Mental illness services in Britain: counting the costs, weighing the benefits

The evidence accumulating from these recent careful studies suggests that care in the community is likely to be less expensive and more beneficial than institution-based care for many people with chronic mental illness. The cost savings are likely to be greater for less severely disabled individuals. These findings are consistent with those of earlier studies conducted in the United States (5) and in Australia (6). The incorporation of cost-benefit analysis into the daily routine of service provision presents a major opportunity for using limited resources in a way that maximizes the benefit to patients. Clinical staff readily recognize the importance of balancing the costs and benefits of the services they provide. Their reservations and skepticism about cost-benefit analysis usually center on doubts about the reliability and validity of the means used to calculate the costs and benefits. Involving clinicians in developing measures of outcome offers an opportunity to secure their commitment to the value ...