The Economics of Mental Health Care in Ireland

A case study of the development of occupational therapy at St. Patrick’s Hospital Dublin, 1935-1969

“…For example, legislation provided legal mechanisms for asylum admission and asylums were frequently used to manage social deprivation, poverty and illhealth rather than mental illness (Kelly, 2016;Brennan, 2014). Institutions were an important source of employment in small Irish communities and the economic and social dependency on asylums contributed to a lack of political will to close them (O'Shea and Kennelly, 2008).…”

‘Show me the money’: improving the economic evaluation of mental health services

“…However, one of the few evaluations that has been undertaken found that costs arising from mental health (i.e. direct care and decreased economic output) amounted to 2% (or h3 billion) of GNP in 2006(O'Shea & Kennelly, 2008. Due to this significant economic burden and the expressed willingness of surveyed members of the public (n 5 435) to pay extra taxation to fund community-based care, the report stressed that investing in mental health services is essential from an economic perspective (O'Shea & Kennelly, 2008).…”

“…This 'Comprehensive Community Model' was also more efficient -it reduced waiting times and had higher attendance rates. However, far more reports of this nature are needed to move Ireland away from its long tradition of ignoring the economic aspects to mental health (O'Shea & Kennelly, 2008). Moreover, if mental health services wish to secure funding for much-needed service development (as the NHS did for IAPT), it is essential that development proposals have a comprehensive economic rationale, especially in our recessionary economy.…”

“…Hence, we present a newly formulated 12-item cost evaluation tool -the 'EcoPsy 12' (see Table 3). This tool's content and structure are informed by the TiC-P (HakkaartVan Roijen, 2002), governmental reports (Layard et al 2006;O'Shea & Kennelly 2008;Gibbons et al 2012) various rigorous cost-benefit analyses conducted within mental health services (Rollman et al 2005;Soeteman et al 2010;Gerhards, 2010) and a 10-point checklist that can be used to assess the quality of economic evaluations (Drummond et al 1997). Whatever scale is used to collect output and health care usage data, these can be supplemented with measures that show general impairment (and thus probable reductions in productivity) such as the 5-item Work and Social Adjustment Scale (Mundt et al 2002).…”

Primary care mental health – A new direction?

“…78 Depression and anxiety disorders in particular have a major public health impact and make a large contribution to the estimated €3 billion annual economic cost nationally that derives from mental health problems. 9 International evidence as well as Irish research suggests that one quarter to one third of primary care patients are likely to have clinically significant mental health problems -only a small proportion of which are referred on to specialist care. 10,11 A recent national survey suggested that the vast majority of adults in Ireland see their G P as the professional contact of choice when they have a mental health problem.…”