The Effects of Three Kinds of Insurance Benefit Design Features on Specialty Mental Health Care Use in Managed Care.
DISCUSSION: Elimination of limits was associated with small average increases in in-network individual psychotherapy utilization and expenditures. Cost sharing sensitivities of individual psychotherapy visits to financial requirements reported here were small, and resembled previous findings based in a managed care setting, which were smaller than findings based on the fee-for-service settings. Cost sharing may not pose a practical barrier to specialty behavioral health for non-elderly adults with employer-sponsored managed care plans. However, the influence of cost sharing may vary by specific healthcare needs, something ...
Source: Journal of Mental Health Policy and Economics - July 20, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

The Impact of Internet Gaming on Alcohol Consumption.
DISCUSSION: We investigate potential channels through which men and women are differently affected by internet gaming on alcohol consumption. We find large disparities in types of gaming devices and playing partners between men and women and that these factors account for part of the different gaming effects by gender. Other gaming preferences contributing to the heterogeneous game effects are not examined due to lack of data, which is the limitation of this study. IMPLICATIONS FOR HEALTH POLICIES: The empirical findings suggest that female users of internet games, in particular those who are vulnerable to social isola...
Source: Journal of Mental Health Policy and Economics - July 20, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Unit Costs of Delinquent Acts for Use in Economic Evaluations.
This study aims to provide a method for estimating the unit costs per perpetrator of 14 delinquent acts common in the Netherlands and included in self reported delinquency questionnaires: robbery/theft with violence, simple theft/pickpocketing, receiving stolen goods, destruction/vandalism of private or public property, disorderly conduct/discrimination, arson, cybercrime, simple and aggravated assault, threat, forced sexual contact, unauthorised driving, driving under the influence, dealing in soft drugs, and dealing in hard drugs. METHODS: Information on government expenditures and the incidence of crimes, number of ...
Source: Journal of Mental Health Policy and Economics - July 20, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Cost Savings from a Navigator Intervention for Repeat Detoxification Clients.
DISCUSSION: While the results for total spending did not reach statistical significance, they suggest some potential for insurers to reduce the health care costs associated with repeat detox utilization by using a navigator-based intervention. Analyses reported elsewhere found that this intervention had favorable effects on rates of initiation of SUD treatment. Limitations of the study include the fact that neither subjects nor sites were randomized between study groups; lack of data on crime or productivity outcomes; low participant use of RSN services; and a policy change which altered the participant pool and truncated ...
Source: Journal of Mental Health Policy and Economics - April 18, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Assessing Costs Using the Treatment Inventory Cost in Psychiatric Patients (TIC-P), TIC-P Mini and TIC-P Midi.
DISCUSSION: A reduction of the number of items resulted in a substantial loss in the ability to measure health care costs compared to the full-length TIC-P, because these outpatient populations consumed health care from a variety of health care providers. Two limitations of the study need to be stressed. Firstly, the number of patients in each of the four studies was relatively small. However, results were consistent over the four studies despite the small number of patients. Secondly, we did not take costs of medication into account. IMPLICATIONS FOR HEALTH POLICIES: In developing mental health policy, it is important...
Source: Journal of Mental Health Policy and Economics - April 18, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

PERSPECTIVES: Mental Health Policy in India: Seven Sets of Questions and Some Answers.
DISCUSSION: Perhaps the highest priority in achieving the goals of greater access and better quality is to increase the number of trained personnel at all levels of specialization and skilling that are relevant. Further, while the new legal framework and policy identify the importance of information technology in rapid expansion of access to mental healthcare, more context-specific research and trials are needed. With respect to the administration and management needs of the public system, important challenges will be the need for significant organizational innovations in the education system, and cultural changes that all...
Source: Journal of Mental Health Policy and Economics - April 18, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

The Potential Impact of Alzheimer's Disease Early Treatment on Societal Costs of Care in Czechia: A Simulation Approach.
DISCUSSION: The results suggest that early treatment of AD would decrease costs of care in Czechia. The main limitation of the simulation arises from the fact that missing domestic information was substituted by input from foreign clinical trials or simplifying assumptions. Because of insufficient data, we do not model hospitalization risk; on the other hand, introduction of this risk into our model would likely increase the savings from early treatment. IMPLICATIONS FOR HEALTH POLICIES: Makers of AD policies ought to appreciate the trade-off between costs of daily assistance in untreated patients and health care costs...
Source: Journal of Mental Health Policy and Economics - January 25, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Estimating Impact Based on Stages of Mental Illness on Employment and Earnings in Bangkok Metropolitan Region.
DISCUSSION: The findings suggest that all stages of mental disorders, particularly chronic one, are associated with substantial individual- and societal-level burden, and highlight differences in employment and earnings gaps among individuals at each stage of illness. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Mental health service should be provided in close coordination with vocational and welfare services in order to alleviate financial and work difficulties faced by mentally ill people at various stages of illness. IMPLICATIONS FOR HEALTH POLICIES: There is a need to tailor disability benefits and employme...
Source: Journal of Mental Health Policy and Economics - January 25, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Higher Benefit for Greater Need: Understanding Changes in Mental Well-being of Young Adults Following the ACA Dependent Coverage Mandate.
Authors: Shane DM, Wehby GL Abstract BACKGROUND: Beginning in late 2010, private health insurance plans were required to allow dependents up to age 26 to remain on a parent's plan. Known as the dependent coverage or young adult mandate, this provision increased coverage substantially within the group of 19-25 year-olds affected by the policy change. Subsequent work evaluating whether increased coverage had a positive effect on mental health found mild improvements in self-reported mental health. This work focused exclusively on average effects among young adults in the years after the policy change, leaving open th...
Source: Journal of Mental Health Policy and Economics - January 25, 2019 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Effects of the Mental Health Parity and Addiction Equity Act on Specialty Outpatient Behavioral Health Spending and Utilization.
DISCUSSION: Potential reasons for MHPAEA's apparent lack of effect are that health plans were already at parity before the law's passage, that many health plans continue to be out of compliance with the law, that concurrent changes in plans' cost-sharing blunted the law's effects, and that other barriers to behavioral health service use continue to limit utilization. While our study cannot provide direct evidence of these mechanisms, we review existing evidence in support of each of them. Our study had several limitations. We cannot test definitively whether the difference-in-differences assumption was violated or fully co...
Source: Journal of Mental Health Policy and Economics - December 12, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Attention Deficit Hyperactivity Disorder (ADHD) and its Comorbid Mental Disorders: An Evaluation of their Labor Market Outcomes.
DISCUSSION AND LIMITATIONS: In contrast to existing evidence, we find that ADHD is not more serious than learning disabilities or depression. Although the magnitude of each employment gap is not substantial, the fact that these are comorbid disorders indicates that their joint occurrence could be detrimental for employment. Females and African Americans with learning disabilities could face more adverse labor market outcomes. Even though our results are robust to a more exogenous measure of depression, the potential endogeneity of the diagnosis of ADHD or anxiety could still bias the estimates. However, baseline results ar...
Source: Journal of Mental Health Policy and Economics - December 12, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

An Economic Evaluation of Coordinated Specialty Care (CSC) Services for First-Episode Psychosis in the U.S. Public Sector.
CONCLUSIONS: Our findings are promising with regard to the value of STEP to third-party payers. PMID: 30530872 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - December 12, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

The Adaption of the Client Sociodemographic and Service Receipt Inventory for Costing Mental Health Services in Brazil.
CONCLUSION: ISDUCS is the first tool for economic evaluation including mental health services translated and adapted to Brazilian context. Despite the widespread use of CRSSI among people with schizophrenia in Europe, this study found that greater severity of symptoms led to high rate of missing responses. Inter-rater reliability was excellent as a whole. Small sample size didn't allow generalisation of results of this preliminary testing. IMPLICATIONS FOR HEALTH PROVISION AND USE: ISDUCS may be suitable for people with mental illness but requires additional sources of information such as carers and medical records. IS...
Source: Journal of Mental Health Policy and Economics - December 12, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Child Labor Hazard on Mental Health: Evidence from Brazil.
CONCLUSION: Our study supports the hypothesis that work during childhood increases the risk of developing depression in adulthood. Family mental health status and chronic physical illness play a substantial role in the risk that child laborers have to develop depression. IMPLICATIONS FOR HEALTH POLICIES: The results of the study indicate the need of basic mental health services aimed to the assessment and care for child laborers who withdraw from work, with the aim of reducing the risk of depression in adulthood. The results underline also the importance of mental health assessment and care for those children with a fa...
Source: Journal of Mental Health Policy and Economics - July 3, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Cost-effectiveness Analysis of a Stepped, Collaborative and Coordinated Health Care Network for Patients with Somatoform Disorders (Sofu-Net).
CONCLUSION: Patients with severe somatic symptoms did not benefit from the health care network. Sofu-Net might have reduced costs in patients with moderate somatic symptoms. IMPLICATIONS FOR FURTHER RESEARCH: Owing to the limitations and due to a short follow-up of this study, further cost-effectiveness analyses with high methodological quality and a follow-up of at least one year are needed in order to produce results that are more reliable. PMID: 29961045 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - July 3, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

A Cost-effectiveness Study of the Impact of the Affordable Care Act on Depression Outcomes in the United States.
CONCLUSIONS: If the savings of these regulations are expanded over the entire cohort of Americans adults, the potential cost savings from treated depression are estimated at USD 47.30 billion in addition to 2.2 million QALYs saved. PMID: 29961046 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - July 3, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Measuring Efficiency at the Interface of Behavioral and Physical Health Care.
DISCUSSION: Measuring efficiency at the interface of behavioral and physical care is particularly difficult due to the number of relevant stakeholders involved, ambiguity over the definition of efficiency and the complexity of providing care for people with multimorbidity. Current measures at this interface concentrate on a limited range of outcomes. LIMITATIONS: We only searched one database and did not review the gray literature, nor solicit a call for relevant but unpublished work. We did not assess the methodological quality of the studies identified. IMPLICATION FOR HEALTH CARE PROVISION AND USE: Most measures...
Source: Journal of Mental Health Policy and Economics - July 3, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Health State Utilities for Patient's Current Health from Bipolar Type I Disorder.
This study was performed on a group of patients with BID in a referral psychiatric center. This sample can potentially make a selection bias. Furthermore, this study was cross-sectional. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Generally, clinical features could explain more than half of the variances in VAS utility scores. Among all clinical features, severity of symptoms and duration of disease were among the main factors significantly associated with the utility decreases. IMPLICATION FOR HEALTH POLICIES: The present study data provide health state preferences useful for cost-utility and outcome-modeling ...
Source: Journal of Mental Health Policy and Economics - April 14, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

How does Economic Recession Affect Substance Use? A Reality Check with Clients of Drug Treatment Centres.
CONCLUSIONS: While this result has potential interest for those developing policies and interventions to reduce drug-related harm, longitudinal studies and future research involving a broader population of drug-users (including those not in treatment) could shed further light on these behavioural mechanisms linking changes in drug use with economic recessions. PMID: 29643264 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - April 14, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Thirty-day Readmission Rates and Associated Factors: A Multilevel Analysis of Practice Variations in French Public Psychiatry.
DISCUSSION: The extent of the variations and the factors associated with it question the adequacy of care and suggest that some of them may be unwarranted. Our findings should however be interpreted in consideration of several limits inherent to data quality and availability as we relied on information from administrative databases. While we considered a wide range of factors potentially associated with variations in 30-day readmissions, our model indeed only explained a limited part of the variations resulting from differences between sectors. IMPLICATIONS FOR HEALTH POLICIES: Our findings underscored that practice va...
Source: Journal of Mental Health Policy and Economics - April 14, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Changes in the Utilization of Mental Health Care Services and Mental Health at the Onset of Medicare.
This study examines if changes in mental health outcomes accompany the changes in health insurance coverage rates at age 65. METHODS: 2006-2013 data from the Sample Adult and Person File components of the National Health Insurance Survey are used to explore the link between the onset of Medicare and the utilization of mental health care services and mental health. A regression discontinuity design is employed to test for changes in perceived financial barriers to mental health care, visits with mental health professionals, and self-reported mental health. In addition to identifying the overall effect, analysis is also ...
Source: Journal of Mental Health Policy and Economics - April 14, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Does Eating Out Make Elderly People Depressed? Empirical Evidence from National Health and Nutrition Survey in Taiwan.
CONCLUSION: Our results show that elderly who eat out have a higher chance of having depressive symptoms. To prevent depressive symptoms in the elderly, policy makers should be aware of the relationship among psychological status, physical health and nutritional health when assisting the elderly to better manage their food consumption away from home. LIMITATONS AND IMPLICATIONS FOR FUTURE RESEARCH: Our study have some caveats. First, the interpretation of our results on the causality issue calls for caution in that our analysis relies on a cross-sectional survey. Second, other measures to define elderly depression, such as...
Source: Journal of Mental Health Policy and Economics - March 16, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

The Cost-effectiveness of the Online MindSpot Clinic for the Treatment of Depression and Anxiety in Australia.
CONCLUSIONS: This study found that the iCBT treatments provided by MindSpot were highly cost-effective in comparison with current routine/usual care in the Australia setting. However, future research using a prospective matched comparator that comprehensively assesses all the respective costs is required to verify the current study findings. PMID: 29300702 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - January 5, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Do High Fidelity Wraparound Services for Youth with Serious Emotional Disturbances Save Money in the Long-Term?
DISCUSSION: Youth participating in Wrap had much higher average monthly costs than youth in the control group for the year prior to entering Wrap, suggesting that the intervention targeted youth with the highest mental health utilization and likely more complex needs. While both groups experienced reductions in spending, the treatment group experienced larger absolute reductions, but smaller relative reductions associated with participation. These differences were driven mainly by reductions in mental health inpatient spending. Larger reductions in general outpatient spending for the treatment group suggest spillover benef...
Source: Journal of Mental Health Policy and Economics - January 5, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Cost-effectiveness and Budget Impact of Specialized Psychotherapy for Borderline Personality Disorder: A Synthesis of the Evidence.
We present a method for the synthesis of evidence from different types of studies in a way that respects the uncertainty surrounding those findings. Limitations of the study pertain to the inclusion of findings from studies with suboptimal designs, the transferability of research findings, and uncertainty regarding the time horizon considered. More research is needed on the sensitivity of our findings to the choice of included studies based on the comparator condition. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: THE results suggest that the provision of specialized outpatient psychotherapy for BPD leads to a reduct...
Source: Journal of Mental Health Policy and Economics - January 5, 2018 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Cost-effectiveness Analysis of an Aftercare Service vs Treatment-As-Usual for Patients with Severe Mental Disorders.
This study was a parallel group randomized controlled trial. A total of 160 post-discharge eligible patients were randomized into two equal patient groups, Aftercare Service (that includes either Home Visiting Care, or Telephone Follow-up for outpatient treatment) vs Treatment-As-Usual, using stratified balanced block randomization method. All patients were followed for 12 months after discharge. The perspective of the present study was the societal perspective. The outcome measures were the rate of readmission at the hospitals after discharge, psychotic symptoms, manic symptoms, depressive symptoms, illness severity, glob...
Source: Journal of Mental Health Policy and Economics - September 6, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

The Affordable Care Act's Dependent Care Coverage Expansion and Behavioral Health Care.
This study shows that insurance coverage increased and financial barriers to getting behavioral health treatment fell. Improving access to care only led to increases in mental health treatment utilization, while substance use treatment utilization remained unchanged. IMPLICATIONS: The ACA succeeded in extending insurance benefits to a population that has been historically underinsured. Along with those benefits, young adults enjoyed greater access to behavioral health care and a measure of financial protection from high costs. While the evidence has yet to be presented for the full implementation of the ACA, if these r...
Source: Journal of Mental Health Policy and Economics - September 6, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Clinicians' Views on Therapeutic Outcomes of Systemic Interventions and on the Ability of the EQ-5D to Capture these Outcomes.
DISCUSSION: The interviewed clinicians considered several dimensions of the EQ-5D useful in evaluating effects of systemic interventions, yet they expressed the need to add additional dimensions particularly relevant to systemic aspects to the instrument when performing economic evaluations of systemic interventions. The explorative analysis was limited by the small number of interviewed clinicians. Furthermore, a relatively high proportion of clinicians were specialized in Multidimensional Family Therapy, a type of systemic intervention particularly used to treat adolescents with substance use disorders and related proble...
Source: Journal of Mental Health Policy and Economics - September 6, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Increased Mental Health Treatment Financing, Community-Based Organization's Treatment Programs, and Latino-White Children's Financing Disparities.
DISCUSSION: EPSDT expanded funding increased proportional expenditures for Whites absent cultural and language-sensitive treatment programs. The programs moderate, but do not overcome, entrenched expenditure disparities. These findings use investment in mental health services for Latino populations to indicate treatment access and utilization, but do not explicitly reflect penetration rates or intensity of services for consumers. IMPLICATIONS FOR POLICY: New funding, along with an expectation that Latino children's well documented mental health treatment disparities will be addressed, holds potential for improved menta...
Source: Journal of Mental Health Policy and Economics - September 6, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Does Eating Out Make Elderly People Depressed? Empirical Evidence from National Health and Nutrition Survey in Taiwan.
CONCLUSION: Our results show that elderly who eat out have a higher chance of having depressive symptoms. To prevent depressive symptoms in the elderly, policy makers should be aware of the relationship among psychological status, physical health and nutritional health when assisting the elderly to better manage their food consumption away from home. LIMITATIONS AND IMPLICATIONS FOR FUTURE RESEARCH: Our study have some caveats. First, the interpretation of our results on the causality issue calls for caution in that our analysis relies on a cross-sectional survey. Second, other measures to define elderly depression, su...
Source: Journal of Mental Health Policy and Economics - June 14, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Mental Health Insurance Parity and Provider Wages.
This study evaluated whether implementation of parity laws was associated with changes in mental health provider wages. METHOD: Quasi-experimental analysis of average wages by state and year for six mental health care-related occupations were considered: Clinical, Counseling, and School Psychologists; Substance Abuse and Behavioral Disorder Counselors; Marriage and Family Therapists; Mental Health Counselors; Mental Health and Substance Abuse Social Workers; and Psychiatrists. Data from 1999-2013 were used to estimate the association between the implementation of state mental health parity laws and the Paul Wellstone a...
Source: Journal of Mental Health Policy and Economics - June 14, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Costs and Performance of English Mental Health Providers.
DISCUSSION AND LIMITATIONS: The results suggest that some providers may have to increase efficiency in order to remain financially viable if providers are paid national fixed prices (tariffs) under the new payment system. Although the classification system for payment is not based on diagnosis, a limitation of the study is the inability to explore the effect of diagnosis due to poor coding in the MHMDS. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: We find that some mental health care providers in England are associated with higher costs of provision after controlling for characteristics of service users and provider...
Source: Journal of Mental Health Policy and Economics - June 14, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Willingness to Pay in Caregivers of Patients Affected by Schizophrenia.
CONCLUSION: Willingness to Pay (WTP) is a method that can be used to determine the strength of preference of patients and caregivers for a recovery in schizophrenia. The higher the income and education, the higher the willingness to pay. No clinical characteristics of patients had a statistically significant relation to the value the caregiver would pay. IMPLICATIONS FOR HEALTH POLICIES: WTP is a potentially useful tool to determine values and health care preferences, and can be used for the development of mental health policies. IMPLICATIONS FOR FURTHER RESEARCH: Future research should be used to enhance WTP tool ...
Source: Journal of Mental Health Policy and Economics - April 19, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Reduction in Costs after Treating Comorbid Panic Disorder with Agoraphobia and Generalized Anxiety Disorder.
DISCUSSION: Methodological choices may have underestimated cost evaluations. Nonetheless, this study supports the cost offset effects of both conventional CBT for primary PDA or GAD and combined CBT for PDA-GAD comorbidity. IMPLICATIONS FOR HEALTHCARE PROVISION AND USE: Treatment of comorbid and costly disorders with evidence-based treatments such as CBT may lead to considerable economic benefits for society. IMPLICATIONS FOR HEALTH POLICIES: Considering the limited resources of healthcare systems, it is important to make choices that will lead to better accessibility of quality services. The application of CBT for...
Source: Journal of Mental Health Policy and Economics - April 19, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Costs and Effectiveness of Treating Homeless Persons with Cocaine Addiction with Alternative Contingency Management Strategies.
DISCUSSION: More intensive methods of counseling improved abstinence but 4 of the 7 treatments were inefficient ("dominated"). Bootstrapping shows that results are sensitive to which individuals were randomly assigned to each arm. A limitation of the analysis is that it does not consider the full societal cost of lost wages, crime costs beyond jail expenses and deterioration of neighborhood quality of life. Additionally, populations treated by Housing First programs may differ from the Birmingham Homeless studies in the severity of addiction or co-occuring psychological problems. IMPLICATIONS FOR TREATMENT: T...
Source: Journal of Mental Health Policy and Economics - April 19, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

PERSPECTIVES: Accountability for Mental Health: The Australian Experience.
CONCLUSION: Existing systems of accountability are not fit for purpose, incapable of firing necessary quality improvement processes. Supported by adequate resources, realistic targets and a culture of openness, new accountability could drive real quality improvement processes for mental health, facilitate jurisdictional comparisons in Australia, and contribute to new efforts to benchmark mental health internationally. PMID: 28418836 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - April 19, 2017 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

The Economic Burden of Chronic Psychotic Disorders in Ontario.
DISCUSSION AND LIMITATIONS: The direct net costs of treating patients with chronic psychotic disorders are substantial and represent a sizeable portion of the Ontario health care budget (3%). Previous research has found similar findings in other jurisdictions. These estimates do not account for costs of addiction services. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Our results suggest there are important utilization/cost differences between age groups. As patients with chronic psychotic disorders become older chronic disease and disability become more prominent, as reflected in higher costs with long-term care and...
Source: Journal of Mental Health Policy and Economics - December 21, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Medical Resource Utilization by Taiwanese Psychiatric Inpatients under the National Health Insurance System.
DISCUSSION AND LIMITATIONS: A longer LOS in Taiwan might reflect more free access to hospitals and further extensive utilization of medical facilities under the National Health Insurance system. It was noted that age, sex, disease characteristics, and insurance policies were associated with a high medical utilization. However, the lack of a copayment may partially explain the long LOS in our study. Other causes, such as inadequate supplies of resources for psychiatric services, may also deserve closer study. A failure to adjust for potentially confounding factors might limit interpretation of the observed relationship betw...
Source: Journal of Mental Health Policy and Economics - December 21, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Cost-Effectiveness of Four Parenting Programs and Bibliotherapy for Parents of Children with Conduct Problems.
CONCLUSIONS: The results suggest the delivery of different programs according to budget constraints and the outcome desired. In the absence of a WTP threshold, bibliotherapy could be a cheap and effective option to initially target CP within a limited budget, whereas Comet could be offered to achieve greater effects based on decision-makers' willingness to make larger investments. In its turn, Cope could be offered when targeting broader outcomes, such as symptom improvement, rather than clinical caseness. PMID: 27991419 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - December 21, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

State Right to Refuse Medication Laws and Procedures: Impact on Homicide and Suicide.
Authors: Edwards G Abstract BACKGROUND: As part of the expansive overhaul of the mental health system that occurred in the latter half of the 20th Century, many states passed laws that allow, under certain conditions, voluntary and involuntarily committed patients to refuse medication. While some predicted the consequences of these laws would be dire, the effect on violent behavior remains untested. AIMS OF THE STUDY: The aim is to decipher any differences state right to refuse medication laws may have on violence. METHOD: Using the homicide rate of every US state between 1972 and 2001 (N = 1,479), and the ...
Source: Journal of Mental Health Policy and Economics - September 1, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Economic Burden of Mental Illnesses in Pakistan.
This study set out to generate evidence using a low cost innovative approach relevant to many LMICs. In Pakistan, like many LMICs, patients access tertiary care directly, even for illness that can be efficiently managed at PHC level. In economic terms the non-medical consequences of mental illnesses are far greater than medical consequences. Based on these finding we recommend, firstly, that mental illnesses should be prioritized equally as other illnesses in health policy and secondly there needs to be integration of mental health in primary health care in Pakistan. PMID: 27572143 [PubMed - in process] (Source: Journa...
Source: Journal of Mental Health Policy and Economics - September 1, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Increased Medicaid Financing and Equalization of African Americans' and Whites' Outpatient and Emergency Treatment Expenditures.
CONCLUSIONS: With new funding that requires no matching funds from the county, county mental health systems did reduce outpatient treatment expenditure inequalities. This was found to be true in counties that initially favored African Americans and in counties that initially favored Whites. Adopting a systems level perspective and taking account of initial conditions and trends can be critical for understanding inequalities. PMID: 27572144 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - September 1, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Got Munchies? Estimating the Relationship between Marijuana Use and Body Mass Index.
Authors: Beulaygue IC, French MT Abstract BACKGROUND: Although marijuana use is commonly associated with increased appetite and the likelihood of weight gain, research findings in this area are mixed. Most studies, however, report cross-sectional associations and rarely control for such important predictors as physical activity, socioeconomic status, and alcohol and other drug use. METHODS: Using data from Waves III (N = 13,038) and IV (N = 13,972) of the National Longitudinal Survey of Adolescent Health, we estimate fixed-effects models to more rigorously study the relationships between marijuana use and body ...
Source: Journal of Mental Health Policy and Economics - September 1, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Mapping the Beck Depression Inventory to the EQ-5D-3L in Patients with Depressive Disorders.
This study specified mapping algorithms from the Beck Depression Inventory (BDI) index to the EQ-5D-3L index adjusted for specific socio-demographic variables for patients with depressive disorders. AIMS OF THE STUDY: The objective of this study was to specify mapping algorithms from the BDI index to the preference-based EQ-5D index for patients with depressive disorders, adjusting for specific socio-demographic variables. METHODS: A sample of 1,074 consecutive patients with depressive disorders from a psychotherapeutic outpatient clinic was included in the study. Standardized clinical interviews were applied to es...
Source: Journal of Mental Health Policy and Economics - July 29, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Does Prevention Pay? Costs and Potential Cost-savings of School Interventions Targeting Children with Mental Health Problems.
This study uses data on the additional support students with mental health problems received in schools. Data was collected from one school district for students aged 6 to 16 years. We modeled two Swedish school interventions, Comet for Teachers and Social and Emotional Training (SET), which both had evidence of reducing mental health problems. We used a cost-offset analysis framework, assuming both interventions were fully implemented throughout the whole school district. Based on the published studies, the expected effects and the costs of the interventions were calculated. We defined the cost-offsets as the amount of pr...
Source: Journal of Mental Health Policy and Economics - July 29, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Services Use of Children and Adolescents before Admission to Psychiatric Inpatient Care.
DISCUSSION: Mentally ill children and adolescents use a broad range of services across sectors before admission to hospital. Service use is associated with specific symptoms of the disease, yet not with the diagnosis. For some carers, this is linked to considerable financial burden because many of those services are only partly publicly funded or are not part of the health sector. A limitation of the study is the uncertainty of self-reports. Furthermore, we do not know whether the services used were needs-based and effective, and what the utilisation patterns of non-hospitalised children and adolescents are. IMPLICATIO...
Source: Journal of Mental Health Policy and Economics - July 29, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Regional Variation in Physician Adoption of Antipsychotics: Impact on US Medicare Expenditures.
Authors: Donohue JM, Normand SL, Horvitz-Lennon M, Men A, Berndt ER, Huskamp HA Abstract BACKGROUND: Regional variation in US Medicare prescription drug spending is driven by higher prescribing of costly brand-name drugs in some regions. This variation likely arises from differences in the speed of diffusion of newly-approved medications. Second-generation antipsychotics were widely adopted for treatment of severe mental illness and for several off-label uses. Rapid diffusion of new psychiatric drugs likely increases drug spending but its relationship to non-drug spending is unclear. The impact of antipsychotic dif...
Source: Journal of Mental Health Policy and Economics - July 29, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Editorial.
Authors: PMID: 27111923 [PubMed - in process] (Source: Journal of Mental Health Policy and Economics)
Source: Journal of Mental Health Policy and Economics - April 27, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

The Effects of the Affordable Care Act Adult Dependent Coverage Expansion on Mental Health.
This study provides the first estimates of a broad range of mental health outcomes that may be responsive to changes in mental health care use and/or the increased financial security that insurance confers. For the population as a whole, there were few short-term changes in young adults' mental health outcome relative to older adults. However, the relative increase in the SF-12 score among young adults, while small, is likely meaningful at a population level given the observed effect sizes for this measure obtained in clinical trials. IMPLICATIONS: The vast majority of mental illnesses emerge before individuals reach a...
Source: Journal of Mental Health Policy and Economics - April 18, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

Body Weight and Suicidal Behavior in Adolescent Females: The Role of Self-Perceptions.
This study examines the relationship between body weight and suicidal behaviors using a rich longitudinal data set of a large nationally-representative sample of female adolescents to account for a number of confounding factors. The study explores the relationship, not only between actual weight status and suicidal behaviors, but also between self-perception of weight and suicidal behaviors. METHOD: Using data from a nationally-representative sample of adolescents in the United States, the study ascertains the effect of body weight status on suicidal behaviors by estimating endogeneity-corrected models including school...
Source: Journal of Mental Health Policy and Economics - April 18, 2016 Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research