J. & Wostear, G. (2002). The Maudsley long term follow up of child and adolescent depression. British Journal of Psychiatry 180, 1923.CrossRefGoogle ScholarPubMed
Knapp, M., Barrett, B., Romeo, R., McCrone, P., Byford, S., Beecham, J., Patel, A. & Simon, J. (2004a). An International Review of Cost-Effectiveness Studies for Mental Disorders. Fogarty International Centre of the National Institutes of Health: Washington.Google Scholar
Knapp, M., Mangalore, R. & Simon, J. (2004b). The global costs of schizophrenia. Schizophrenia Bulletin 2, 297–293.Google Scholar
Knapp, M., Funk, M., Curran, C., Prince, M., Grigg, M. & McDaid, D. (2006). Economie barriers to better mental health policy and practice. Health Policy and Planning 21(3), 157170.CrossRefGoogle Scholar
Lothgren, M. (2004a). Economic evidence in anxiety disorders: a review. European Journal of Health Economics 5, Suppl 1, S2025.CrossRefGoogle ScholarPubMed
Lothgren, M. (2004b). Economic evidence in psychotic disorders: a review. European Journal of Health Economics 5, Suppl 1, S6774.CrossRefGoogle ScholarPubMed
Marwaha, S. & Johnson, S. (2004). Schizophrenia and employment: a review. Social Psychiatry and Psychiatric Epidemiology 39, 337349.CrossRefGoogle ScholarPubMed
Matschinger, H. & Angemeyer, M. (2004). The public's preference concerning the allocation of financial resources to health care: results from a representative population survey in Germany. European Psychiatry 19, 478482.CrossRefGoogle ScholarPubMed
McCrone, P., Knapp, M. & Fombonne, E. (2005). The Maudsley long-term follow-up of child and adolescent depression. Predicting costs in adulthood. European Child and Adolescent Psychiatry 14, 407413.CrossRefGoogle ScholarPubMed
McDaid, D., Knapp, M., Curran, C. & MHEEN Group (2004). Mental Health Economics European Network. Phase I Final Report to the European Commission. European Commission: Luxembourg.Google Scholar
McDaid, D., Curran, C. & Knapp, M. (2005). Promoting mental well-being in the workplace: a European policy perspective. International Review of Psychiatry 17, 365373.CrossRefGoogle ScholarPubMed
McDaid, D., Samyshkin, Y., Jenkins, R., Potasheva, A.P., Nikiforov, A.I. & Atun, R (in press). Health system factors impacting on delivery of mental health services in Russia: multi-methods study. Health Policy [Epub ahead of print, 2006 Feb 9].CrossRefGoogle ScholarPubMed
Office of the Deputy Prime Minister (2004). Mental Health and Social Exclusion. Social Exclusion Unit Report. Office of the Deputy Prime Minister: London.Google Scholar
Romeo, R., Byford, S. & Knapp, M. (2005). Annotation: Economic evaluations of child and adolescent mental health interventions: a systematic review. Journal of Child Psychology and Psychiatry 46(9), 919930.CrossRefGoogle ScholarPubMed
Salvador-Carulla, L., Garrido, M., McDaid, D. & Haro, J.M. (2006). Financing mental health in Spain: context and critical issues. European Journal of Psychiatry 20(1), 2944.CrossRefGoogle Scholar
Sartorius, N. (2004). Reducing the social and economic burden of depression (SEBoD) in Asia. Australasian Psychiatry 12, Suppl., S13.CrossRefGoogle Scholar
Scott, S., Knapp, M., Henderson, J. & Maughan, B. (2001). Financial cost of social exclusion: follow up study of antisocial children into adulthood. British Medical Journal 323, 191.CrossRefGoogle ScholarPubMed
Thomas, C. & Morris, S. (2003). Cost of depression among adults in England in 2000. British Journal of Psychiatry 183, 514519.CrossRefGoogle ScholarPubMed
Thornicroft, G., Tansella, M., Becker, T., Knapp, M., Leese, M., Schene, A. & Vazquez-Barquero, J.L. (2004). The personal impact of schizophrenia in Europe. Schizophrenia Research 69, 125132.CrossRefGoogle ScholarPubMed
Wittchen, H.-U & Jacobi, F. (2005). Size and burden of mental disorders in Europe - a critical review and appraisal of 27 studies. European Neuropsychopharmacology 15, 357376.CrossRefGoogle ScholarPubMed
World Health Organization (2004). Changing History. The World Health Report 2004. World Health Organization: Geneva.Google Scholar
World Health Organization (2005a). Atlas. Mental Health Resources around the World. World Health Organisation: Geneva.Google Scholar
World Health Organization (2005b). Mental Health Action Plan for Europe. Facing the Challenges, Building Solutions. World Health Organization: Copenhagen.Google Scholar
World Health Organization (2005c). Mental Health Declaration for Europe. Facing the Challenges, Building Solutions. World Health Organization: Copenhagen.Google Scholar
World Mental Health Survey Consortium (2004). Prevalence, severity and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Journal of the American Medical Association 291, 25812590.CrossRefGoogle Scholar