Mental health care

The production of welfare approach assumes that the final outcomes of a mental health-care intervention will be influenced ( produced ) by the nature of the services provided, the types, levels and mixes of resources employed, the social environment of the care setting and other non-resource factors. This core theme of the production of welfare model is obviously not built up from economic theory as such, but it is a logical corollary of theory and evidence from psychology, psychiatry and certain other disciplines. However, the formalization of the links between intervention characteristics, resource inputs and patient and family outcomes owes much to economic theories of cost and production relations and their... [Pg.7]

The simplest economic theories assume— somewhat unrealistically—that markets work sufficiendy well to ensure that society s scarce resources are allocated efficiendy. Of course, few markets are as well-behaved as in the elementary textbook, but nevertheless market forces can often be relied upon to allocate goods and services reasonably well between competing demands. If this is the case, then the need for economic evaluation of the costs and outcomes flowing from alternative uses of scarce resources is lessened. Mental health-care services in Britain are purchased and provided within internal markets (quasi-markets) within the state sector (mainly), and these muted market forces have clearly had some influence over allocations. Market forces have a more overt role in countries such as the USA, strongly influencing who obtains what service and at what cost to different parties. However, it is difficult to imagine circumstances in which techniques such as... [Pg.7]

Beecham J (1995). Collecting and estimating costs. In Knapp MRJ, ed. T e Economic Evaluation of Mental Health Care. Aldershot Arena,... [Pg.17]

Chisholm DH, Healey AT, Knapp MRJ (1997). QALYs and mental health care. Soc Psychiatry PsychiatrEpidemiol ) , 68-75. [Pg.17]

FFealey AT, Ghisholm DFF (1999). Willingness-to-pay methods in mental health care. /Ment Health Policy Econ 2, 55—8. [Pg.18]

Carter C, Stevens M, Durkin M (1998). Effects of risperidone therapy on the use of mental health care resources in Salt Lake County, Utah. Clin Ther20,352-63. [Pg.38]

Reid WH, Mason M (1998). Psychiatric hospital utilization in patients treated with clozapine for up to 4.5 years in a State mental health care system. J Clin Psychiatry 189—94. [Pg.41]

Viale G, Mechling L, Maislin G, et al (1997). Impact of risperidone on the use of mental health care resources. Psychiatr Serv4S, 1153-9. [Pg.42]

Further detailed analyses of the ECA data have been extrapolated to USA national costs (Rice and Miller, 1998). It was calculated that the economic costs of mental disorders in 1990 in the USA totalled US 147.8 billion. Anxiety disorders were the most cosdy, amounting to 46.6 billion, just under a third of the total. Direct costs spent on mental health care totalled 67 billion, of which anxiety disorders accounted for only 11 billion (16.5%). Drug costs were 2191 million, of which anxiety disorders accounted for 1167 million—over half Morbidity costs—the value of goods and services not produced because of mental disorders — amounted to 63.1 billion, with anxiety disorders accounting for 34.2 billion, 54.2% of the total. This reflects the high prevalence of anxiety disorders in the community and the high associated rate of lost productivity. In contrast, patients with affective disorders appeared better able to function (Rice and Miller, 1995). In summary, anxiety disorders are common, disruptive and costly to society drug treatment is a substantial element of treatment costs (11%) compared with, say, schizophrenia (2.2%). [Pg.60]

The availability of medications that are effective in the treatment of mental disorders, and safe even after extended use, is essential for the success of programs directed to the improvement of mental health care. It is essential but not sufficient because such programs must - if they are to be successful - also include efforts to improve knowledge, skills, and attitudes of health workers involved in the provision of mental health care additional investment into mental health programs and a... [Pg.156]

NIMH (2005). Treatment Research in Mental Illness Improving the Nation s Public Mental Health Care through NIMH Funded Interventions Research. Report of the National Advisory Mental Health Council s Workgroup on Clinical Trials. Washington, D.C. [Pg.168]

Professionals working with a suicidal drug client may wish to determine whether the person meets criteria for Borderline Personality Disorder. Borderline clients often have a history of suicidal behavior and high utilization of health and mental health care services. Most people who meet criteria for Borderline Personality Disorder are women, but not all. As mentioned, some professionals find it difficult to work with borderline clients without becoming very upset or cynical. If you cannot work with such a client respectfully, then it is recommended that a referral be made to someone who can (see Chapter 3). Treating the client with dignity is important if trust and a solid therapeutic alliance are to develop. [Pg.67]

When is medication indicated in the treatment of psychiatric illness There is no short answer to this question. At one end of the continuum, patients with schizophrenia and other psychotic disorders, bipolar disorder, and severe major depressive disorder should always be considered candidates for pharmacotherapy, and neglecting to use medication, or at least discuss the use of medication with these patients, fails to adhere to the current standard of mental health care. Less severe depressive disorders, many anxiety disorders, and binge eating disorders can respond to psychotherapy and/or pharmacotherapy, and different therapies can target distinct symptom complexes in these situations. Finally, at the opposite end of the spectrum, adjustment disorders, specific phobias, or grief reactions should generally be treated with psychotherapy alone. [Pg.8]

The referral for mental health care is often not made until an extensive medical evaluation has been completed. This medical assessment is often warranted, but a delay in recognizing the presence of panic disorder can result in an unending battery of expensive, unnecessary, and sometimes unpleasant medical tests. [Pg.139]

In contrast to panic disorder, the somewhat more subtle and persistent symptoms of GAD do not always command immediate attention. Although patients with GAD may present with a primary complaint of anxiety, they are more likely to complain of a physical ailment or another psychiatric condition or symptoms, for example, depression or insomnia. As such, many patients with GAD will seek treatment from a primary care physician long before recognizing the need for mental health care despite readily acknowledging that they have been anxious virtually all of their lives. [Pg.146]

With the notable exception of the Veteran s Administration (VA) hospital system, health care providers, both in primary care and mental health care, do a relatively poor job of identifying PTSD. There are two basic steps to diagnosing PTSD (1) determining that the patient has been exposed to a traumatic event, and (2) determining that the trauma-exposed patient is experiencing symptoms that fulfill diagnostic criteria for the disorder. [Pg.170]

In our experience, victims of TBI most often come to the attention of mental health care providers when referred by other clinicians. Their first psychiatric encounter may be a consultation during the initial postinjury hospitalization or later during active rehabilitation. Patients may also be referred for mental health treatment during the postconvalescent phase when faced with the realization that some of their physical dehcits may be permanent. As we mentioned earlier, TBI patients infrequently seek psychiatric care on their own, because they are often unaware that their psychiatric symptoms are a consequence of a past brain injury. [Pg.339]

On the twentieth of March, there was general agreement that Dennis was totally back with us. It was an occasion of great happiness and we celebrated at one of Bogota s finest restaurants. It was an immense accomplishment to have been able to allow the reversal to work itself out without the aggravating influence of modem mental health care procedures. The ordeal in the wilderness that all shamans must face had been endured. A step on the path to knowledge had been taken. [Pg.125]

Bond, A.J., and Lader, M.H. (1996) Understanding drug treatment in mental health care. Chichester, John Wiley Sons. [Pg.569]

For example, assume that Mary Cooper enters a pharmacy wanting to purchase St. John s wort because her friend told her that it would help her feel better. After talking briefly with the woman, the pharmacist realizes that her symptoms are more grave than communicated initially. Given this additional information, the pharmacist refers her to a mental health care provider for further evaluation and treatment. In this case, the customer (Mary) stated a solution, not a need. The pharmacist appropriately recognized Mary s need and was able to help her by appropriately influencing her wants and demands. [Pg.342]

Hannigan, B. Allen, D. 2006, Complexity and change in the United Kingdom s system of mental health care, Soc. Theory Plealth, vol. 4, pp. 244-263. [Pg.242]

Connelly JC, Fullick J. Experience with clozapine in a community mental health care setting. South Med J 1998 91(9) 838—41. [Pg.283]

There was greater involvement of physicians in patient mental health care and greater use of psychotropic medications. [Pg.6]

Families are often significantly affected by a family member s SUD. There are few areas in mental health care where patient and family education are as important as they are in the treatment of SUDs. The initial management and intervention described above is focused on educating the patient and family about the nature of SUDs and the need for abstinence. The process of intervention is rarely effective in a single visit, and typically the therapist must conclude the effort with a mutual agreement to keep the door open for future discussion. Referral to AA, Alanon, and Alateen may provide the patient and family with excellent information and edncational materials. [Pg.161]

An internist is a specialist physician who provides health care to adults. Some internists provide a wide range of primary care, and others limit their practice to metabolic disorders and conditions of organs between the neck and the navel. The internal medicine residency is 3 years long and does not require training in psychiatry or behavioral health per se however, many internal medicine residents seek out such training by elective experiences and additional study. Many internists feel comfortable treating their patients who suffer from mild to moderate depression, but most will refer patients with more serious mental health care needs. [Pg.216]

Can help the patient who has forensic mental health care needs or disability evaluation because of mental illness. [Pg.219]

Sample letter 4 (see Figure 9.4) is written to a mental health care professional who is acting as the screening clinician in the psychiatric emergency department of the county mental hospital. There is no mention of a release of information or consent from the patient, allowing the therapist and screening clinician to speak to each other. It would be good... [Pg.223]

Coordination with specialty mental health care, hospital, nursing homes, other care venues... [Pg.237]

Patient self-refers for mental health care or comes to treatment via a referral. [Pg.237]

Patient can call in for medical and mental health care. [Pg.237]

Big Chemical Encyclopedia

Chemical substances, components, reactions, process design ...