Economics and mental health: the current scenario
Economics and mental health: the current scenario
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DOI：
10.1002/wps.20692
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发表时间：
2020-02-01
期刊：
影响因子：
73.3
通讯作者：
Wong, Gloria
中科院分区：
文献类型：
--
作者：
Knapp, Martin;Wong, Gloria
经济和心理健康是相互交织的。除了越来越多的证据表明精神疾病对经济产生巨大影响，以及人们越来越认识到经济环境对心理健康的影响之外，各国政府和其他预算持有者也越来越重视经济数据来支持他们的决策。在这里，我们考虑经济评估（包括成本效益分析、成本效用分析和相关技术）如何为精神卫生政策战略的制定提供证据，并确定与服务提供者和资助机构相关的治疗或护理层面的一些后果。我们从寿命的角度提供与心理健康相关的经济证据的更新和反思，分析成本和结果，以阐明一系列紧迫问题。过去 30 年见证了心理健康经济学的快速发展，但重大知识差距仍然存在。在整个生命周期中，在围产期抑郁症识别和治疗领域存在更明确的证据；减少儿童和青少年心理健康问题的风险；扩大抑郁症的治疗，特别是心理治疗；基于社区的精神病早期干预和就业支持；针对痴呆症的认知刺激和多成分护理干预。从这次讨论中，我们总结了在试图从研究中获取证据并将其转化为政策或实践建议，并从那里转化为更好的治疗和护理方面的实际实施时所面临的主要挑战。
Economics and mental health are intertwined. Apart from the accumulating evidence of the huge economic impacts of mental ill-health, and the growing recognition of the effects that economic circumstances can exert on mental health, governments and other budget-holders are putting increasing emphasis on economic data to support their decisions. Here we consider how economic evaluation (including cost-effectiveness analysis, cost-utility analysis and related techniques) can contribute evidence to inform the development of mental health policy strategies, and to identify some consequences at the treatment or care level that are of relevance to service providers and funding bodies. We provide an update and reflection on economic evidence relating to mental health using a lifespan perspective, analyzing costs and outcomes to shed light on a range of pressing issues. The past 30 years have witnessed a rapid growth in mental health economics, but major knowledge gaps remain. Across the lifespan, clearer evidence exists in the areas of perinatal depression identification-plus-treatment; risk-reduction of mental health problems in childhood and adolescence; scaling up treatment, particularly psychotherapy, for depression; community-based early intervention and employment support for psychosis; and cognitive stimulation and multicomponent carer interventions for dementia. From this discussion, we pull out the main challenges that are faced when trying to take evidence from research and translating it into policy or practice recommendations, and from there to actual implementation in terms of better treatment and care.