Priority-setting for mental health services

Abstract

Background: Economic evaluation of individual interventions can have limited usefulness due to the potential for methodological confounding, particularly for those decision contexts where strategies involving multiple interventions are required.

Aims: To introduce readers to different approaches of priority-setting, with a focus on economics-based examples of priority-setting in mental health.

Method: A selective review of the priority-setting literature, with particular attention given to the mental health context and economics-based approaches.

Results: Six priority-setting approaches in mental health are described and assessed.

Conclusions: Priority-setting approaches that incorporate methodological rigour, due process for involving stakeholders and broad-based notions of “benefit”, are likely to be of most use to mental healthcare decision-makers. Challenges, both in relation to data bases and method remain, but are within the capacity of the mental health research community to resolve.

Keywords:

• economic evaluation
• priority-setting
• mental health
• mental disorders

Acknowledgements

This paper is largely based on the PhD thesis titled: “The Cost-Effectiveness of Preventive Interventions for Mental Disorders: The Application and Evaluation of a Priority-Setting Model” (University of Melbourne, 2011) completed by the first author of this paper and supervised by the subsequent three authors.

Declaration of interest: The authors report no conflict of interest.