Closing the mental health treatment gap in South Africa: a review of costs and cost-effectiveness.
Identifieur interne : 000513 ( Main/Exploration ); précédent : 000512; suivant : 000514Closing the mental health treatment gap in South Africa: a review of costs and cost-effectiveness.
Auteurs : Helen Jack [Royaume-Uni] ; Ryan G. Wagner [Afrique du Sud] ; Inge Petersen [Afrique du Sud] ; Rita Thom [Afrique du Sud] ; Charles R. Newton [Royaume-Uni] ; Alan Stein [Royaume-Uni] ; Kathleen Kahn [Afrique du Sud] ; Stephen Tollman [Afrique du Sud] ; Karen J. Hofman [Afrique du Sud]Source :
- Global health action [ 1654-9880 ] ; 2014.
Abstract
Background Nearly one in three South Africans will suffer from a mental disorder in his or her lifetime, a higher prevalence than many low- and middle-income countries. Understanding the economic costs and consequences of prevention and packages of care is essential, particularly as South Africa considers scaling-up mental health services and works towards universal health coverage. Economic evaluations can inform how priorities are set in system or spending changes. Objective To identify and review research from South Africa and sub-Saharan Africa on the direct and indirect costs of mental, neurological, and substance use (MNS) disorders and the cost-effectiveness of treatment interventions. Design Narrative overview methodology. Results and conclusions Reviewed studies indicate that integrating mental health care into existing health systems may be the most effective and cost-efficient approach to increase access to mental health services in South Africa. Integration would also direct treatment, prevention, and screening to people with HIV and other chronic health conditions who are at high risk for mental disorders. We identify four major knowledge gaps: 1) accurate and thorough assessment of the health burdens of MNS disorders, 2) design and assessment of interventions that integrate mental health screening and treatment into existing health systems, 3) information on the use and costs of traditional medicines, and 4) cost-effectiveness evaluation of a range of specific interventions or packages of interventions that are tailored to the national context.
DOI: 10.3402/gha.v7.23431
PubMed: 28672545
Affiliations:
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Newton</name><affiliation wicri:level="1"><nlm:affiliation>a Department of Psychiatry University of Oxford , Oxford , UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>a Department of Psychiatry University of Oxford , Oxford </wicri:regionArea><wicri:noRegion>Oxford </wicri:noRegion></affiliation></author><author><name sortKey="Stein, Alan" sort="Stein, Alan" uniqKey="Stein A" first="Alan" last="Stein">Alan Stein</name><affiliation wicri:level="1"><nlm:affiliation>a Department of Psychiatry University of Oxford , Oxford , UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>a Department of Psychiatry University of Oxford , Oxford </wicri:regionArea><wicri:noRegion>Oxford </wicri:noRegion></affiliation></author><author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><affiliation wicri:level="1"><nlm:affiliation>b MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>b MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg </wicri:regionArea><wicri:noRegion>Johannesburg </wicri:noRegion></affiliation></author><author><name sortKey="Tollman, Stephen" sort="Tollman, Stephen" uniqKey="Tollman S" first="Stephen" last="Tollman">Stephen Tollman</name><affiliation wicri:level="1"><nlm:affiliation>b MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>b MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg </wicri:regionArea><wicri:noRegion>Johannesburg </wicri:noRegion></affiliation></author><author><name sortKey="Hofman, Karen J" sort="Hofman, Karen J" uniqKey="Hofman K" first="Karen J" last="Hofman">Karen J. Hofman</name><affiliation wicri:level="1"><nlm:affiliation>b MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>b MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg </wicri:regionArea><wicri:noRegion>Johannesburg </wicri:noRegion></affiliation></author></analytic><series><title level="j">Global health action</title><idno type="eISSN">1654-9880</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Nearly one in three South Africans will suffer from a mental disorder in his or her lifetime, a higher prevalence than many low- and middle-income countries. Understanding the economic costs and consequences of prevention and packages of care is essential, particularly as South Africa considers scaling-up mental health services and works towards universal health coverage. Economic evaluations can inform how priorities are set in system or spending changes. Objective To identify and review research from South Africa and sub-Saharan Africa on the direct and indirect costs of mental, neurological, and substance use (MNS) disorders and the cost-effectiveness of treatment interventions. Design Narrative overview methodology. Results and conclusions Reviewed studies indicate that integrating mental health care into existing health systems may be the most effective and cost-efficient approach to increase access to mental health services in South Africa. Integration would also direct treatment, prevention, and screening to people with HIV and other chronic health conditions who are at high risk for mental disorders. We identify four major knowledge gaps: 1) accurate and thorough assessment of the health burdens of MNS disorders, 2) design and assessment of interventions that integrate mental health screening and treatment into existing health systems, 3) information on the use and costs of traditional medicines, and 4) cost-effectiveness evaluation of a range of specific interventions or packages of interventions that are tailored to the national context.</div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Royaume-Uni</li></country></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Jack, Helen" sort="Jack, Helen" uniqKey="Jack H" first="Helen" last="Jack">Helen Jack</name></noRegion><name sortKey="Newton, Charles R" sort="Newton, Charles R" uniqKey="Newton C" first="Charles R" last="Newton">Charles R. Newton</name><name sortKey="Stein, Alan" sort="Stein, Alan" uniqKey="Stein A" first="Alan" last="Stein">Alan Stein</name></country><country name="Afrique du Sud"><noRegion><name sortKey="Wagner, Ryan G" sort="Wagner, Ryan G" uniqKey="Wagner R" first="Ryan G" last="Wagner">Ryan G. Wagner</name></noRegion><name sortKey="Hofman, Karen J" sort="Hofman, Karen J" uniqKey="Hofman K" first="Karen J" last="Hofman">Karen J. Hofman</name><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><name sortKey="Petersen, Inge" sort="Petersen, Inge" uniqKey="Petersen I" first="Inge" last="Petersen">Inge Petersen</name><name sortKey="Thom, Rita" sort="Thom, Rita" uniqKey="Thom R" first="Rita" last="Thom">Rita Thom</name><name sortKey="Tollman, Stephen" sort="Tollman, Stephen" uniqKey="Tollman S" first="Stephen" last="Tollman">Stephen Tollman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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