Journal of Mental Health Policy and Economics最新文献

{"title":"Food Security and Mental Health in the United States: Evidence from the Medical Expenditure Panel Survey.","authors":"Chandler B McClellan, Samuel H Zuvekas","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>With over 40 million food insecure Americans, access to food is a significant policy challenge. Food insecurity is associated with many adverse health conditions, including poorer mental health outcomes. However, previous research generally does not address that poor mental health can both be a cause and a consequence of food insecurity.</p><p><strong>Aims of the study: </strong>We estimate the directional causal effect of food insecurity on mental health status and mental health treatment using bounding methods to partially identify the causal effects from food insecurity to mental health status and mental health treatment.</p><p><strong>Methods: </strong>Data on food security, mental health status, mental health treatment, and individual and family socioeconomic characteristics for adults come from the nationally representative 2016 and 2017 Medical Expenditure Panel Survey. We use both the continuous score (0-10) of a 10-question module on food security as well as classifying adults as living in households that are food secure (0) or having marginal (1-2), low (3-5), or very low food security (6-10). Mental health status is measured using the Kessler-6 (K6) and the PHQ2 depression screening scales. A K6 score of 13 or greater indicates serious psychological distress while a score of 7 to 12 indicates moderate distress. A score of 3 or more on the PHQ-2 indicates probable depression. Mental health treatment is measured by ambulatory mental health visits, prescriptions for psychotropic medications, and total mental health expenditures. Standard parametric regression models are used as a baseline for partial identification models that bound the effects of food security on mental health. In our preferred specification, we impose the following assumptions: monotone treatment selection (MTS), monotone treatment response (MTR), and monotone instrumental variables (MIV) using household income as an instrument.</p><p><strong>Results: </strong>Those living in food insecure households are more likely to experience psychological distress and depression than those who in food secure households, but do not seek commensurately more mental health treatment. Non-parametric bounds suggest food insecurity increases the probability of moderate psychological distress by no more than 7.2 percentage points, serious psychological distress by no more than 3 percentage points, and probable depression by no more than 4.2 percentage points. The estimated effect sizes of food security on mental health treatment are much smaller, with treatment uptake increasing by no more than 2.4 percentage points.</p><p><strong>Discussion: </strong>Our parametric results are consistent with prior findings on the relationship between food security and mental health. We provide evidence for a causal effect of food insecurity which may account for about half the observed association of food security on mental health. A new and previously unreported result in","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 4","pages":"115-128"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PERSPECTIVE: Has Value-Based Reimbursement Arrived for Behavioral Health? A Payer Perspective.","authors":"Stuart L Lustig, Vikram Shah, Lisa Kay, Andrew DiGiacomo, Douglas A Nemecek","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Value-based reimbursement (VBR) has become increasingly common among medical practitioners but mental health practitioners (MHPs) have largely remained in fee-for-service (FFS) arrangements. Aligning payment incentives to clinical outcomes rather than volume of services, VBR aspires to achieve health care's quadruple aim, namely improved patient experience, improved population health, reduced costs, and improved work life of health care providers.</p><p><strong>Aims of the study: </strong>(i) Describe both the historical challenges to implementing VBR for mental health care within the United States, along with the shifting healthcare landscape which now enables VBR arrangements between payers and MHPs; (ii) Highlight considerations for defining quality care and establishing VBR contracting.</p><p><strong>Results, discussion and implications: </strong>Historically, VBR has been challenging to implement due to a shortage of MHPs in payer networks. Technological challenges such as the absence of electronic medical records required for efficient data analysis and immature data-sharing capabilities, have hindered VBR, as has a culture of clinical practice that relies on clinical intuition as opposed to measured outcomes. VBR is now gaining traction based on overwhelming evidence for measurement-based care, a prerequisite for outcome reporting that larger practices have begun to achieve. Multiple stakeholder organizations have been advocating for measurement-based care. Payers and MHPs can and should collaboratively structure VBR contracts to align greater reimbursements with achievable increases in quality across multiple domains. Contracts can focus on numerous process metrics, such as time to care, treatment adherence, and appropriate avoidance of emergency care, along with clinical and functional outcomes. In some instances, case rates for episodes of care can meanwhile help payer and MHPs transition from FFS to VBR.</p>","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 4","pages":"109-113"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Evaluation of Self-Management for Patients with Persistent Depressive Disorder and their Caregivers.","authors":"Ericka C Solis, Ingrid V E Carlier, Noelle Kamminga, Albert M van Hemert, M Elske van den Akker-van Marle","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Persistent depressive disorder (PDD; chronic depression) is associated with high personal, economic, and societal burden. Patients with PDD often fail to respond to treatment, despite long-term, intensive care, suggesting that future treatment should focus more on functional recovery. The \"Patient and Partner Education Program for All Chronic Diseases-Persistent Depressive Disorder\" (PPEP4All-PDD) is a brief self-management program for patients with PDD with nine weekly sessions, provided in group or individual format. Its focus on functional recovery may increase quality of life and shorten treatment duration, thus reducing healthcare and societal costs. This study examined the cost-effectiveness of PPEP4All-PDD for adults and elderly with PDD and their partners/caregivers compared to care-as-usual (CAU).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims of the study: &lt;/strong&gt;In this economic evaluation, we examined whether a favorable cost-utility of PPEP4All-PDD compared to CAU could be attained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;In this multicenter pragmatic randomized controlled trial, 70 patients with PDD and 14 partners/caregivers were included. Data were collected at 0, 3, 6, and 12 months. Health-related quality of life was measured using the EuroQoL 5-Dimensions/Levels (EQ-5D-5L). Cost of healthcare utilization and productivity loss were assessed using the Trimbos questionnaire for Costs associated with Psychiatric illness (TiC-P). We examined incremental costs per quality-adjusted life years (QALYs) after one year.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In relation to PPEP4All-PDD, 62% (n = 23) of patients had no participating PPEP4All-PDD partner/caregiver, and 89% (n = 33) of patients participated in group format. On average, PPEP4All-PDD cost €232 including the PPEP4All-PDD partner/caregiver, or €166 excluding the partner/caregiver. There was no statistical difference in mean costs per patient for (mental) healthcare, non-healthcare, and societal costs nor in QALYs between PPEP4All-PDD and CAU. The probability that PPEP4All-PDD is cost-effective compared to CAU remained below 50% for all acceptable values of willingness-to-pay for a QALY.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;This was the first economic evaluation of PPEP4All-PDD. Compared to CAU, PPEP4All-PDD did not lead to lower total healthcare costs nor higher quality of life in the one-year follow-up period. PPEP4All-PDD patients continued to receive additional mental healthcare sessions, showing that the process of ending treatment after a self-management intervention is not clear. The COVID-19 situation may have also affected this process after PPEP4All-PDD, due to higher levels of anxiety and loneliness. We could not confirm that involvement of the partner/caregiver was beneficial to patient treatment outcomes and requires further examination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications: &lt;/strong&gt;This economic evaluation failed to find significant differences in costs between PPEP4All-PDD and CAU over","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 4","pages":"129-143"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Digital Preventive Parent Training for Early Childhood Disruptive Behaviour.","authors":"Elisa Rissanen, Virpi Kuvaja-Köllner, Eila Kankaanpää","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Childhood disruptive behaviour disorder associates with various, also costly problems. Parent training is effective in reducing childhood disruptive behaviour. Only a few studies have evaluated the cost-effectiveness of digital parent training in reducing children's disruptive behaviour.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims of the study: &lt;/strong&gt;We evaluated the two-year cost-effectiveness of an Internet and telephone assisted parent training intervention called the Strongest Families Smart Website (SFSW) for prevention of children's disruptive behaviour compared to education control (EC) from the combined perspective of the health care funder and parents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used data from a randomized controlled trial (RCT). The trial screened a population-based sample of 4,656 four-year-olds at annual child health clinic check-ups in Finnish primary care. A total of 464 disruptively behaving children participated in the RCT; half received the SFSW and half EC. We evaluated intention-to-treat based incremental net monetary benefit with a range of willingness to pay values. Costs contained the interventions' and parents' time-use costs. The effectiveness measure was the Child Behavior Checklist (CBCL/1.5-5) externalizing score. The trial is registered at Clinicaltrials.gov (NCT01750996).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From the health care funder's perspective, SFSW costs per family were €1,982 and EC €661, and from the parents' perspective SFSW costs per family were €462 and EC €77. From the combined health care funder and parents' perspective, costs were €1,707 higher in the SFSW intervention than in EC. The SFSW decreased the CBCL externalizing score (1.94, SE=0.78, p=0.01) more in comparison to the EC group. In cost-effectiveness analysis using the combined perspective, the incremental net monetary benefit was zero [95% CI €-1,524 to €1,524] if the willingness to pay for one extra point of CBCL externalizing score reduced was €879. If the willingness to pay was more than €879, the average incremental net monetary benefit was positive.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The cost-effectiveness of the SFSW depends on the decision makers' willingness to pay, which is not stated for CBCL outcomes. Also, the decision maker should consider the uncertainty of cost-effectiveness estimates. The lack of other service use information and micro-costing of SFSW and EC intervention costs weakens our conclusions. However, our study had multiple strengths, such as population-based screening, high sample size, 2-year follow-up, and use of proper methods to conduct a full economic evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for health care provision and use: &lt;/strong&gt;The SFSW is effective in reducing children's disruptive behaviour. Although digitally provided, the SFSW intervention included professional time and, thus, costs. The costs of intervention to the healthcare provider and time cost to families should be taken into ac","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 3","pages":"85-98"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Cryptocurrency Trading to Quality of Life, Sleep and Stress Levels in Academics","authors":"Mehmet Uçar, Metin Yildiz, Necmettin Çiftci, Rukuye Aylaz","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cryptocurrency trading has become popular with a large section of society, and the number of investors is increasing daily. It is critical to address the health impacts of cryptocurrency trading. Of particular importance is the issue of how such trading affects mental health. Research should be conducted on this topic, and where necessary, national governments should develop policies to combat these effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This study was conducted to examine the relationship of cryptocurrency trading to quality of life, sleep, and stress levels in academics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This descriptive and cross-sectional study was conducted with 437 academics working at a state university in Turkey. A Personal Information Form, the SF-12 Quality of Life Scale, the Scopa Sleep Scale, and the Perceived Stress Scale were used to collect data. These data were analyzed using SPSS 25.0 and G*Power 3.1 programs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The data obtained in this study were analyzed using SPSS program (SPSS-25). The effect size and r-effect size were calculated with Cohen’s d value. It was found that the mean scores for the SF-12 Quality of Life Scale were statistically lower in academics who traded cryptocurrency than in those who did not. The results showed that the mean scores for the Scopa Sleep Scale and Perceived Stress Scale were statistically higher in academics who traded cryptocurrency than in those who did not (p&lt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The academics who traded cryptocurrency had more negative health outcomes when compared to those who did not. Social awareness should be raised on the negative effects of cryptocurrency trading. A limitation of the study is that only data obtained from the statements of the participants were included in the study. The study may have some generalizability to other academics, but has less generalizability to populations other than academics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for health care provision and use: &lt;/strong&gt;Cryptocurrency trading is a significant public health problem. Although cryptocurrency trading has been found to profoundly affect mental health (sleep, stress, and quality of life), the current policies that address these problems are generally inadequate in terms of implementing and sustaining mental healthcare systems. The limitations of these health policies prevent many individuals in society from receiving high quality services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for health policies: &lt;/strong&gt;Health systems alone cannot solve the systemic problems that lead to the population’s dependence of mental health services and institutions. In order to solve this basic problem, it may be necessary for governments to increase individuals’ basic incomes and develop specific mental health policies for people engaged in cryptocurrency trading.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for further research: &lt;/strong&gt;Future studies should examine expert perspectiv","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 3","pages":"63-70"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Expenditure in Canada.","authors":"Olga Milliken, Hui Wang, Marie-Chantal Benda, Thy Dinh, Alan Diener","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mental ill-health-illness or conditions related to mental health, including dementia, schizophrenia, mood (affective) disorders, and mental and behaviour disorders due to psychoactive substance and alcohol use - places a significant burden on society in terms of economic, health, and social costs. Focusing on direct health care costs, estimated expenditures on treating mental health conditions accounted for up to 14% of total health expenditures across 12 OECD countries over the period of 2003 to 2010.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims of the study: &lt;/strong&gt;The purpose of this study was to estimate the direct health care costs associated with the treatment of mental ill-health in Canada for the year 2019 using currently available guidelines. A consistent and systematic method, such as that used in the OECD guidelines on expenditure by disease, age and gender under the System of Health Accounts, can provide valuable information for policy makers and improve comparability of Canadian estimates with those of peer countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;To derive comprehensive, and internationally comparable estimates of mental health care expenditures, the results were classified according to the OECD System of Health Accounts 2011 for the following cost components: hospitals, physicians, psychologists in private practice, prescription drugs, and community mental health care. Based on data availability, both public and private expenditures were captured. Where data were lacking, estimates were based on the published literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Total expenditure for mental health care was estimated at $17.1 billion in Canada in 2019. Hospital services (inpatient and outpatient) represent the largest component totaling $5.5 billion or 32% of total mental health spending. They are followed by expenditures on prescribed pharmaceutical drugs of $4.3 billion (25%), community-based care of $3.6 billion (21%), physician services of $2.7 billion (16%) and services of psychologists in private practice of $1.1 billion (6%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The study provided the most recent and comprehensive estimate of mental health expenditure in Canada. The results for similar cost components, are comparable to those found in the previous studies. Expenditures directed towards mental health treatment accounted for 6.4% of total health expenditures, and 6.9% of public health expenditures, in 2019, on par with the OECD average of 6.7% for twenty-three countries. Among considered cost components, community-based mental health and addiction services remain an area where further work is needed the most, including a standardized list of services reported by each Canadian province/territory regardless of care setting, service administrator or funder.  In Canada, data challenges are considerable to assess private spending out-of-pocket or through third-party insurance for services by psychologists or psychotherapists, as well ","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 3","pages":"75-84"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Depression and Physical Health of Under-Five Children in Turkey.","authors":"Gokben Aydilek, Deniz Karaoğlan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Maternal depression is the most prevalent mental health problem worldwide, especially in low- and middle-income countries. It impairs the cognitive, physical, and social abilities of mothers and disturbs effective parenting practices. Therefore, the consequences of mental, physical, and social suffering are not limited to the mother herself but are transmitted to future generations by negatively affecting the child's health.</p><p><strong>Aim of the study: </strong>This study aims to analyse the relationship between maternal depression and child's physical health in Turkey, a middle-income, developing country.</p><p><strong>Methods: </strong>By using the 2019 round of the \"Turkish Health Survey\" dataset prepared by the Turkish Statistical Institute (TurkStat), we focus on the general health status, anaemia prevalence, morbidity of acute respiratory infections (ARI) and diarrhoea along with other common short-term childhood illnesses among under-five children. Maternal depression is assessed by the standardised eight-item version of the Patient Health Questionnaire (PHQ-8). We employ a linear probability model to examine the relationship between maternal depression and the physical health of under-five children. In addition, we investigate the potential protective role of maternal education against the detrimental effects of maternal depression on child health. Since we are simultaneously analysing several outcome measures, in order to avoid any Type I error, we use the novel Romano-Wolf multiple hypothesis testing method.</p><p><strong>Results: </strong>We find that children whose mothers suffer from mild to severe depression are at a 12 percentage points higher risk of contracting infectious diseases. Similarly, the total number of non-chronic illnesses a child falls victim to increases by one-third if the mother portrays depressive symptoms. In addition, our results suggest that completing at least high school reduces the burdens of maternal depression on children's physical health by 8 percentage points.</p><p><strong>Discussion: </strong>Considering both the individual and societal burden of infectious disease prevalence, we conclude that the development of worldwide policies and initiatives aimed at decreasing maternal depression as much as increasing maternal education is essential for safeguarding the rights of both women and children, especially in developing countries.</p><p><strong>Limitations of the study: </strong>The findings of this research provide a linear association between maternal mental health and under-five child's physical health, rather than a causal effect.</p>","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 2","pages":"47-58"},"PeriodicalIF":1.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PERSPECTIVE: Implications of Recent Health Policies for Women's Reproductive Mental Health.","authors":"Kara Zivin, Anna Courant","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The economic cost of perinatal mood and anxiety disorders (PMADs) is high and includes the cost of reduced maternal economic productivity, more preterm births, and increases in other maternal mental health expenditures. PMADs also substantially contribute the cost of maternal morbidity. This paper offers a discussion of the quality-of-care cascade model of PMADs, which outlines care pathways that people typically face as well as gaps and unmet needs that frequently happen along the way. The model uses the US health system as an example. A discussion of international implications follows.</p><p><strong>Discussion: </strong>The quality-of-care cascade model outlines downward dips in quality of care along the perinatal mental health treatment continuum, including access (many Americans do not have access to affordable health insurance), enrollment (even when individuals are offered health insurance, some do not enroll), coverage (even if individuals have health insurance, some needed services or providers may not be covered), choice (even if services and providers are covered, patients may not be able to choose among plans, institutions, or clinicians), consistency (even if patients have a choice of plan or provider, a consistent source of care may not be accessible), referral (even if care is available and accessible, referral services may not be), quality (even if patients have access to both care and referral services, there may be gaps in the quality of care provided), adherence (even if patients receive high-quality care, they may not be adherent to treatment), barriers (societal forces that may influence people's choices and behaviors), and shocks (unanticipated events that could disrupt care pathways). In describing the quality-of-care cascade model, this paper uses the US healthcare system as the primary example. However, the model can extend to examine quality-of-care dips along the perinatal mental health treatment continuum within the international context. Although the US healthcare system may differ from other healthcare systems in many respects, shared commonalities lead to quality-of-care dips in countries with healthcare systems structured differently than in the US.</p><p><strong>Implications for health policies: </strong>The global cost of PMADs remains substantial, and addressing the costs of these conditions could have a significant impact on overall cost and quality of care internationally. The quality-of-care cascade model presented in this paper could help identify, understand, and address the complex contributing factors that lead to dips in quality-of-care for perinatal mental health conditions across the world.</p>","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 2","pages":"63-70"},"PeriodicalIF":1.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PERSPECTIVE: A Fireside Chat about Global Mental Health with Dr. Esther Duflo, Nobel Laureate in Economics.","authors":"Benjamin Lê Cook, Esther Duflo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dr. Esther Duflo, Nobel Laureate in Economics, and co-founder and co-director of the Abdul Latif Jameel Poverty Action Lab (J-PAL) sat down with Dr. Benjamin Cook for a \"fireside chat\" at the 12th National Institute of Mental Health Global Mental Health Research Without Borders Conference. Dr. Duflo discussed J-PAL's efforts to develop and test interventions for improving mental health and how cash transfer programs can be used to improve mental health. She also discussed the importance of using randomized control trials (RCTs) in shaping global mental health initiatives. Dr. Duflo shared insights from projects addressing loneliness among older individuals in India, secondary school scholarships in Ghana, and other studies that have informed social policies. Looking forward, she discusses climate change as a threat to the reductions in poverty realized in the last 30 years and encourages the expansion of networks of research and policy collaborations to improve global health.</p>","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 2","pages":"59-62"},"PeriodicalIF":1.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PERSPECTIVE: Health Economic Interests at NIMH and NIDA to Improve Delivery of Behavioral Health Services.","authors":"Jennifer L Humensky, Sarah Q Duffy, Leonardo Cubillos, Michael C Freed, Agnes Rupp","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Effective financing mechanisms are essential to ensuring that people can access and utilize effective treatments and services. Financing mechanisms are needed not only to pay for the delivery of those treatments and services, but also ancillary costs, while also keeping care affordable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This article highlights key areas of the interest of the National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse (NIDA) in supporting applied health economics and health care financing research. Specifically, this article discusses the long-range impact of NIH's earlier investments in applied health economics research, and NIH's ongoing efforts to communicate its interests in health economics research. We discuss the 2023 NIMH-NIDA-sponsored health economics conference, and the ideas presented there for developing and assessing innovative behavioral health care financing models; three of the presented papers were recently published in the Journal of Mental Health Policy and Economics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We describe the history and impact of NIMH- and NIDA-sponsored economic research and identify current research interests as identified in the NIMH and NIDA Strategic Plans and recent funding announcements. We examine themes presented at the NIMH-NIDA Health Economics conference. The conference included over 300 participants from 20 countries, from six continents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The topics highlighted at the conference highlight the ways in which NIH-funded research has promoted the development of innovative health care financing methods, both from the supply side (e.g., providers and payers) and demand side (e.g., service users and families). Invited speakers discussed the findings from NIH-supported research in the topic areas of payment and financing, behavioral economics and social determinants of health. Keynote speakers highlighted emerging topics in the field, including the economics of health equity, biases in mental health models in health care, and value-based insurance design.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;We demonstrate a resurgence of and explicit interest in health economics and policy research at NIMH and NIDA. However, more work is needed in order to design funding mechanisms that fully provide access to and facilitate use of effective evidence-based practices to improve mental health outcomes. For example, it is important that policy and health economic research projects include decision makers who will be the end users of data and study results, to ensure that results can be meaningfully put into practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for health care: &lt;/strong&gt;Designing effective and efficient funding mechanisms can help ensure that service users have access to effective treatments and that clinicians and provider organizations are adequately compensated for their work.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for health policies: &lt;/strong&gt;Fe","PeriodicalId":46381,"journal":{"name":"Journal of Mental Health Policy and Economics","volume":"27 1","pages":"33-39"},"PeriodicalIF":1.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}