Introduction

This chapter will explore the economic aspects of providing emergency mental health services in hospital and community settings. The methodology which lies behind the economic evaluation of emergency mental health care services will be discussed as will the areas of cost which are of relevance. It will identify both formal emergency services, and those programmes which incorporate emergency or crisis care within them. The key studies which have included an economic element will be reviewed.

Economic burden of mental health problems

Mental health care is resource hungry. In the UK mental health problems account for 10% of all health care expenditure, 23% of in-patient costs and 25% of pharmaceutical charges, and in addition are the cause of 14% of all days lost to the workplace (Davies & Drummond, 1990). As a consequence of the high expenditure on health care in general, governments in the UK and elsewhere have wanted to encourage cost containment within the health sector.

There are also economic consequences associated with the tragedy of suicide. Suicide is not easy to predict (Henry, 1993) and it cannot be said that the absence of emergency and crisis services will necessarily increase the suicide rate. However, one of the hopes of such services is that they will help to prevent suicide. This is matched at a national level with the UK government making a reduction in the suicide rate one of its targets in The Health of the Nation (Department of Health, 1991).