R. Raghavan and others
Children and Youth Services Review, vol.28, 2006, p.1482-1496
Bringing children with mental health needs under an insurance umbrella has been a priority in the USA for the past several decades. A stable source of health insurance is particularly important for young people in the child welfare system, given their disproportionately high levels of need for mental health services and their reliance on Medicaid to pay for those services. Medicaid has undergone significant structural changes, the principal of these being the rise of Medicaid managed care. Medicaid managed care affects children in the welfare system in three important ways:
D. McDaid and others
Health Policy, vol.79, 2006, p.144-152
This study evaluated how the regulatory environment and health system organisation, financing and provider payment systems influence the delivery of mental health services in the Sverdlovsk region of Russia. Results showed that mental health services are still largely provided in hospitals, although the need for more community-based services is widely recognised. Resource allocation and provider payment systems remain largely unchanged from Soviet times and favour large inpatient institutions, creating incentives for hospitals to maintain large numbers of beds and staff. Community-based social services and human resources remain limited, especially in the areas of social work, housing support and vocational rehabilitation.
R.F.G. Williams and others
International Journal of Social Economics, vol.33, 2006, p.808-831
This paper first presents some aggregate economic data for Australia as a whole on dedicated public psychiatric hospitals. Queensland government expenditure is then singled out for analysis. Next, data on private fee-for-service psychiatric services are studied in some detail, in order to shed light on the operation of Medicare in this area. Evidence is found that expenditures on psychiatric hospitals have fallen. Further evidence was found of a decline in the absolute and relative size of private practice psychiatry since the mid 1990s.
International Social Work, vol.49, 2006, p.805-817
This analysis suggests that in the UK and the USA the closure of mental hospitals and the discharge of their patients has led to the overloading of community care services, especially as families have proved reluctant to assume caring responsibilities. In Hong Kong, in contrast, family caregivers are severely burdened by poor community care and highly institutionalised services. The author shows how in each case the various groups involved in the care of mental health service users try to offload their responsibilities onto someone else.