The cost of fragmented mental health financing: Is it worth it?

Three major aspects of mental health systems-the way they are financed, the configuration of services, and the outcome of services-are discussed. Problems of resource consumption, fragmentation of goals, and deleterious impacts due to financing systems per se, are described. Levels of staff involvement in the financing system (as distinct from direct services) influence staff attitudes toward financing, services, and clients. Financing schemes appear to both influence the effectiveness of mental health systems and provide the dubious "advantage" of costing more. Studies are suggested that will compare comprehensive systems with an eye toward reform.