Rupp Agnes, Freed Michael C, Juliano-Bult Denise
NIMH/NIH 9000 Rockville Pike, Bethesda, MD 20892, USA,
J Ment Health Policy Econ. 2019 Dec 1;22(4):151-154.
The authors are health scientist administrators at the National Institute of Mental Health (NIMH). The mission of NIMH is "to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure." As part of its portfolio, NIMH supports research on mental health economics, and mental health services research.
In this perspective article, the authors comment on two papers presented at the NIMH-sponsored Mental Health Services Research Conference in 2018 and subsequently published in the September 2019 issue of the Journal of Mental Health Policy and Economics. Two important areas are highlighted in this review: (i) the impact of insurance and labor markets on the delivery of high-quality mental health services, and (ii) the need for advancements in method development and design in future studies.
The complexity of health insurance markets created some unintended consequence of the mental health insurance parity legislation. Mental health provider shortages in local labor markets are a barrier to successful implementation and sustainment of innovative and evidence-based mental health service-delivery models for people with serious mental illness.
Data-capture techniques that seamlessly integrate insurance claims with clinical outcomes (e.g., from electronic health records) will better equip health economists and other end-users with rigorous research findings to inform public health policy and practice recommendations. Despite early signals of success, larger sample sizes and more rigorous research designs are needed to refine predictive models of functional outcomes of evidence-based service-delivery models (e.g., coordinated specialty care model including supported education, and supported employment) for people with first-episode psychosis.
作者是美国国立精神卫生研究所（NIMH）的健康科学家管理人员。NIMH的使命是“通过基础和临床研究改变对精神疾病的理解和治疗方式，为预防、康复和治愈铺平道路”。作为其工作组合的一部分，NIMH支持心理健康经济学和心理健康服务研究。
在这篇观点文章中，作者对2018年在NIMH主办的心理健康服务研究会议上发表并随后发表在2019年9月《心理健康政策与经济学杂志》上的两篇论文发表评论。本综述突出了两个重要领域：（i）保险和劳动力市场对高质量心理健康服务提供的影响，以及（ii）未来研究中方法开发和设计进步的必要性。
健康保险市场的复杂性造成了心理健康保险平价立法的一些意外后果。当地劳动力市场中心理健康服务提供者短缺是为严重精神疾病患者成功实施和维持创新且基于证据的心理健康服务提供模式的障碍。
将保险理赔与临床结果（例如来自电子健康记录）无缝整合的数据捕获技术，将使健康经济学家和其他终端用户更好地获得严谨的研究结果，以为公共卫生政策和实践建议提供依据。尽管有早期成功的迹象，但仍需要更大的样本量和更严谨的研究设计，以完善针对首发精神病患者的基于证据的服务提供模式（例如包括支持性教育和支持性就业的综合专科护理模式）功能结果的预测模型。
