RESUMO
Using data from a 1992 community survey of children and their parents (or guardians), we found major gaps in mental health insurance coverage. Interestingly, private insurance had no statistically significant effect on use of mental health services. Youth without insurance coverage and those with public insurance had higher rates of serious emotional disorder than did those with private insurance. The analysis is based on the National Institute of Mental Health's Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, conducted in three mainland U.S. sites and in Puerto Rico.
Assuntos
Serviços de Saúde do Adolescente/economia , Serviços de Saúde da Criança/economia , Acessibilidade aos Serviços de Saúde/economia , Seguro Psiquiátrico/estatística & dados numéricos , Serviços de Saúde Mental/economia , Adolescente , Criança , Connecticut , Georgia , Pesquisas sobre Atenção à Saúde , Humanos , Cobertura do Seguro/estatística & dados numéricos , Transtornos Mentais/economia , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , New York , Pobreza , Prevalência , Porto Rico , Classe Social , Estados Unidos/epidemiologiaRESUMO
The prevalence of mental health problems is far more than what is perceived by the general public. The billions of dollars of lost productivity due to mental health problems and the affect of mental health on total health costs cannot be ignored.
Assuntos
Efeitos Psicossociais da Doença , Planos de Assistência de Saúde para Empregados/economia , Seguro Psiquiátrico/economia , Transtornos Mentais/economia , Reforma dos Serviços de Saúde/economia , Acessibilidade aos Serviços de Saúde/economia , Humanos , Estados UnidosRESUMO
To gain an understanding of the challenges and opportunities confronting mental health professionals throughout the world, the author sent a brief questionnaire to psychiatric leaders in a diverse group of countries. Questions focused on patient care issues, education, and delivery systems. Responses from 13 countries indicated universal concern about the cost of psychiatric care and how it is delivered. Most countries consider health care a national responsibility and provide some form of universal insurance coverage. There is a lack of uniformity in resource distribution and use as well as in standards of care for acute and chronic patients. ICD-9 is the diagnostic classification system used in almost all responding countries, but use of DSM-III is increasing. The author emphasizes the importance of considering national differences and similarities in the delivery of psychiatric services so that professionals around the world can learn from each other's experiences.
Assuntos
Comparação Transcultural , Serviços de Saúde Mental , Psiquiatria , África , Ásia , Austrália , Canadá , Certificação , Doença Crônica , Europa (Continente) , Acessibilidade aos Serviços de Saúde , Humanos , Seguro Psiquiátrico , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/economia , Nova Zelândia , Psicoterapia , Inquéritos e Questionários , Estados Unidos , VenezuelaRESUMO
The family doctor's medical care for emotional problems in a prepaid group practice plan during a period when mental health services were limited to psychiatric consultation is compared with the situation two years later when services included psychiatric treatment at no cost to the patient. During this time the annual rates for psychiatric consultation increased from 7 to 11 per 1000. There was a greater tendency during the later period to prescribe a wider range of drugs, and stronger drugs. Psychiatric referrals for patients with a wide range of emotional problems, including those whose emotional problems interferred with or more life activities and those whose emotional problems caused no interferences, increased. There was an increased tendency in the later period to refer patients whose self-reports described less serious or less acute problems (AU)