Setting priorities

Since public systems are invariably faced with the dilemma of having insufficient resources, they are forced to set priorities or to establish some system of rationing. Waiting lists constitute one familiar type of rationing. If people have to wait for long periods to obtain the service, some individuals will lose patience and opt out of treatment, some may go elsewhere, some conditions may resolve spontaneously, and some individuals may die. The most patient and persistent individuals will get the service. This form of rationing takes no account of need. Other systems ration services on the basis of means: those individuals who can afford to pay get the services they need or demand, others may get no services, or an inferior level of service that does not adequately meet their needs. Public service systems try to set priorities on the basis of need, rather than ability to pay or other considerations. Commonly, priority is given to those with the greatest need, that is those with the most severe illnesses and disabilities, designated as a 'target population' for mental health services. Priority may also be given to those with least access to alternatives, such as those with least ability to pay. In the United States two levels of priority are currently recognized by the federal government. 'Serious mental illness' is defined in terms of having a DSM diagnosis of mental disorder'4.1.' and a level of functional impairment that indicates a need for treatment or rehabilitation. (39 This category is taken to approximate the broad scope of persons needing mental health services. 'Severe mental illness' is a term used to designate a more narrowly defined, more disabled, group that requires more intensive and specialized services for treatment, support, and rehabilitation. This group is defined in terms of specific diagnoses (e.g. schizophrenia, major affective disorders, or severe personality disorders), duration or chronicity (e.g. two or more admissions to hospital in a 5-year period), and level of disability (e.g. documented inability to function in areas such as employment, family relationships, and housing). (42)

Booze Basher

Booze Basher

Get All The Support And Guidance You Need To Permanently STOP The Battle With Alcohol Once And For All. This Book Is One Of The Most Valuable Resources In The World When It Comes To Transformational Tools For Battling Booze Binges And Staying Alcohol-Free.

Get My Free Ebook


Post a comment