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OECD Health Policy Studies
Making Mental Health Count
The Social and Economic Costs of Neglecting Mental Health Care
OECD Publishing , Publication date:  31 Jul 2014
Pages: 244 , Language: English
Version: Print (Paperback) + PDF
ISBN: 9789264208438 , OECD Code: 812014031P1
Price:   €75 | $105 | £68 | ¥9700 | MXN1350 , Standard shipping included!
Availability: Available
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Other Versions:  E-book - PDF Format

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Tables: 37  Charts: 33 


Despite the enormous burden that mental ill-health imposes on individuals, their families, society, health systems and the economy, mental health care remains a neglected area of health policy in too many countries. Mental disorders represent a considerable disease burden, and have a significant impact on the lives of the OECD population, and account for considerable direct and indirect costs. This report argues that even in those OECD countries with a long history of deinstitutionalisation, there is still a long way to go to make community-based mental health care that achieves good outcomes for people with severe mental illness a reality. The disproportionate focus on severe mental illness has meant that mild-to-moderate mental illnesses, which makes up the largest burden of disease, have remained overwhelmingly neglected. This book addresses the high cost of mental illness, weaknesses and innovative developments in the organisation of care, changes and future directions for the mental health workforce, the need to develop better indicators for mental health care and quality, and tools for better governance of the mental health system. The high burden of mental ill health and the accompanying costs in terms of reduced quality of life, loss of productivity, and premature mortality, mean that making mental health count for all OECD countries is a priority.

Table of contents:

Acronyms and abbreviations 11
Executive summary 15
Assessment and recommendations 17
Chapter 1. The cost of mental illness 31
-1.1. Introduction 32
-1.2. G etting a full picture of the costs of mental ill-health 33
-1.3. M ental health accounts for a significant proportion of health spending in OECD countries 34
-1.4. M easuring intangible costs, and estimating the human cost of mental ill-health 47
-1.5. Conclusion 48
-References 50
Chapter 2. Securing better care for mild-to-moderate disorders 53
-2.1. Introduction 54
-2.2. The burden of mild-to-moderate mental disorders in OECD countries 55
-2.3. How are OECD countries treating mild-to-moderate disorders? 60
-2.4. Strengthening primary care provision 66
-2.5. N ew interventions for mild-to-moderate disorders can represent good value for money 78
-2.6. Conclusion 89
-References 90
Chapter 3. Advancing the organisation, payment and integration of care for people with severe mental illness 97
-3.1. Introduction 98
-3.2. The high burden of severe mental illness and co-morbidities with physical ill-health 98
-3.3. Organisation and delivery of mental health care for people with SMI 103
-3.4. Provider payment for treatment of SMI 118
-3.5. Employment and vocational rehabilitation for people with SMI 125
-3.6. Conclusion 128
-References 129
-Annex 3.A1. Definitions of mental health care facilities and community teams 135
Chapter 4. Improving quality measurement and data collection for mental health 137
-4.1. Introduction 138
-4.2. The epidemiological burden of mental ill-health: Using surveys and mortality indicators to collect information on prevalence and need 138
-4.3. F illing gaps in the information to help drive improvements in the quality of mental health care 143
-4.4. Quality and outcome measures for mental health care must improve in order to catch up with other disease areas 150
-4.5. OECD HCQI work on measuring the quality of mental health care 154
-4.6. I nternational initiatives to measure and benchmark quality and outcomes of mental health care 158
-4.7. U sing data to drive improvements: Developing mental health quality and outcome indicators, targets and standards  162
-4.8. Conclusion 172
-References 173
Chapter 5. Developing skilled workforces for high-performing mental health systems 177
-5.1. Introduction 178
-5.2. Composition of the mental health workforce in OECD countries 178
-5.3. Education and accreditation of mental health professionals  184
-5.4. Continuous professional education and development 188
-5.5. Shortages in mental health professions 189
-5.6. Changing models of human resources in mental health care 193
-5.7. Integration of service users and carers into the mental health workforce  197
-5.8. Conclusion 201
-References 202
-Annex 5.A1. Definitions of mental health professional categories 205
Chapter 6. Good governance for better mental health  207
-6.1. Introduction 208
-6.2. What are the key leadership challenges for mental health systems? 208
-6.3. Who will lead efforts to address these challenges? Key stakeholders in mental health governance  211
-6.4. Influencing the functioning of the mental health system through mental health legislation 216
-6.5. A high-level perspective for system-wide improvements: Setting strategic directions to plan and execute change in mental health  223
-6.6. Identifying and addressing gaps in mental health systems using vertical programmes  227
-6.7. Conclusion 235
-References 236

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