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Advances in Financing, Quality, and Effectiveness of Mental Health Systems
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Advances in Financing, Quality, and Effectiveness of Mental Health Systems

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (1 April 2023) | Viewed by 14498

Special Issue Editors

Dr. Juan Luis González-Caballero

E-Mail Website
Guest Editor
Department of Statistics and Operational Research, Universidad de Cadiz, 11003 Cadiz, Spain
Interests: data analysis, multivariate analysis, regression analysis; psychometric; scale design; mental health; public health
Dr. Cristina Romero López-Alberca

E-Mail Website
Assistant Guest Editor
Department of Psychology, Universidad Cádiz, 11003 Cadiz, Spain
Interests: mental health; mental health services; health care
Dr. Mencia Ruiz Gutiérrez-Colosía

E-Mail Website
Assistant Guest Editor
Department of Psychology, Universidad Loyola Andalucía, 41014 Sevilla, Spain
Interests: mental health services evaluation; cost assessment in mental health; emotional intelligence, anxiety and stress in the workplace
Special Issues, Collections and Topics in MDPI journals
Dr. Carolina Lagares-Franco

E-Mail Website
Assistant Guest Editor
Statistics and Operational Research Department, Universidad de Cadiz, 11003 Cadiz, Spain
Interests: biostatistics; research methodology; mental health

Special Issue Information

Dear Colleagues,

The World Health Organization published the Assessment Instrument for Mental Health Systems (WHO-AIMS) in 2005. WHO-AIMS is a tool to collect the necessary information on mental health systems from regions or countries to carry out an analysis of their needs and assign the appropriate resources for improvement. In the past 15 years, there have been a variety of funded programs, projects, and tool developments aimed at advancing on the knowledge, quality, and effectiveness of mental health systems. This evidence-informed knowledge has been established as a key element to support policy makers regarding resource allocation and funding. 
For this Special Issue, we wish to publish a collection of studies aimed at the improvement of mental health systems. This includes research dedicated to the development of standardized tools for the comparison of resources, mapping, identifying barriers, and increasing the effectiveness and quality of mental health provision systems at local, regional, and national levels, all with the objective of guiding financing policies of mental health systems and ensuring they are better integrated in general health systems.

WHO (2005). World Health Organization Assessment Instrument for Mental health Systems (WHO-AIMS) v2.2. WHO: Geneva.

Objectives:
-    Develop standardized measurement tools to 

  • evaluate mental health services
  • analyze mental health care quality, effectiveness, and efficiency
  • analyze mental health care distribution and organization

-    Compare mental health systems (financing, policies, care provision)
-    Propose improvements in the quality of mental health services
-    Propose improvements in the efficiency of mental health services

Dr. Juan Luis González-Caballero
Dr. Cristina Romero López-Alberca
Dr. Mencia Ruiz Gutiérrez-Colosía
Dr. Carolina Lagares-Franco
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mental health systems
  • standardization tools
  • mental health policy
  • quality of care
  • mental health services and effectiveness
  • mental health care provision
  • care financing

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (5 papers)

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14 pages, 953 KiB  
Article
The Cost-Effectiveness Analysis of an Integrated Mental Health Care Programme in Germany
by Annabel Sandra Mueller-Stierlin, Uemmueguelsuem Dinc, Katrin Herder, Julia Walendzik, Matthias Schuetzwohl, Thomas Becker and Reinhold Kilian
Int. J. Environ. Res. Public Health 2022, 19(11), 6814; https://doi.org/10.3390/ijerph19116814 - 2 Jun 2022
Viewed by 2451
Abstract
The network for mental health (NWpG = Netzwerk psychische Gesundheit) is an umbrella association for non-medical community mental health care facilities across Germany which are enabled to provide multi-professional mental health care packages including medical and psychosocial services reimbursed by German statutory health [...] Read more.
The network for mental health (NWpG = Netzwerk psychische Gesundheit) is an umbrella association for non-medical community mental health care facilities across Germany which are enabled to provide multi-professional mental health care packages including medical and psychosocial services reimbursed by German statutory health insurances since 2009. The aim of this study is to analyse the cost-effectiveness of providing NWpG mental health care packages plus treatment as usual (NWpG) to treatment as usual alone (TAU) in Germany. In a prospective, multicenter, controlled trial over 18 months, a total of 511 patients (NWpG = 251; TAU = 260) were observed in five regions, four times at six-month intervals. The EQ-5D-3L and the Client Sociodemographic and Service Receipt Inventory (CSSRI) were used to estimate quality-adjusted life-years and total costs of illness. Propensity score-adjusted cost–utility analysis was applied using the net benefit approach. No significant differences in costs and QALYs between NWpG and TAU groups were identified. The probability of NWpG being cost-effective compared to TAU was estimated below 75% for maximum willingness to pay (MWTP) values between 0 and 125,000 EUR. The additional provision of the NWpG package is not cost-effective compared to TAU alone. Full article
(This article belongs to the Special Issue Advances in Financing, Quality, and Effectiveness of Mental Health Systems)
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15 pages, 725 KiB  
Article
In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe
by Susanne Mayer, Michael Berger, Alexander Konnopka, Valentin Brodszky, Silvia M. A. A. Evers, Leona Hakkaart-van Roijen, Mencia R. Guitérrez-Colosia, Luis Salvador-Carulla, A-La Park, William Hollingworth, Lidia García-Pérez, Judit Simon and on behalf of the PECUNIA Group
Int. J. Environ. Res. Public Health 2022, 19(6), 3500; https://doi.org/10.3390/ijerph19063500 - 16 Mar 2022
Cited by 15 | Viewed by 3213
Abstract
Improving the efficiency of mental healthcare service delivery by learning from international best-practice examples requires valid data, including robust unit costs, which currently often lack cross-country comparability. The European ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National [...] Read more.
Improving the efficiency of mental healthcare service delivery by learning from international best-practice examples requires valid data, including robust unit costs, which currently often lack cross-country comparability. The European ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) aimed to harmonize the international unit cost development. This article presents the methodology and set of 36 externally validated, standardized reference unit costs (RUCs) for five health and social care services (general practitioner, dentist, help-line, day-care center, nursing home) in Austria, England, Germany, Hungary, The Netherlands, and Spain based on unambiguous service definitions using the extended DESDE PECUNIA coding framework. The resulting PECUNIA RUCs are largely comparable across countries, with any causes for deviations (e.g., country-specific scope of services) transparently documented. Even under standardized methods, notable limitations due to data-driven divergences in key costing parameters remain. Increased cross-country comparability by adopting a uniform methodology and definitions can advance the quality of evidence-based policy guidance derived from health economic evaluations. The PECUNIA RUCs are available free of charge and aim to significantly improve the quality and feasibility of future economic evaluations and their transferability across mental health systems. Full article
(This article belongs to the Special Issue Advances in Financing, Quality, and Effectiveness of Mental Health Systems)
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16 pages, 332 KiB  
Article
Benchmarks for Needed Psychiatric Beds for the United States: A Test of a Predictive Analytics Model
by Christopher G. Hudson
Int. J. Environ. Res. Public Health 2021, 18(22), 12205; https://doi.org/10.3390/ijerph182212205 - 20 Nov 2021
Cited by 4 | Viewed by 2476
Abstract
The ideal balanced mental health service system presupposes that planners can determine the need for various required services. The history of deinstitutionalization has shown that one of the most difficult such determinations involves the number of needed psychiatric beds for various localities. Historically, [...] Read more.
The ideal balanced mental health service system presupposes that planners can determine the need for various required services. The history of deinstitutionalization has shown that one of the most difficult such determinations involves the number of needed psychiatric beds for various localities. Historically, such assessments have been made on the basis of waiting and vacancy lists, expert estimates, or social indicator approaches that do not take into account local conditions. Specifically, this study aims to generate benchmarks or estimated rates of needed psychiatric beds for the 50 U.S. states by employing a predictive analytics methodology that uses nonlinear regression. Data used were secured primarily from the U.S. Census’ American Community Survey and from the Substance Abuse and Mental Health Administration. Key predictors used were indicators of community mental health (CMH) service coverage, mental health disability in the adult population, longevity from birth, and the percentage of the 15+ who were married in 2018. The model was then used to calculate predicted bed rates based on the ‘what-if’ assumption of an optimal level of CMH service availability. The final model revealed an overall rate of needed beds of 34.9 per 100,000 population, or between 28.1 and 41.7. In total, 32% of the states provide inpatient psychiatric care at a level less than the estimated need; 28% at a level in excess of the need; with the remainder at a level within 95% confidence limits of the estimated need. These projections are in the low range of prior estimates, ranging from 33.8 to 64.1 since the 1980s. The study demonstrates the possibility of using predictive analytics to generate individualized estimates for a variety of service modalities for a range of localities. Full article
(This article belongs to the Special Issue Advances in Financing, Quality, and Effectiveness of Mental Health Systems)
15 pages, 1206 KiB  
Article
Impact of Ed-LinQ: A Public Policy Strategy to Facilitate Engagement between Schools and the Mental Health Care System in Queensland, Australia
by Luis Salvador-Carulla, Ana Fernandez, Haribondhu Sarma, John Mendoza, Marion Wands, Coralie Gandre, Karine Chevreul and Sue Lukersmith
Int. J. Environ. Res. Public Health 2021, 18(15), 7924; https://doi.org/10.3390/ijerph18157924 - 27 Jul 2021
Cited by 3 | Viewed by 2661
Abstract
Ed-LinQ is a mental health policy initiative to enhance the early detection and treatment of children with mental illness by improving the liaison between schools and health services in Queensland, Australia. We measured its impact from policy to practice to inform further program [...] Read more.
Ed-LinQ is a mental health policy initiative to enhance the early detection and treatment of children with mental illness by improving the liaison between schools and health services in Queensland, Australia. We measured its impact from policy to practice to inform further program developments and public strategies. We followed a mixed quantitative/qualitative approach. The Adoption Impact Ladder (AIL) was used to analyse the adoption of this initiative by end-users (decision makers both in the health and education sectors) and the penetration of the initiative in the school sector. Survey respondents included representatives of schools (n = 186) and mental health providers (n = 78). In total, 63% of the school representative respondents were at least aware of the existence of the Ed-LinQ initiative, 74% were satisfied with the initiative and 28% of the respondent schools adopted the initiative to a significant extent. Adoption was higher in urban districts and in the health sector. The overall level of penetration in the school sector of Queensland was low (3%). The qualitative analysis indicated an improvement in the referral and communication processes between schools and the health sectors and the importance of funding in the implementation of the initiative. Mapping of existing programs is needed to assess the implementation of a new one as well as the design of different implementation strategies for urban and rural areas. Assessing the adoption of health policy strategies and their penetration in a target audience is critical to understand their proportional impacts across a defined ecosystem and constitutes a necessary preliminary step for the evaluation of their quality and efficiency. Full article
(This article belongs to the Special Issue Advances in Financing, Quality, and Effectiveness of Mental Health Systems)
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10 pages, 755 KiB  
Concept Paper
Mental Health Reform: Design and Implementation of a System to Optimize Outcomes for Veterans and Their Families
by Andrea Phelps, Ellie Lawrence-Wood, Anne-Laure Couineau, Mark Hinton, Paul Dolan, Patrick Smith, MaryAnn Notarianni, David Forbes and Fardous Hosseiny
Int. J. Environ. Res. Public Health 2022, 19(19), 12681; https://doi.org/10.3390/ijerph191912681 - 4 Oct 2022
Viewed by 2625
Abstract
The social, health, and economic burden of mental health problems in the veteran community is heavy. Internationally, the array of services and support available to veterans and their families are extensive but vary in quality, are often disconnected, complex to navigate, and lack [...] Read more.
The social, health, and economic burden of mental health problems in the veteran community is heavy. Internationally, the array of services and support available to veterans and their families are extensive but vary in quality, are often disconnected, complex to navigate, and lack clear coordination. This paper describes a conceptual framework to guide the design and implementation of a system of services and supports to optimize the mental health and wellbeing of all veterans and their families. The framework recognizes the diversity of veterans across intersecting identities that uniquely shape experiences of posttraumatic mental health and wellbeing. It brings together several strands of research: the values and principles that should underpin the system; the needs of diverse veterans and their families; challenges in the current services and supports; evidence-based interventions; and principles of effective implementation. Central to the future system design is a next generation stepped model of care that organizes best and next practice interventions in a coherent system, matches service provision to level of need and addresses access and navigation. Practical guidance on implementation provides an aspirational and flexible structure for system evolution, and a template for all stakeholders—individuals, groups, agencies and organizations—to effect system change. Full article
(This article belongs to the Special Issue Advances in Financing, Quality, and Effectiveness of Mental Health Systems)
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