Of the very large sum of money spent on mental health services, almost all comes from the public directly in the form of central or local government taxation. In 1990, approximately £2 billion was spent in the National Health Service directly on mental health services. That represents 10% of total health service expenditure. In addition, local authority social services departments spend around £50 million annually on residential and day care services for people with mental problems. A further £100 million is spent on supplementary benefit for board and lodgings payments and a considerable amount expended by prisons, courts and the police. These figures omit the growing amount of money spent on supporting elderly people with senile dementia outside mental illness hospitals, in residential and nursing homes. Almost two thirds of all residential care for elderly people provide care for those with mental disorder, adding a further staggering £5–600 million by 1990. The current direct care costs of disabling mental disorder to the public purse is approximately £3,000 million (£3 billion). For all the huge amount of money, resources appear inadequate, ill-directed and uncoordinated. Several actions need to be taken to improve the use of these vast resources.
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