Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-10-31T23:14:19.957Z Has data issue: false hasContentIssue false

10 - Meeting unmet needs: can evidence-based approaches help?

from Part II - Unmet need: general problems and solutions

Published online by Cambridge University Press:  21 August 2009

Gavin Andrews
Affiliation:
University of New South Wales, Sydney
Scott Henderson
Affiliation:
Australian National University, Canberra
Get access

Summary

In this chapter, we will discuss our attempt to develop evidence-based systems for defining, guiding, and monitoring aspects of psychiatric care in the USA; some of the limitations in these approaches (i.e., we should not get too overconfident about our capacities); and finally provide some recommendations about how to deal with some of these limitations – and particularly the role of a practice-based research network.

Basically, the problem put before contributors to this volume can be framed as four questions. Who gets treatment? What treatments are or should be provided? How are treatments provided – by whom, how much, and for how long? (and this ultimately translates into the economics). And, on what basis do we determine the above ‘who’, ‘what’, and ‘how’ – do we base it on tradition, on market values, or on evidence?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) introduction is clear in defining mental disorders as a grouping of symptoms plus either clinically significant distress or impairment in major role functioning [American Psychiatric Association (APA), 1994a]. The challenges are to determine which treatments are effective for whom, and to make sure that the people most in need get those treatments. It is important to define how we develop systems that encourage incentives for ensuring that the people in need of treatment receive the most appropriate medical care. In the USA there has been enormous growth in ‘managed care’ as a general approach for making these determinations. Our group has developed a model (Figure 10.1) of how managed care affects patient care, which can be applied to evaluating the processes of any health plan (Pincus, Zarin & West, 1996).

Type
Chapter
Information
Unmet Need in Psychiatry
Problems, Resources, Responses
, pp. 146 - 156
Publisher: Cambridge University Press
Print publication year: 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×