Friday, January 30, 2004

Priority Setting in Mental Health Services
Article in Applied Health Economics and Health Policy at Medscape - " This paper sets out an approach to priority setting in mental health services, built around programme budgeting and marginal analysis (PBMA). The paper also discusses the question of building in equity, especially the concept of vertical equity which, given the relative neglect of mental health services when resources have been allocated in the past, might serve as a mechanism for redressing the imbalance in resource allocation to the mentally ill. Beyond that the importance of eliciting community values to aid priority setting in mental health services is highlighted, particularly with respect to the principles underlying the mental health services or what one might call 'the nature of the good' that society wants from its mental health services. While it can be argued that trying to ascertain these principles or the nature of the good applies in all health services - and that is not disputed here - in mental health there is yet more need for clarification than in many other, indeed most other, health services. The need to exercise value judgements is emphasised. There is also a word of caution on the dangers of over-reliance on waiting for perfect evidence. Finally the paper considers how best to operationalise priority setting in mental health services, and perhaps make it less of a nightmare for mental health service planners than it currently seems to be." [Viewing Medscape resources requires registration, which is free].  
  

National report finds Alabama a leader in mental health care
Press release from Governing magazine - "An assessment of health care in the 50 states, released here today, finds that Alabama is a pioneer in the field of mental health care. The report touts Alabama’s creation of regional mental health teams in rural areas where the state is closing psychiatric hospitals. ... 'Deinstitutionalization has failed in many parts of the country because states have failed to build their community-based mental health systems to adequately support people with mental illness,' says Michele Mariani, co-author of the special issue of Governing. 'Alabama should be commended for its foresight in leaving teams of specialists in areas that used to be served by hospitals and would have been seriously underserved otherwise.' ” See also the article A Case of Neglect ("Why Health Care Is Getting Worse, Even Though Medicine Is Getting Better") and the state summaries and press releases.  
  

Gov. Johanns Unveils Report Confirming Feasibility of Mental Health Reform (Nebraska)
Southwest Nebraska News story - "Gov. Mike Johanns and State Senator Jim Jensen presented a report today compiled by a prominent health care expert which concludes that the proposed mental health reform plan, introduced by Sen. Jensen as LB 1083, can be achieved. The Lewin Group report is titled Balancing New Adult Behavioral Health Community Supports. The Executive Summary of the report concludes that, “Lewin not only believes that the Road to Recovery is a highly principled plan… we believe that the Road to Recovery is achievable on the timeline, and for the budget, laid out by Governor Johanns and Senator Jensen.” See also the full report (in Adobe Acrobat format) at the section of the governor's web site on reforming mental health services and the McCook Daily Gazette story Mental health plans questioned.