Introduction

One of the greatest challenges facing mental health care today is its financing. With increasing emphasis being placed on controlling costs in both publicly and privately financed health insurance systems, mental health providers need to develop informed policy on priority setting for financing mental health care and research. Research on the management of mental and addictive disorders to date has been conducted separately in various scientific disciplines such as epidemiology, clinical sciences, economics, and public health. There is a need to integrate these different research areas and, although this chapter is focused on economic perspectives, it also tries to demonstrate how researchers from different disciplines can work together to assist decision makers to formulate mental health policy. The central task for researchers who deal with the unmet need for treatment is to find efficient and equitable delivery alternatives and ways to finance a variety of mental health services in a changing mental health care system.

The economist researcher faces a number of challenges in attempting to meet the unmet need for treatment. These include:

• Defining the need for treatment

• Measuring need

• Identifying unmet need

• Establishing economic criteria for treatment

• Evaluating the economic effectiveness of treatment

• Estimating the cost of not treating treatable illnesses

• Reducing financial barriers to treatment

These challenges include methodological issues relating to definitions, measurement, and estimation techniques as well as conceptual issues involving the formulation of mental health policy and the establishment of priorities based on scientific knowledge.