To compare the health costs of groups with and without psychiatric diagnoses (PDs) using 9 years of physician billing data.
A dataset containing registration data for all patients receiving public mental health service was constructed and subsequently matched, on age and sex, in a final patient to comparison patient ratio of 1:8, with health care users who did not receive treatment in the mental health system. Three groups emerged: a patient PD group-patients with psychiatric disorders treated in public mental health care (n = 76 677); a comparison patient PD group-comparison patients with PDs treated in physicians only (n = 277 627); and a patient- comparison patient non-PD group-patients (treated in specialized publicly funded care or by their physician) without PDs (n = 329 177). Examining over 42 million billing records for all of these patients, we compared the average number of visits and the average health only (nonpsychiatric) billing cost per each patient during the 9-year study period across the groups.
Among all health care users in the data, the health costs (Total Costs - Mental Health Costs) were greater on average for the patients with PD group ($3437) and the comparison patient PD group ($3265), compared with patient-comparison patient non-PD group ($1345). Forty-six percent of the comparison sample had a PD.
Having a mental health problem is related to greater health-related expenditures. This has important policy implications on how mental health resources are constructed and rationed within the health care system.
Based on system, correlation and regression analyses of official medical and social/economic information over 1992-2008, we developed epidemiological models linking parameters of morbidity and incidence of mental disorders in the Russia Federation with main medical-demographic and social-economic factors. These models may be used for optimal planning of medical/social programs in the field of mental health protection, its operative monitoring and optimal planning of the structure and activity of the Russian system for psychiatric aid.
Social enterprises are market-based activities that provide social benefits through the direct engagement of people in productive activities. Participation in social enterprise development brings psychosocial wellbeing benefits, by strengthening family networks, enhancing trust, increasing self-reliance and social esteem and promoting cultural safety. Our objective is to explore how social enterprise activities can meet community needs and foster self-sustainability while generating profits for redistribution as social investment into other ventures that aid social functioning and emotional well-being.
Social entrepreneurship enhances both interdependence and independence. Concomitant mental health and social wellbeing dividends accrue overtime to communities engaged in self-determined enterprise activities. Social entrepreneurship builds social capital that supports social wellbeing. Strengths-based approaches to social entrepreneurship can assuage disempowering effects of the "welfare economy" through shifting the focus onto productive activities generated on people's own terms.
This retrospective clinical audit compared changes in community mental health service utilization before and during an economic recession in an oil sands region in Canada which was characterized by a doubling of unemployment rates and poor economic outlook.
Sociodemographic descriptors, psychiatric antecedents, clinical characteristics and follow-up care were compared before and during the recession for newly assessed patients in community mental health clinics located across a Northern Alberta oil mining region. Data were collected retrospectively as part of a clinical audit process and then analysed with descriptive statistics, cross-tabular univariate analyses with chi-square tests using SPSS version 20.
A total of 1,465 patients were included. Sociodemographic factors disproportionately elevated during the recession included male sex, Caucasian ethnicity, own home ownership, higher levels of education and unemployment. More patients seeking mental health care were already taking psychotropic medications (e.g. antipsychotics, benzodiazepines and stimulants). At the same time, disproportionately fewer patients engaged in substance abuse or had a prior formal history of mental health problems. The referral reasons during recession were less likely to be associated with substance abuse or mood concerns and more likely for 'other' reasons. The patients seeking psychiatric help during a recession were disproportionately likely to be diagnosed with personality disorders and 'other' less common diagnostic categories and less likely to suffer from mood or trauma-related diagnoses. Referrals for counselling and social services were also disproportionately more common during the recession.
This study provides a comprehensive description of longitudinal patterns of mental health service utilization before and during a recession. The findings provide important evidence for policy and planning decisions to encourage resource allocation to help promote accessibility of the most needed community mental health resources.
Like most of other developed countries, Canada experienced baby boom in the 20 years after World War II. With the eldest baby turned 65 in 2011, it is expected that a considerable number of people will retire in coming years and consequently, retired people will soon constitute a significant part of Canadian population. In this context, an interesting question would be how retirement impacts mental health. This question is related to the well-being of the retired population as well as to over all health care expenditures.
The major objective of this study is to examine the impact of retirement on mental health as measured by the Short Form Depression Scale. This study further conducts separate analyses to examine whether the impact of retirement on mental health differs between males and females, and among different education and income groups.
This study uses large scale Canadian National Population Heath Survey (Longitudinal Component) data and adopts fixed effect method and fixed effect instrumental variable method to deal with possible endogeneity problem.
After controlling for unobserved individual specific heterogeneity, the study found that retirement has an insignificant impact on depression. As a robustness check, the study utilizes logit, conditional fixed effect logit, and fixed effect instrumental variable regression on a dichotomous variable representing depression and found that retirement has an insignificant impact on depression. The study further examined this issue using different subgroups based on gender, education and marital status, and again found that impacts of retirement on depression are not statistically significant.
Though the coefficients are statistically insignificant, however, most of the results are economically meaningful since the magnitudes are relatively large, implying very large effects. The effects of retirement on mental health appear to be complex and multidimensional; however, based on the FE-IV models, most of the effects seem to suggest that there may be some increase in depression symptoms. The findings of this study will have important policy implications. If retirement worsens mental health, then policy encouraging retirement may actually increase health care expenditures. On the other hand, if retirement improves mental health, then such policy will likely to decrease health care expenditure. Studies based on data from Canada and other OECD countries suggest that the provisions of social security programs themselves often provide strong incentive to leave the labor force early. The finding of this study that retirement has negative impact on mental health in Canada will imply that current Canadian policy of encouraging early retirement is likely to increase mental health care expenditure.
There are a number of ways to extend this study. Depending on the availability of data, future studies can focus on sub populations: voluntary retiree/ involuntary retirement, early retiree/ late retiree and complete retiree/ partial retiree. Future study can also conduct more detailed analysis by including variables such as previous job characteristics, voluntary activity during retirement and family characteristics.
ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU Pepsy, F-75004 Paris, France; Foundation FondaMental, French National Science Foundation, Créteil, France. Electronic address: firstname.lastname@example.org.
As part of the Roamer project, we aimed at revealing the share of health research budgets dedicated to mental health, as well as on the amounts allocated to such research for four European countries. Finland, France, Spain and the United Kingdom national public and non-profit funding allocated to mental health research in 2011 were investigated using, when possible, bottom-up approaches. Specifics of the data collection varied from country to country. The total amount of public and private not for profit mental health research funding for Finland, France, Spain and the UK was €10·2, €84·8, €16·8, and €127·6 million, respectively. Charities accounted for a quarter of the funding in the UK and less than six per cent elsewhere. The share of health research dedicated to mental health ranged from 4·0% in the UK to 9·7% in Finland. When compared to the DALY attributable to mental disorders, Spain, France, Finland, and the UK invested respectively €12·5, €31·2, €39·5, and €48·7 per DALY. Among these European countries, there is an important gap between the level of mental health research funding and the economic and epidemiologic burden of mental disorders.
The number of practising psychiatrists in Sweden has increased by nearly 30% between the years 1995-2009; however, the profession has suffered serious recruitment difficulties. The Swedish National Board of Health and Welfare estimated that about 5-10% of the population is in need of psychiatric treatment, but only 3-4% seek psychiatric care. Among patients who receive psychiatric care, approximately 47% are treated with psychopharmacology, 13% are treated with psychotherapy and 40% receive both treatments. There are still challenges facing Swedish psychiatry: reduction in waiting times for psychiatric care, broader accessibility of evidence-based treatment methods for all groups of psychiatric patients both in rural and urban areas, and targeting the needs of immigrants and refugees. The allocation of resources to psychiatric research, and development of novel treatment methods are crucially needed. The Swedish government is strongly committed to decreasing the number of suicides, as there are approximately 1,400 individuals lost to suicide every year in a country with a population of around 10 million. Given that nearly 20% of all suicides are amongst psychiatric inpatients, a regulation has been passed regarding the analysis of all completed suicides in the healthcare system. Results from these analyses can be used for increasing quality of treatment.