Making Mental Health Count: The Social and Economic Costs of Neglecting Mental Health Care

Despite the enormous burden that mental ill-health imposes on individuals, their families, society, health systems and the economy, mental health care remains a neglected area of health policy in too many countries. Mental disorders represent a considerable disease burden, and have a significant impact on the lives of the OECD population, and account for considerable direct and indirect costs.

This report argues that even in those OECD countries with a long history of deinstitutionalisation, there is still a long way to go to make community-based mental health care that achieves good outcomes for people with severe mental illness a reality. The disproportionate focus on severe mental illness has meant that mild-to-moderate mental illnesses, which makes up the largest burden of disease, have remained overwhelmingly neglected.

This book addresses the high cost of mental illness, weaknesses and innovative developments in the organisation of care, changes and future directions for the mental health workforce, the need to develop better indicators for mental health care and quality, and tools for better governance of the mental health system. The high burden of mental ill health and the accompanying costs in terms of reduced quality of life, loss of productivity, and premature mortality, mean that making mental health count for all OECD countries is a priority.

Contents:

+ Acronyms and abbreviations

+ Executive summary

+ Assessment and recommendations

+ Chapter 1. The cost of mental illness
-1.1. Introduction
-1.2. Getting a full picture of the costs of mental ill-health
-1.3. Mental health accounts for a significant proportion of health spending in OECD countries
-1.4. Measuring intangible costs, and estimating the human cost of mental ill-health
-1.5. Conclusion
-References

+ Chapter 2. Securing better care for mild-to-moderate disorders
-2.1. Introduction
-2.2. The burden of mild-to-moderate mental disorders in OECD countries
-2.3. How are OECD countries treating mild-to-moderate disorders?
-2.4. Strengthening primary care provision
-2.5. New interventions for mild-to-moderate disorders can represent good value for money
-2.6. Conclusion
-References

+ Chapter 3. Advancing the organisation, payment and integration of care for people with severe mental illness
-3.1. Introduction
-3.2. The high burden of severe mental illness and co-morbidities with physical ill-health
-3.3. Organisation and delivery of mental health care for people with SMI
-3.4. Provider payment for treatment of SMI
-3.5. Employment and vocational rehabilitation for people with SMI
-3.6. Conclusion
-References
-Annex 3.A1. Definitions of mental health care facilities and community teams

+ Chapter 4. Improving quality measurement and data collection for mental health
-4.1. Introduction
-4.2. The epidemiological burden of mental ill-health: Using surveys and mortality indicators to collect information on prevalence and need
-4.3. Filling gaps in the information to help drive improvements in the quality of mental health care
-4.4. Quality and outcome measures for mental health care must improve in order to catch up with other disease areas
-4.5. OECD HCQI work on measuring the quality of mental health care
-4.6. International initiatives to measure and benchmark quality and outcomes of mental health care
-4.7. Using data to drive improvements: Developing mental health quality and outcome indicators, targets and standards
-4.8. Conclusion
-References

+ Chapter 5. Developing skilled workforces for high-performing mental health systems
-5.1. Introduction
-5.2. Composition of the mental health workforce in OECD countries
-5.3. Education and accreditation of mental health professionals
-5.4. Continuous professional education and development
-5.5. Shortages in mental health professions
-5.6. Changing models of human resources in mental health care
-5.7. Integration of service users and carers into the mental health workforce
-5.8. Conclusion
-References
-Annex 5.A1. Definitions of mental health professional categories

+ Chapter 6. Good governance for better mental health
-6.1. Introduction
-6.2. What are the key leadership challenges for mental health systems?
-6.3. Who will lead efforts to address these challenges? Key stakeholders in mental health governance
-6.4. Influencing the functioning of the mental health system through mental health legislation
-6.5. A high-level perspective for system-wide improvements: Setting strategic directions to plan and execute change in mental health
-6.6. Identifying and addressing gaps in mental health systems using vertical programmes
-6.7. Conclusion
-References

Website: OECD iLibrary http://www.oecd-ilibrary.org/

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