Are Mental Health Services Efficient?

What is the role of economics in the delivery of mental health services? The purpose of this paper is to answer this question by indicating the nature of the economic problem scarcity; by examining what economic techniques are available for determining which mental health services are value for the money (i.e., cost effective); and by analyzing the characteristics of a good economic evaluation of mental health care. All this, however, is by way of introduction to the fundamental issue to be addressed here: What evidence is there that mental health services are provided efficiently? In the final part of the paper, it will be argued that most things psychiatrists do have not been evaluated, and that most of the decisions they make about patient treatment are based not on scientific fact, but on hope and guesses. It is concluded that such an approach is inefficient, unethical, and unlikely to survive in a world where constant scarcity is increasing the competition for resources in all health care.