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Making Mental Health Count

The Social and Economic Costs of Neglecting Mental Health Care

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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.

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Developing skilled workforces for high-performing mental health systems

The composition of the mental health workforce in OECD countries is diverse, and this chapter examines how OECD countries differ in terms of the numbers and mix of mental health professionals, which can in turn impact on the access, quality and cost of care provided. Cross-country comparisons of the human resources available to respond to mental health care needs are, however, hampered by the non-standardisation of data, the overlapping roles and tasks of different providers, and the challenge in properly measuring the input of primary care providers (notably general practitioners) in diagnosing and treating different mental health problems. The training, accreditation and continuing professional education of the mental health workforce plays a critical role in the supply, remuneration and mobility of mental health professions as well as the quality of care provided. Changing models of human resources and mental health care delivery have increased the potential for the provision of more efficient and effective services that promote better quality and service integration. As mental health care has become more integrated into community settings, service users and family caregivers play an increasing and critical role in supporting people with mental health problems.

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