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Welfare Reform on the Web (February 2009): Mental health services - overseas

Eliciting preferences for resource allocation in mental health care in Ireland

E. O'Shea, B. Gannon and B. Kennelly

Health Policy, vol. 88, 2008, p. 359-370

Rising public expenditures on health care have led policymakers around the world to focus their attention on priority setting to ensure value for money. This paper provides information on ranking and willingness to pay (WTP) estimates for marginal changes to three healthcare programmes in Ireland: cancer, elderly care and mental health care. People ranked the cancer programme as their most preferred programme, but mean and median WTP for the cancer programme was the same as the community care programme for the elderly. People ranked the community-based mental health programme lowest and gave it a lower WTP valuation than the other two programmes, significantly so in the case of median values. The low priority accorded to mental health may be explained by the fact that people believed they had a low risk of ever needing mental health services and had less direct experience of mental illness than of either cancer or elderly care.

Integrating behavioral health care and primary care: application of a clinical and economic model in culturally diverse communities

K.L. Grazier

International Journal of Public Administration, vol. 31, 2008, p. 1532-1547

Refugees, immigrants and other groups vulnerable due to their ethnicity, race and culture face enormous barriers to receiving culturally sensitive screening, treatment and long-term management of mental illnesses in the USA. This article provides a brief overview of the empirical evidence related to mental health treatment, mental illness in vulnerable populations, and the role of primary care. It then describes a comprehensive model that addresses the clinical and economic considerations for system change. Finally it argues for an integrated, collaborative primary care and speciality mental health model that recognises appropriate infrastructure, processes and incentives to meet the needs of those with depression accompanied by special cultural and social risks.

'It's the system working for the system': carers' experiences of learning disability services in Ireland

A. Power

Health and Social Care in the Community, vol. 17, 2009, p. 92-98

This article examines the community care landscape for young adults with learning disabilities and their carers in Ireland. Services available for this group comprise day care, special vocational training and respite places. This article identifies the main challenges faced by family carers seeking to access appropriate services for their adult child. Despite government rhetoric, carers thought services geared to supporting care in the community were lacking both in availability and quality. Carers identified a large amount of non-supportive interactions in their experiences of trying to access and use services.

Mental health and primary health care

N. Sartorius

Mental Health in Family Medicine, vol. 5, 2008, p. 75-77

The promotion of mental health is listed among the essential elements of primary health care in the report of the Alma Ata Conference of 1978. This article presents a brief overview of how the mental health component of primary care has been defined and delivered since then.

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