The journal of mental health policy and economics
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J Ment Health Policy Econ · Jun 2011
Pursuing cost-effectiveness in mental health service delivery for youth with complex needs.
Mental health advocates seek to expand children's services, noting widespread failure to meet the needs of public sector youth suffering from serious emotional disturbance (SED). However, state and national budgets face deepening cuts, with rising health care costs taking the blame. As the gap between needs and finances widens, identification of cost-effective treatments that will benefit children with SED and their families is of increasing importance. Community-based interventions for this population, such as the wraparound approach and systems-of-care, are being disseminated but literature is scant regarding effects on expense. The Mental Health Services Program for Youth (MHSPY) model is aligned philosophically with wraparound and systems-of-care but unique in blending public agency dollars to deliver integrated medical, mental health and social services. MHSPY's linked clinical and expense data is useful to study community-based treatment cost-effectiveness. ⋯ Further research is needed regarding which intervention elements contribute the most towards improved clinical functioning, as well as which patients are most likely to benefit. A randomized trial of MHSPY vs. "usual care,'' including examination of the sustainability of effects post-disenrollment, would provide a chance to further test this innovative model.
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J Ment Health Policy Econ · Jun 2011
This recession is wearing me out! Health-related quality of life and economic downturns.
Health-related quality of life refers to an individual's perceived physical and mental health and goes beyond the presence or absence of illnesses to encompass a multidimensional concept of well being. Previous research on the relationships between macroeconomic conditions and health status reveal improvements in physical health during economic downturns. However, few studies have examined whether mental health status improves or declines during tough economic times. ⋯ With the recent worldwide economic recession causing steep drops in the U.S. Gross Domestic Product along with double-digit unemployment rates, the implications of this study are disheartening. Besides macroeconomic policies to help stimulate the economy, government officials and policymakers should also consider social policies to help people cope with the recession and buffer the potential negative health impact, both mental and physical. Moreover, policymakers should keep in mind that the mental health effects might be greater and longer lasting.
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J Ment Health Policy Econ · Dec 2010
The effect of employee assistance plan benefits on the use of outpatient behavioral health care.
Nearly half of all US workers have access to an employee assistance plan (EAP). At the same time, most large US employers also purchase health benefits for their employees, and these benefits packages typically include behavioral health services. There is some potential overlap in services covered by the EAP and the health plan, and some employers choose to purchase the two jointly as an 'integrated product'. It is not clear whether EAP services substitute for outpatient behavioral health care services covered by the health plan. ⋯ Future studies should see whether these results are reproduced, ideally by looking at employer plans with a wider range of EAP visit allowances.
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J Ment Health Policy Econ · Jun 2010
Review Comparative StudyEvaluating mental health care and policy in Spain.
The reform and expansion of mental health care (MHC) systems is a key health policy target worldwide. Evidence informed policy aims to make use of a wide range of relevant data, taking into account past experience and local culture and context. ⋯ The evolution of MHC in Spain may be regarded as a useful contextual case study for other countries embarking on reform, including some in Eastern Europe and Latin America. Spain is an example of a country that has undergone substantial economic and democratic transition in a short time frame; it has seen significant economic growth in some areas and has experienced mass immigration. While it is too early to judge the effectiveness of reforms in Spain, work to date clearly indicates some of the challenges that have to be overcome. These include better harmonisation and integration between health and social care, and more attention paid to the development or monitoring mechanisms to assess progress in reform implementation and better identify any widening of geographical disparities.
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J Ment Health Policy Econ · Jun 2010
Body weight, self-perception and mental health outcomes among adolescents.
The prevalence of childhood obesity in the United States has increased three-fold over the last thirty years. During the same period, the prevalence of depressive symptoms in children also rose significantly. Previous literature suggests an association between actual body weight and mental health, but there is little evidence on self-perception of weight and mental health status. ⋯ Recent studies have found evidence that weight stigmatization and body dissatisfaction are predictors of depressive symptoms. It may be that the causal pathway between perceived weight status and depression occurs through weight stigmatization and body dissatisfaction. Future studies should investigate this causal mechanism further.