Barriers to delivering mental health services in Georgia with an economic and financial focus: informing policy and acting on evidence.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Health Policy* ; Policy Making*; Health Services Accessibility/*economics ; Mental Health Services/*economics; Female ; Georgia ; Health Expenditures ; Healthcare Financing ; Humans ; Qualitative Research

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 Georgia, as in many other countries, there are clear opportunities to improve the effectiveness of the current mental health programme. Addressing system-wide barriers could enable the delivery of services that aim to 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.

Psychol Med. 2013 Apr;43(4):849-63. (PMID: 22785067)
Health Policy Plan. 2006 May;21(3):157-70. (PMID: 16522714)
Health Res Policy Syst. 2013 Nov 15;11:45. (PMID: 24228796)
PLoS One. 2012;7(6):e38490. (PMID: 22715387)
PLoS One. 2015 Feb 06;10(2):e0116820. (PMID: 25658103)
PLoS Med. 2013;10(1):e1001366. (PMID: 23319895)
BMJ. 2005 Jan 15;330(7483):123-6. (PMID: 15567803)
Int Rev Psychiatry. 2004 Feb-May;16(1-2):107-16. (PMID: 15276943)
Lancet. 2007 Sep 8;370(9590):878-89. (PMID: 17804062)
World Psychiatry. 2008;7(2):79-86. (PMID: 18560485)
PLoS One. 2015 Apr 08;10(4):e0122673. (PMID: 25853246)
Lancet. 2013 Nov 9;382(9904):1575-86. (PMID: 23993280)
Lancet. 2011 Nov 5;378(9803):1654-63. (PMID: 22008420)
Harv Rev Psychiatry. 2012 Jan-Feb;20(1):6-12. (PMID: 22335178)

Keywords: Georgia; Health policy; Health systems; Low-and-middle income countries; Mental health

Date Created: 20180214 Date Completed: 20180816 Latest Revision: 20181202

20231215

PMC5809973

10.1186/s12913-018-2912-5

29433491