BackgroundAn essential element of mental health service scale up relates to an assessment of resource requirements and cost implications.AimsTo assess the expected resource needs of scaling up services in five districts in sub-Saharan Africa and south Asia.MethodThe resource quantities associated with each site's specified care package were identified and subsequently costed, both at current and target levels of coverage.ResultsThe cost of the care package at target coverage ranged from US$0.21 to 0.56 per head of population in four of the districts (in the higher-income context of South Africa, it was US$1.86). In all districts, the additional amount needed each year to reach target coverage goals after 10 years was below $0.10 per head of population.ConclusionsEstimation of resource needs and costs for district-level mental health services provides relevant information concerning the financial feasibility of locally developed plans for successful scale up.
Specialist occupational psychiatry clinics do not replicate the work already being done by standard mental health services. Patients referred to a new specialist clinic within an occupational health department had chronic, debilitating psychiatric illnesses, which in many cases had failed to respond adequately to primary care treatment and were at risk of falling into the gap between primary and secondary services.
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