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Mental disorders account for one of the largest and fastest growing categories of the burden of disease with which health systems must cope, often accounting for a greater burden than cardiovascular disease and cancer. Moreover, many mild to moderate mental disorders are under diagnosed and untreated meaning that a significant proportion of the population suffering from mental ill health remains hidden. 

Mental disorders also account for a significant share of health spending, particularly public health spending. OECD estimates of expenditure on mental and behavioural disorders show a wide variation between countries. There is also significant variation in inputs, clinical outcomes and health care quality indicators. 

Given the large burden of disease and the variations in financing, delivery and outcomes, there is considerable interest in how to measure the performance of the mental health system in an objective and standardised way. There is also vast potential for cross-country learning and sharing of best practices between OECD members.

The project

Launched in January 2011, this project has two main activity streams: (1) conducting reviews of evidence and best practices in key policy areas; and (2) building and applying a framework for assessing mental health system performance, particularly value-for-money.

Anticipated outputs

The project is expected to result in a publication on what makes a high-performing mental health system based on the evidence available.
The publication will include the following:

• A report reviewing evidence and effective practices in methods of payment for mental health services (e.g. DRGs for mental health)
• A review of evidence and effective practices in models of service integration
• A report presenting a framework of mental health system performance and synthesising available data on health system performance according to the framework
• A compendium of recovery-oriented outcome indicators currently being developed and used in OECD countries, and recommendations on indicators for mental health quality of care
• An analysis of mental health expenditures for selected countries and recommendations on the minimum data set needed for mental health policy development, monitoring and resource allocation
• The development of a framework for assessing mental health system performance that evaluates the value of increased spending on mental health given a) different aggregate levels of spending b) composition of spending (inpatient, outpatient etc); c) social service spending on people with mental disorders. This offers a way of using alternative health accounts as an organising framework to ask “Would increasing mental health spending in circumstances X result in moving the country to more efficient spending levels?”
• A report on trends and mix of mental health workforce in OECD countries
• Profiles of mental health systems in selected OECD countries

Contact

Michael.Borowitz@oecd.org

Permanent URL: http://www.oecd.org/health/mentalhealth

Related Documents

The OECD "Mental Health and Work Project"