Daniel S Park1, Jing Han2, Mahmoud Torabi2, Evelyn L Forget3. 1. Somerville College, University of Oxford, Woodstock Road, Oxford, OX26HD, UK. 2. Rady Faculty of Health Sciences, University of Manitoba, 727 McDermot Avenue, Winnipeg, MB, R3E 3P5, Canada. 3. Rady Faculty of Health Sciences, University of Manitoba, 727 McDermot Avenue, Winnipeg, MB, R3E 3P5, Canada. Evelyn.Forget@umanitoba.ca.
Abstract
BACKGROUND: Mental health outcomes vary widely among high-income countries, although mental health problems represent an increasing proportion of the burden of disease for all countries. This has led to increased demand for healthcare services, but mental health outcomes may also be particularly sensitive to the availability of social services. This paper examines the variation in the absolute and relative amounts that high-income countries spend on healthcare and social services to determine whether increased expenditure on social services relative to healthcare expenditure might be associated with better mental health outcomes. METHODS: This paper estimates the association between patterns of government spending and population mental health, as measured by the death rate resulting from mental and behavioural disorders, across member countries of the Organisation for Economic Cooperation and Development (OECD). We use country-level repeated measures multivariable modelling for the period from 1995 to 2016 with region and time effects, adjusted for total spending and demographic and economic characteristics. Healthcare spending includes all curative services, long-term care, ancillary services, medical goods, preventative care and administration whilst social spending consists of all transfer payments made to individuals and families as part of the welfare state. RESULTS: We find that a higher ratio of social to healthcare expenditure is associated with significantly better mental health outcomes for OECD populations, as measured by the death rate resulting from mental and behavioural disorders. We also find that there is no statistically significant association between healthcare spending and population mental health when we do not control for social spending. CONCLUSION: This study suggests that OECD countries can have a significant impact on population mental health by investing a greater proportion of total expenditure in social services.
BACKGROUND: Mental health outcomes vary widely among high-income countries, although mental health problems represent an increasing proportion of the burden of disease for all countries. This has led to increased demand for healthcare services, but mental health outcomes may also be particularly sensitive to the availability of social services. This paper examines the variation in the absolute and relative amounts that high-income countries spend on healthcare and social services to determine whether increased expenditure on social services relative to healthcare expenditure might be associated with better mental health outcomes. METHODS: This paper estimates the association between patterns of government spending and population mental health, as measured by the death rate resulting from mental and behavioural disorders, across member countries of the Organisation for Economic Cooperation and Development (OECD). We use country-level repeated measures multivariable modelling for the period from 1995 to 2016 with region and time effects, adjusted for total spending and demographic and economic characteristics. Healthcare spending includes all curative services, long-term care, ancillary services, medical goods, preventative care and administration whilst social spending consists of all transfer payments made to individuals and families as part of the welfare state. RESULTS: We find that a higher ratio of social to healthcare expenditure is associated with significantly better mental health outcomes for OECD populations, as measured by the death rate resulting from mental and behavioural disorders. We also find that there is no statistically significant association between healthcare spending and population mental health when we do not control for social spending. CONCLUSION: This study suggests that OECD countries can have a significant impact on population mental health by investing a greater proportion of total expenditure in social services.
Entities:
Keywords:
Healthcare spending; Mental and behavioural disorders; Mental health; OECD; Population health; Social determinants; Social spending
Authors: Srividya N Iyer; Megan Pope; Aarati Taksal; Greeshma Mohan; Thara Rangaswamy; Heleen Loohuis; Jai Shah; Ridha Joober; Norbert Schmitz; Howard C Margolese; Ramachandran Padmavati; Ashok Malla Journal: Int J Ment Health Syst Date: 2022-01-10