Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
Adm Policy Ment Health. 2012 May;39(3):158-69. doi: 10.1007/s10488-011-0341-4.
Insurance coverage for mental health services has historically lagged behind other types of health services. We used a simulation exercise in which groups of laypersons deliberate about healthcare tradeoffs. Groups deciding for their "community" were more likely to select mental health coverage than individuals. Individual prioritization of mental health coverage, however, increased after group discussion. Participants discussed: value, cost and perceived need for mental health coverage, moral hazard and community benefit. A deliberative exercise in priority-setting led a significant proportion of persons to reconsider decisions about coverage for mental health services. Deliberations illustrated public-spiritedness, stigma and significant polarity of views.
医疗保险对心理健康服务的覆盖范围历来落后于其他类型的健康服务。我们使用了一个模拟练习，让一群外行人就医疗保健的取舍进行协商。为他们的“社区”做出决策的群体更有可能选择心理健康保险，而不是个人。然而，在小组讨论后，个人对心理健康保险的优先排序增加了。参与者讨论了：心理健康保险的价值、成本和感知需求、道德风险和社区利益。优先排序的审议性练习使相当一部分人重新考虑了心理健康服务的覆盖范围决策。审议过程体现了公益精神、污名化和观点的显著对立。
