RESOURCE ALLOCATION FOR MENTAL HEALTH IN US AND CANADA

This Research Scientist Development Award application addresses a
fundamental question for policy makers -- namely, how to sub-divide the
resources allocated to health care. The research focuses on the financing
of mental health services. The methodology involves comparing different
mental health delivery systems -- including those of the United States and
Canada. There is a large body of research showing that mental health problems are
common, potentially disabling, yet often quite treatable. Recent studies
have indicated that many mental disorders have a biological component.
There is growing impetus to further the integration of mental health
within the larger health care system. The question naturally arises as to
how much of the health care dollar should be allocated for mental health.
This question is complicated by the different populations of individuals
who use mental health services as well as by the diverse settings in which
these services are delivered. Methodology is needed to compare mental
health financing, services, and outcomes among different types of health
care systems. There is considerable interest in comparing Canadian and American systems
for financing mental health services. Detailed accounting methods will be
used to compare the portion of the health care dollar assigned to mental
health in Oregon with the analogous figure in British Columbia. Methods
for calculating those figures will be documented. The techniques necessary
to replicate this work in other states and provinces will be disseminated. The award will also lead to the development and refinement of methodology
for linking the financial data with outcome measures. Conceptual work will
be performed to elaborate a model that relates resource expenditures to
mental health outcomes. The model will then be applied to local and
national data sets. The anticipated product is a better understanding of
the changes in individual and system level outcome measures that might be
expected under various health care reform scenarios. The results will
include a picture of the changes that might be expected in the mental
health area if the United States (or a single state) were to adopt a
Canadian style single payer system.