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Economics and mental health: a concise European history of demand and supply

Published online by Cambridge University Press:  07 July 2014

Martin R.J. Knapp*
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, and Centre for the Economics of Mental Health, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
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Extract

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.

Type
Section C: Evaluating the Costs of Mental Health Services
Copyright
Copyright © Cambridge University Press 1997

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References

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