Published online by Cambridge University Press: 07 July 2014
It is no longer a pleasant surprise (to most health economists) or an unwelcome shock (to most non-economists) to find costs on the core conference agenda of a mental health conference. In the Amsterdam ENMESH conference in 1994, economics appeared as a late but welcome addition to the programme, effectively on the margins but - and this was unusual at the time - it had formal representation. In Verona in 1996, as at a growing number of conferences (and in more books and academic journals), economics has moved rather closer to the mainstream. In this paper I offer a short historical account of this ‘mainstreaming’ and tease out its implications for mental health care evaluation.
In many European countries today there are rapidly growing demands for cost information, cost-effectiveness evaluation, and analyses of systems and the incentives within them. It is useful to distinguish between underlying needs for a costs perspective linked to scarcity of resources (latent demands) and expressed wants for actual cost or cost-effectiveness evaluations or insights (manifest demands) (Knapp, 1997). The latent demands stem from scarcity, in turn linked to a variety of factors.