Barriers to delivering mental health services in Georgia with an economic and financial focus: informing policy and acting on evidence
Author(s)
Green, SA
Type
Journal Article
Abstract
Background:
Whilst there is recognition that the global burden of disease associated with mental health disorders
is significant, the economic resources available, especially in Low and Middle Income Countries, are particularly scarce.
Identifying the economic (system) and financial (individual) barriers to delivering mental health services and assessing
the opportunities for reform can support the development of strategies for change.
Methods:
A mixed methods study was developed, which engaged with a range of stakeholders from mental health
services, including key informants, service managers, healthcare professional and patients and their care-takers. Data
generated from interviews and focus groups were analysed using an existing framework that outlines a range of
economic and financial barriers to improving mental health practice. In addition, the study utilised health financing
and programmatic data.
Results:
The analysis identified a variety of local economic barriers, including: the inhibition of the diversification of the
mental health workforce and services due to inflexible resources; the variable and limited provision of services across
the country; and the absence of mechanisms to assess the delivery and quality of existing services. The main financial
barriers identified were related to out-of pocket payments for purchasing high quality medications and transportation
to access mental health services.
Conclusions:
Whilst scarcity of financial resources exists in Ge
orgia, as in many other countries, there are clear
opportunities to improve the effectiveness of the cu
rrent mental health programme. Addressing system-wide
barriers could enable the delivery of services that aim t
o meet the needs of patients. The use of existing data
to assess the implementation of the mental health programme
offers opportunities to benchmark and improve services
and to support the appropriate commissioning and reconfiguration of services.
Whilst there is recognition that the global burden of disease associated with mental health disorders
is significant, the economic resources available, especially in Low and Middle Income Countries, are particularly scarce.
Identifying the economic (system) and financial (individual) barriers to delivering mental health services and assessing
the opportunities for reform can support the development of strategies for change.
Methods:
A mixed methods study was developed, which engaged with a range of stakeholders from mental health
services, including key informants, service managers, healthcare professional and patients and their care-takers. Data
generated from interviews and focus groups were analysed using an existing framework that outlines a range of
economic and financial barriers to improving mental health practice. In addition, the study utilised health financing
and programmatic data.
Results:
The analysis identified a variety of local economic barriers, including: the inhibition of the diversification of the
mental health workforce and services due to inflexible resources; the variable and limited provision of services across
the country; and the absence of mechanisms to assess the delivery and quality of existing services. The main financial
barriers identified were related to out-of pocket payments for purchasing high quality medications and transportation
to access mental health services.
Conclusions:
Whilst scarcity of financial resources exists in Ge
orgia, as in many other countries, there are clear
opportunities to improve the effectiveness of the cu
rrent mental health programme. Addressing system-wide
barriers could enable the delivery of services that aim t
o meet the needs of patients. The use of existing data
to assess the implementation of the mental health programme
offers opportunities to benchmark and improve services
and to support the appropriate commissioning and reconfiguration of services.
Date Issued
2018-02-13
Date Acceptance
2018-02-06
Citation
BMC Health Services Research, 2018, 18
ISSN
1472-6963
Publisher
BioMed Central
Journal / Book Title
BMC Health Services Research
Volume
18
Copyright Statement
© The Author(s). 2018
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (
http://creativecommons.org/licenses/by/4.0/
), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(
http://creativecommons.org/publicdomain/zero/1.0/
) applies to the data made available in this article, unless otherwise stated.
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (
http://creativecommons.org/licenses/by/4.0/
), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(
http://creativecommons.org/publicdomain/zero/1.0/
) applies to the data made available in this article, unless otherwise stated.
Subjects
1117 Public Health And Health Services
0807 Library And Information Studies
Health Policy & Services
Publication Status
Published
Article Number
ARTN 108
Date Publish Online
2018-02-13