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The mental health policy template: domains and elements for mental health policy formulation.

Mental disorders are a major and rising cause of disease burden in all countries. Even when resources are available, many countries do not have the policy and planning frameworks in place to identify and deliver effective interventions. The World Health Organization (WHO) and the World Bank have emphasized the need for ready access to the basic tools for mental health policy formulation, implementation and sustained development. The Analytical Studies on Mental Health Policy and Service Project, undertaken in 1999-2001 by the International Consortium for Mental Health Services and funded by the Global Forum for Health Research aims to address this need through the development of a template for mental health policy formulation. A mental health policy template has been developed based on an inventory of the key elements of a successful mental health policy. These elements have been validated against a review of international literature, a study of existing mental health policies and the results of extensive consultations with experts in the six WHO regions of the world. The Mental Health Policy Template has been revised and its applicability will be tested in a number of developing countries during 2001-2002. The Mental Health Policy Template and the work of the Consortium for Mental Health Services will be presented and the future role of the template in mental health policy development and reform in developing countries will be discussed.

Developed Countries↗

Health policy perception and health behaviours: a multilevel analysis and implications for public health psychology.

Associations of health policy perception with health behaviours are analysed. Policy perception is differentiated in information about programmes and appraisal of health policy's contribution to policy goals, and conceptualized on the level of: (1) individuals; and (2) populations (as a social climate indicator). Survey data from the Biomed2-Project MAREPS gathered in Belgium, Finland, Germany, The Netherlands, Spain and Switzerland (N= 3343) show that at the individual level, only policy information is associated with utilizing mammography, quitting smoking, physical activity and political participation in creating healthy environments. In contrast, multilevel regression analyses show that policy appraisal is related to physical activity and political participation as a social climate factor. Implications for integrating health psychology and public health within public health psychology are discussed.

Behavioral Medicine↗

Health policy and mental health.

Health policy can be described as policy directed at the determinants of health, i.e. biological and environmental factors, lifestyle and the health care system. This type of policy now has become a policy objective in an increasing number of countries. In this article mental health is placed in the broad context of this policy. The central question is: can the mental health field grasp the opportunity of a growing interest in prevention and health promotion in general, as major objectives of health policy? Or will it stay more or less isolated from the mainstream of current developments? Answering this question means looking at the conditions of health policy. For health policy it is required that a definition be given of health problems and "causing" conditions. There should further be available intervention possibilities of a preventive and intersectoral character and also preventive strategies. It is stated that there is enough standardized information on mental health problems and experience with community-based research to let mental health participate in drawing up a community diagnosis. It also appears possible to construct an ecological health status model for mental health. Research on the factors in this model shows a shift in focus from risk populations to risk situations, e.g. unemployment, industrial disability, divorce and isolation. Further it is recognized that the search for causal factors is substituted by that for precipitating factors. Social-demographic factors, taken alone, are not precipitating factors. What matters is the combination of an underdeveloped coping mechanism, little social support, and prolonged stressful conditions or sudden stressful events.(ABSTRACT TRUNCATED AT 250 WORDS)

Europe↗

Values and policy conceptions of health policy elites in the United States, the United Kingdom, and the Federal Republic of Germany.

This essay presents data on the thinking of health policy elites in the United States, the United Kingdom and the Federal Republic of Germany. These three national groups are compared in terms of the values they perceive health policy should serve and their conceptions of appropriate policies for realizing these values. The different values and policy conceptions are then related to various propositions as to why social policies differ across nations, particularly to the hypothesis that social policies differ as a consequence of elite values and attitudes.

Attitude to Health↗

Health policy implications of health promotion and disease prevention for allied health.

Regardless of the direction health policies in this country may take, allied health professionals seem uniquely positioned to meet the health promotion needs of a variety of clients, such as patients, families, other providers, employees, and members of communities. If allied health professionals choose to respond to health promotion as an area of clinical expertise, they will have to accept the challenge presented by the numerous complex issues associated with implementing a new discipline. However, the successful application of energy and resources to resolving these problems would allow allied health professionals to provide significant interventions in meeting national health goals. This article reviews the history of health promotion in the United States, discusses current practices in health promotion, and suggests some future trends.

Allied Health Personnel↗

Comprehensive versus selective primary health care: lessons for global health policy.

Primary health care was declared the model for global health policy at a 1978 meeting of health ministers and experts from around the world. Primary health care requires a change in socioeconomic status, distribution of resources, a focus on health system development, and emphasis on basic health services. Considered too idealistic and expensive, it was replaced with a disease-focused, selective model. After several years of investment in vertical interventions, preventable diseases remain a major challenge for developing countries. The selective model has not responded adequately to the interrelationship between health and socioeconomic development, and a rethinking of global health policy is urgently needed.

Global Health↗

Computer-assisted health impact assessment for intersectoral health policy.

Intersectoral health policy implies negotiations with politicians outside the health sector. Health politicians have a stronger position if they can quantify health impact. In this Dutch case-study we used a computer simulation approach to answer the following questions: Which anti-tobacco intervention has the largest health gain? Will a commuter cycling policy result in any substantial health gain? What is the relative health gain of promoting higher consumption of vegetables and fruit? We concluded that substantial health gain can be achieved if cigarette packet price were to increase by 2 Dutch guilders. A commitment of all general practitioners to implement a smoking cessation intervention will result in a similar health gain. Stimulating commuter cycling could be a promising example of intersectoral health policy. Interventions to promote higher vegetable and fruit consumption will result in a relatively small health gain. Pros and cons of simulation models to support intersectoral health policy are discussed.

Adult↗

Consumer attitudes toward health policy and knowledge about health legislation.

Consumer attitudes toward key issues affecting health policy decisions in the local community have been ignored both by local health policy makers and by medical sociologists. The authors report an empirical analysis of: (1) consumer attitudes towards federal intervention in health care; (2) consumer perceptions of the free market philosophy of health providers; (3) consumer perceptions of their involvement in health policy making; (4) consumer confidence in present systems of health services delivery; and (5) consumer awareness of recent major health legislation. It was found that consumers are poorly informed about recent health care legislation. The authors compared the attitudes of consumers with those held by local hospital board members toward health policy issues. The differences for all comparisons were statistically significant. The authors argue that hospital board members attribute problems in health services delivery to demand dysfunctions while consumers perceive the problems to be a result of supply dysfunctions. Thus, failure to include consumers on health policy boards guarantees the absence of a solution-oriented dialogue and promotes the continuing predominance of a provider-biased ideology.

Attitude to Health↗

Defining 'mental illness' in mental health policy.

Mental health policy is shaped fundamentally by the definition of mental illness associated with the policy. Changing policies reflect changing definitions. At various times, the definition may be narrow or broad with respect to the scope of conditions covered by a specific policy. The priority accorded to impairment severity is the most crucial and enduring policy issue related to the definition of mental illness and the scope of that definition. This paper explores the role of definitions in framing mental health policy, using examples from the history of policy making over the past half-century.

Advisory Committees↗