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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >The Productivity Commission's Draft Report illustrates the benefits and risks of economic perspectives on mental healthcare
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The Productivity Commission's Draft Report illustrates the benefits and risks of economic perspectives on mental healthcare

机译：生产力委员会的报告草稿说明了对心理医疗保健的经济观点的益处和风险

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摘要

In 2018, the Australian Government instructed the Productivity Commission to examine the social and economic effects of poor mental health, as well as make recommendations on how they might be addressed. The resulting Draft Report demonstrates both the benefits and risks of an economic approach to these issues. Some of the broader systemic recommendations have merit such as the need for stepped care, coordinated crisis management and the important role of welfare, housing and the workplace in improving mental health. However, there are areas of concern, particularly for mental health services in the public sector. One is a disproportionate emphasis on prevention and intervention in the early years of life for strategies where evidence for effectiveness is limited. Another is the introduction of market-based approaches such as shadow billing or a commissioner/provider split to the funding of mental health services across Australia. Among the numerous problems of such market-driven approaches are the increased costs of additional bureaucracy and the lack of commissioner expertise in planning services or evidence-based practice. As a result, similar arrangements have been abandoned in other jurisdictions. The Commission's final recommendations and the Australian Government's response are awaited and the resulting changes to the mental health system, and beyond, may well be influenced by the COVID-19 pandemic. However, reform should be based on evidence and achieved without increasing administrative complexity.
机译：2018年，澳大利亚政府指示生产力委员会审查不良心理健康的社会和经济影响，并就如何解决这些问题提出建议。由此产生的报告草案表明了以经济方式解决这些问题的好处和风险。一些更广泛的系统性建议有其优点，例如需要阶梯式护理、协调的危机管理，以及福利、住房和工作场所在改善心理健康方面的重要作用。然而，也有一些令人担忧的领域，尤其是公共部门的心理健康服务。一个是在生命早期对有效性证据有限的策略过分强调预防和干预。另一个是引入基于市场的方法，如影子计费或将专员/提供者拆分为澳大利亚各地的心理健康服务提供资金。这种以市场为导向的方法存在诸多问题，其中包括额外官僚机构的成本增加，以及专员缺乏规划服务或循证实践方面的专业知识。因此，其他司法管辖区也放弃了类似的安排。委员会的最终建议和澳大利亚政府的反应等待着，由此产生的心理健康系统的变化，以及超出，很可能会受到COVID-19流行病的影响。然而，改革应该以证据为基础，在不增加行政复杂性的情况下实现。

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