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Cited by 189Mental Health Treatment and AccessPsychiatric care and mental health servicesHealthcare Systems and Reforms

Economic barriers to better mental health practice and policy

Open access
Knapp, M.·2006·Health Policy and Planning
DOI 10.1093/heapol/czl003
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Abstract

Mental health systems in many countries are seriously under-developed, yet mental health problems not only have huge consequences for quality of life, but--particularly in low- and middle-income countries--contribute to continued economic burden and reinforce poverty. This paper discusses economic barriers to improving the availability, accessibility, efficiency and equity of mental health care in low- and middle-income countries. Six sets of barriers are identified: an information barrier, resource insufficiency, resource distribution, resource inappropriateness, resource inflexibility and resource timing. Overcoming these barriers will be a major task, although there is no shortage of suggestions for action. The paper discusses broadening the evidence base, improving mental health literacy, tackling stigma, improving financing mechanisms, prioritizing and protecting mental health care budgets, emphasizing mental health promotion through the development of resilience, exploring routes to improved equity, experimenting with new arrangements for purchasing and delivering services, improving coordination between agencies and professionals at both macro- and micro-levels, building alliances between public and private sectors, and training and mobilizing primary care services to improve identification and treatment of mental health problems.

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Crossref · 10.1093/heapol/czl003

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  • The relationship between mental illness and poverty has been extensively evaluated in high income countries, documenting impact on quality of life, increased economic burden of care, and reduced productivity, all of which reinforce poverty.

    “The relationship between mental illness and poverty has been extensively evaluated in high income countries, and its impact on quality of life, increased economic burden of care, and reduced productivity, all of which ultimately reinforces poverty have been documented [6, 7].”

    From Sustainable financing mechanisms for strengthening mental health systems in Nigeria (2019) · cites this paper as [6]

    The Introduction links mental health problems to poorer quality of life, economic burden, reduced productivity, and a reinforcing relationship with poverty. However, it emphasizes these economic effects particularly in low- and middle-income countries. The Information barriers section says much mental health research comes from high-income countries, but does not establish that the mental illness–poverty relationship has been extensively evaluated there. Page numbers were not available in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • There is an established relationship between mental illness and poverty.

    “established relationship between mental illness and poverty”

    From Sustainable financing mechanisms for strengthening mental health systems in Nigeria (2019) · cites this paper as [6]

  • Maximizing the public health impact of EBPs requires strategies that align service delivery and financing to effectively support and sustain implementation.

    “Maximizing the public health impact of EBPs requires strategies that align service delivery and financing to effectively support and sustain implementation [23].”

    From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [23]

  • Adoption and continued use of EBPs is challenging due to the complex and fragmented methods of financing health services.

    “Adoption and continued use of EBPs is challenging due to the complex and fragmented methods of financing health services [21–23].”

    From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [23]

  • Typically, health service providers offer services for which funding agencies are willing to offer payment.

    “Typically, health service providers offer services for which funding agencies are willing to offer payment [23] (see also Fig. 1).”

    From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [23]

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Cites

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Research works printed but not linked: 4

  1. Joint Statement. 2004. Galvanising mental health research in low- and middle-income centres: role of scientific journals. Joint Statement issued by editors of scientific journals publishing mental health research and Department of Mental Health and Substance Abuse, WHO, Geneva. Bulletin of the World Health Organization 82: 226-8.
  2. Padarath A, Ntuli A. 2004. The brain drain in South Africa. Harvard Health Policy Review 5: 88-96.
  3. Sidandi P, Mambwe C, Zoric Z et al. 1999. Psychiatric rehabilita- tion: the perspective from Botswana. International Journal of Mental Health 28: 31-7.
  4. David McDaid is a Research Fellow in Health Policy and Health Economics at LSE Health and Social Care and the European Observatory on Health Systems and Policies at the London School of Economics and Political Science. He has an MSc in Health Economics and also an MSc in Information Processing, both from the University of York, and a BSc in Economics from Brunel University. He is co-ordinator of the Mental Health Economics European Network, a director of the Health Equity Network and co-editor of the forthcoming book Mental health policy and practice across Europe, due to be published by Open University Press in 2006. [Address: LSE Health and Social Care, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK]. Correspondence: Martin Knapp, LSE Health & Social Care, London School of Economics, Houghton Street, London, WC2A 2AE, UK. Tel: þ44 (0)20-7955-6225.

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Authors
Knapp, M.
Affiliations
King's College London (GB)
Corresponding author
Knapp, M.
ORCID
Knapp, M.
Venue
Health Policy and Planning
Publisher
Oxford University Press (OUP)
Published
2006-02-21
Volume
21
Issue
3
Pages
157-170
ISSN
  • 0268-1080 (ISSN-L)
  • 1460-2237
DOI
10.1093/heapol/czl003
OpenAlex
W2163456605
Cited by
189
References
59
Citations by year
2026: 8 · 2025: 9 · 2024: 8 · 2023: 8 · 2022: 26 · 2021: 11 · 2020: 12 · 2019: 7 · 2018: 5 · 2017: 9 · 2016: 7 · 2015: 11 · 2014: 13 · 2013: 11 · 2012: 12
FWCI
6.48
Type
journal article
Language
en
Open access
Locations
  • Health Policy and Planning (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
Keywords
mental health system, economic barriers, low- and middle-income countries, mental health funding, access to mental health care, stigma, resilience, primary care mental health, public-private sector collaboration, health system coordination, resource allocation
MeSH terms
Developing Countries, United Kingdom, Health Policy, Health Services Accessibility, Mental Health Services, State Medicine

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