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Behavioral Health Conditions: Direct Treatment Costs and Indirect Social Costs

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Quality Improvement in Behavioral Health

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Abstract

Behavioral health conditions, including both mental health and substance use conditions, are prevalent and costly. Full implementation of the Patient Protection and Affordable Care Act (PPACA) is expected to lead to both increased utilization of behavioral health care due to the reduction in financial barriers to access, and continued evolution of the patterns of care as providers respond to incentives to strengthen the healthcare efficiency and quality. These incentives highlight the importance of measuring the direct and indirect costs and benefits of alternate strategies for providing behavioral healthcare. This chapter presents published evidence of the magnitudes of these impacts, along with a discussion of strategies for assessing cost-effectiveness. The chapter concludes with a discussion of the results of studies that addressed the question of whether integrated care is a cost-effective strategy for delivering behavioral and physical healthcare.

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Abbreviations

Absenteeism:

A habitual pattern of absence from the workplace usually as a result of a medical or mental health condition.

Co-located Models of Care:

Co-located models of care are mid-level models in the integration spectrum that locate behavioral health providers in the same location as primary care without system-wide integration.

Cost–Effectiveness Analysis:

CEA is a method of economic evaluation that assesses the costs and health outcomes of a therapy, intervention, program, or policy. Costs are compared to the intervention’s effectiveness, which is measured in terms of health outcomes (e.g., depression-free days or quality adjusted life years). Results are presented as a cost per health outcome, which is often referred to as a cost–effectiveness ratio. Programs can be compared using the same outcome or a single intervention can be examined and compared to a standard threshold (e.g., the cost per QALY threshold that is commonly accepted in the health care arena as acceptable is anything under $50,000 per QALY).

Cost–Benefit Analysis:

CBA is a method of economic evaluation whereby all the positive (beneficial) and negative (costly) consequences of a therapy, intervention, program, r policy are expressed in monetary terms. The valuation of the outcomes in monetary terms (e.g., dollars) allows for direct comparisons of health outcomes so that those who are making a decision, whether individuals, providers, or policy makers, can make decisions using an “apples to apples” technique.

Cost Offsets:

Cost offsets occur when less medical care is provided as a result of behavioral health services that led to prevention of medical conditions.

Efficacy:

The measure of how well a treatment works in a controlled atmosphere such as a clinical trial.

Effectiveness:

The measure of how well a treatment works in a real world setting (e.g., as it is delivered in the health care system with users going about their lives outside of a controlled environment).

Incidence:

Incidence is the number of new cases of a condition over a specified period of time. It is a rate as the time period is an important part of determining incidence.

Integrated Care Models:

Integrated care models are models where the behavioral health providers are not only located in the same place but are also close to or fully integrated with respect to service delivery.

Leveraging:

Savings that occur as a result of less time spent by the physician on behavioral health as a result of the behavioral health provider taking on treatment for those issues.

Prevalence:

Prevalence is the proportion of a specific population that has a problem at a specific point in time. It is a proportion and is a cross-sectional metric of disease burden.

Transinstitutionalization:

The shift from institutionalization of those with a mental health condition within the hospital system to the institutionalization within the prison system.

References

  • Agency for Healthcare Research and Quality. (2012). Experts call for integrating mental health into primary care. Rockville, MD: Agency for Healthcare Research and Quality.

    Google Scholar 

  • Alonso, J., Petukhova, M., Vilagut, G., Chatterji, S., Herringa, S., Ustun, T. B., et al. (2011). Days out of role due to common physical and mental conditions: Results from the WHO World Mental Health surveys. Molecular Psychiatry, 16, 1234–1246.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Substance Related and Addictive Disorders. Retrieved June 2014, from http://www.dsm5.org/Documents/Substance%20Use%20Disorder%20Fact%20Sheet.pdf

  • Andrews, G., Sanderson, K., Corry, J., & Lapsley, H. (2004). Utilising survey data to inform public policy: Comparison of the cost-effectiveness of treatment of ten mental disorders. British Journal of Psychiatry, 184, 526–533.

    Article  PubMed  Google Scholar 

  • Beecham, J. (2014). Annual research review: Child and adolescent mental health interventions: A review of progress in economic studies across different disorders. Journal of Child Psychology and Psychiatry, 55(6), 714–732.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bernabei, R., Landi, F., Gambassi, G., Sgadari, A., Zuccala, G., Mor, V., et al. (1998). Randomised trial of impact of model of integrated care and case management for older people living in the community. British Medical Journal, 316(7141), 1348–1351.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bhui, K. S., Dinos, S., Stansfeld, S. A., & White, P. D. (2012). A synthesis of the evidence for managing stress at work: A review of the reviews reporting on anxiety, depression, and absenteeism. Journal of Environmental and Public Health, 2012, 1–21.

    Article  Google Scholar 

  • Bird, S. R., Kurowski, W., Dickman, G. K., & Kronborg, I. (2007). Integrated care facilitation for older patients with complex health care needs reduces hospital demand. Australian Health Review, 31(3), 451–461.

    Article  PubMed  Google Scholar 

  • Birnbaum, H. G., Kessler, R. C., Kelly, D., Ben-Hamadi, R., Joish, V. N., & Greenberg, P. E. (2010). Employer burden of mild, moderate, and severe major depressive disorder: Mental health services utilization and costs, and work performance. Depression and Anxiety, 27(1), 78–89.

    Article  PubMed  Google Scholar 

  • Blount, A., Schoenbaum, M., Kathol, R., Rollman, B. L., Thomas, M., O’Donohue, W., et al. (2007). The economics of behavioral health services in medical settings: A summary of the evidence. Professional Psychology: Research and Practice, 38(3), 290–297.

    Article  Google Scholar 

  • Bogner, H. R., Morales, K. H., de Vries, H. F., & Cappola, A. R. (2012). Integrated management of type 2 diabetes mellitus and depression treatment to improve medication adherence: A randomized controlled trial. Annals of Family Medicine, 10(1), 115–122.

    Article  Google Scholar 

  • Boscarino, J., Hoffman, S., Gerhard, G., Han, J., Rukstalis, M., Erlich, P., et al. (2012). Generalized Anxiety and Depression Among Chronic Pain Patients on Opioid Therapy are Associated With Higher Pain Impairment, Increased Service Utilization and Poorer Health Status. HMORN. 3 (August), p. 183. HMORN 2012-Selected Abstracts.

    Google Scholar 

  • Cauce, A. M., Paradise, M., Ginzler, J. A., Embry, L., Morgan, C. J., Lohr, Y., et al. (2000). The characteristics and mental health of homeless adolescents age and gender differences. Journal of Emotional and Behavioral Disorders, 8(4), 230–239.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention. (2013, October 4). Mental Illness. Retrieved June 2014, from CDC Mental Health: http://www.cdc.gov/mentalhealth/basics/mental-illness.htm

  • Chambers, L. A., Greene, S., Watson, J., Rourke, S. B., Tucker, R., Koornstra, J., et al. (2014). Not just “a roof over your head”: The meaning of healthy housing for people living with HIV. Housing, Theory and Society, 31(3), 310–333.

    Article  Google Scholar 

  • Chisolm, D., Kames, S., Sekar, K., Kumar, K., Murthy, S., Saeed, K., et al. (2000). Integration of mental health care into primary care Demonstration cost-outcome study in India and Pakistan. British Journal of Psychiatry, 176, 581–588.

    Article  Google Scholar 

  • Coiro, M., Riley, A., Broitman, M., & Miranda, J. (2012). Effects on children of treating their Mothers’ depression: Results of a 12-month follow-up. Psychiatric Services, 63(4), 357–363.

    Article  PubMed  Google Scholar 

  • Collins, C., Hewson, D. L., Munger, R., & Wade, T. (2010). Evolving models of behavioral health integration in primary care. New York, NY: The Milbank Memorial Fund.

    Book  Google Scholar 

  • Connell, A. M., & Goodman, S. H. (2002). The association between psychopathology in fathers versus mothers and children’s internalizing and externalizing behavior problems: A meta-analysis. Psychological Bulletin, 128, 746–773.

    Article  PubMed  Google Scholar 

  • Cornwell, K., Forbes, C., Inder, B., & Meadows, G. (2009). Mental illness and its effects on labour market outcomes. Journal of Mental Health Policy and Economics, 12(13), 107–118.

    PubMed  Google Scholar 

  • Cottini, E., Kato, T., & Westergård-Nielsen, N. C. (2011). Adverse workplace conditions, high-involvement work practices and labor turnover: Evidence from Danish linked employer-employee data. Labour Economics, 18(6), 872–880.

    Article  Google Scholar 

  • Cowell, A. J., Luo, Z., & Masuda, Y. J. (2009). Psychiatric disorders and the labor market: An analysis by disorder profiles. Journal of Mental Health Policy and Economics, 12(1), 3–17.

    PubMed  Google Scholar 

  • Currie, J., & Kahn, R. (2012). Children with disabilities: Introducing the issue. The Future of Children, 22(1), 3–11.

    Google Scholar 

  • Currie, J., Stabile, M., & Jones, L. E. (2013, June). Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with ADHD? Retrieved July 2014, from National Bureau of Economic Research: http://www.nber.org/papers/w19105.pdf

  • Dilsaver, S. C. (2011). An estimate of the minimum economic burden of bipolar I and II disorders in the United States: 2009. Journal of Affective Disorders, 129(1-3), 79–83.

    Article  PubMed  Google Scholar 

  • Donohue, J. M., & Pincus, H. A. (2007). Reducing the societal burden of depression: A review of economic costs, quality of care and effects of treatment. PharmacoEconomics, 25(1), 7–24.

    Article  PubMed  Google Scholar 

  • Drake, R., Yovetich, N., Bebout, R., Harris, M., & McHugo, G. (1997). Integrated treatment for dually diagnosed adults. Journal of Nervous and Mental Disease, 185(5), 298–305.

    Article  PubMed  Google Scholar 

  • Engel, A. G., Malta, L. S., Davies, C. A., & Baker, M. M. (2011). Clinical effectiveness of using an integrated model to treat depressive symptoms in veterans affairs primary care clinics and its impact on health care utilization. Primary Care Companion for CNS Disorders, 13(4), 93–101.

    Google Scholar 

  • Falba, T. A., Sindelar, J. L., & Gallo, W. T. (2009). Work expectations, realizations, and depression in older workers. Journal of Mental Health Policy and Economics, 12(4), 175–186.

    PubMed  PubMed Central  Google Scholar 

  • Feder, A., Alonso, A., Tang, M., Liriano, W., Warner, V., Pilowsky, D., et al. (2009). Children of low-income depressed mothers: Psychiatric disorders and social adjustment. Depression and Anxiety, 26(6), 513–520.

    PubMed  PubMed Central  Google Scholar 

  • Folsom, D. P., Hawthorne, W., Lindamer, L., Gilmer, T., Bailey, A., Golshan, S., et al. (2005). Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. American Journal of Psychiatry, 162(2), 370–376.

    Article  PubMed  Google Scholar 

  • Gadermann, A. M., Alonso, J., Vilagut, G., Zaslovsky, A. M., & Kessler, R. C. (2012). Comorbidity and disease burden in the National Comorbidity Survey Replication (NCS-R). Depression and Anxiety, 29(9), 797–806.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gershon, A., Hayward, C., Schraedley-Desmond, P., Rudolph, K. D., Booster, G. D., & Gotlib, I. H. (2011). Life stress and first onset of psychiatric disorders in daughters of depressed mothers. Journal of Psychiatry Research, 45(7), 855–862.

    Article  Google Scholar 

  • Gilmer, T. P., Stefanic, A., Ettner, S. L., Manning, W. G., & Tsemberis, S. (2010). Effect of full-service partnerships on homelessness, use and costs of mental health services, and quality of life among adults with serious mental illness. Archives of General Psychiatry, 67(6), 645–652.

    Article  PubMed  Google Scholar 

  • Goodman, S. H. (2007). Depression in mothers. Annual Review of Clinical Psychology, 3, 107–135.

    Article  PubMed  Google Scholar 

  • Grimes, K. E., Schulz, M. F., Cohen, S. A., Mullin, B. O., Lehar, S. E., & Tien, S. (2011). Pursuing cost-effectiveness in mental health service delivery for youth with complex needs. Journal of Mental Health Policy and Economics, 14(2), 73–83.

    PubMed  Google Scholar 

  • Hammen, C. (2003). Social stress and women’s risk for recurrent depression. Archives of Women and Mental Health, 6, 9–13.

    Article  Google Scholar 

  • Harrison, J. P., Satterwhite, L. F., & Ruday, W., Jr. (2010). The financial impact of post-traumatic stress disorder on returning US military personnel. Journal of Healthcare Finance, 36(4), 65–74.

    Google Scholar 

  • Hilton, M. E., Fleming, M., Glick, H., Gutman, M. A., Lu, Y., McKay, J., et al. (2003). Services integration and cost-effectiveness. Alcoholism: Clinical and Experimental Research, 27(2), 271–280.

    Article  Google Scholar 

  • Hjortsberg, C., Helldin, L., Hjaerthag, F., & Loethgren, M. (2011). Costs for patients with psychotic illness: Differences depending upon state of remission. The Journal of Mental Health Policy and Economics, 14(2), 87–93.

    PubMed  Google Scholar 

  • Kaaya, S., Eustache, E., Lapidos-Salaiz, I., Musisi, S., Psaros, C., & Wissow, L. (2013). Grand challenges: Improving HIV treatment outcomes by integrating interventions for Co-morbid mental illness. PLoS Medicine, 10(5), e1001447.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kaplan, C., & Zhang, Y. (2012). Assessing the comparative-effectiveness of antidepressants commonly prescribed for depression in the US medicare population. Journal of Mental Health Policy and Economics, 15(4), 171–178.

    PubMed  PubMed Central  Google Scholar 

  • Katon, W. J., & Unützer, J. (2013). Health reform and the affordable care act: The importance of mental health treatment to achieving the triple aim. Journal of Psychosomatic Research, 74(6), 533–537.

    Article  PubMed  Google Scholar 

  • Keiling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O., et al. (2011). Child and adolescent mental health worldwide: Evidence for action. The Lancet, 378(9801), 1515–1525.

    Article  Google Scholar 

  • Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., et al. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the national Comorbidity survey replication adolescent supplement. Archives of General Psychiatry, 69(4), 372–380.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627.

    Article  PubMed  PubMed Central  Google Scholar 

  • Knapp, M., King, D., Healey, A., & Thomas, C. (2011). Economic outcomes in adulthood and their associations with antisocial conduct, attention deficit and anxiety problems in childhood. Journal of Mental Health Policy and Economics, 14(3), 137–147.

    PubMed  Google Scholar 

  • Kotsopoulous, N., Connelly, M. P., Sobanski, E., & Postma, M. J. (2013). The fiscal consequences of ADHD in Germany: A quantitative analysis based on differences in educational attainment and lifetime earnings. Journal of Mental Health Policy and Economics, 16(1), 27–33.

    Google Scholar 

  • Lamb, H. R., & Weinberger, L. E. (2005). The shift of psychiatric inpatient care from hospitals to jails and prisons. Journal of the American Academy of Psychiatry and the Law, 33(4), 529–534.

    PubMed  Google Scholar 

  • Lépine, J.-P., & Briley, M. (2011). The increasing burden of depression. Neuropsychiatric Disease and Treatment, 7(Suppl 1), 3–7.

    PubMed  PubMed Central  Google Scholar 

  • Lo Sasso, A. T., Rost, K., & Beck, A. (2006). Modeling the impact of enhanced depression treatment on workplace functioning and costs. Medical Care, 44, 352–358.

    Article  PubMed  Google Scholar 

  • MacAdam, M. (2008). Frameworks of integrated care for the elderly: A systematic review. Ontario, CA: Canadian Policy Research Networks.

    Google Scholar 

  • McCrone, P., Knapp, M., Proudfoot, J., Ryden, C., Cavanagh, K., Shapiro, D. A., et al. (2004). Cost-effectiveness of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial. British Journal of Psychiatry, 185, 55–62.

    Article  PubMed  Google Scholar 

  • Miller, K. M., Orellana, E. R., Briggs, H. E., & Quinn, A. (2014). Influence of caregiver substance dependence and serious mental illness on Children’s mental health: Moderating effects of social support. Child and Adolescent Social Work Journal, 1–20.

    Google Scholar 

  • Nelson, R. E., & Kim, J. (2011). The impact of mental illness on the risk of employment termination. Journal of Mental Health Policy and Economics, 14(1), 39–52.

    PubMed  Google Scholar 

  • Parthasarathy, S., & Weisner, C. M. (2005). Five-year trajectories of health care utilization and cost in a drug and alcohol treatment sample. Drug and Alcohol Dependence, 80(2), 231–240.

    Article  PubMed  Google Scholar 

  • Patient-Centered Outcomes Research Institute. (2014, April). FAQs for Applicants. Retrieved from Patient-Centered Outcomes Research Institute: http://www.pcori.org/funding-opportunities/funding-center/faqs-for-applicants/

    Google Scholar 

  • Pecora, P., Williams, J., Kessler, R. C., Downs, C. A., O'Brien, K., Hiripi, E., et al. (2003). Assessing the effects of foster care: Early results from the Casey National Alumni Study. The Foster Care Alumni Studies. Casey Family Programs.

    Google Scholar 

  • Peterson, I., Lund, C., Bhana, A., & Flisher, A. J. (2012). A task shifting approach to primary mental health care for adults in South Africa: Human resource requirements and costs for rural settings. Health Policy and Planning, 27(1), 42–51.

    Article  Google Scholar 

  • Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., et al. (2007). No health without mental health. The Lancet, 370(9590), 859–877.

    Article  Google Scholar 

  • Prins, S. J. (2011). Does transinstitutionalization explain the overrepresentation of people with serious mental illnesses in the criminal justice system? Community Mental Health Journal, 47(6), 716–722.

    Article  PubMed  Google Scholar 

  • Rothbard, A. B., Metraux, S., & Blank, M. B. (2009). Cost of care for medicaid recipients with serious mental illness and HIV infection or AIDS. Psychiatric Services, 54(9), 1240–1246.

    Article  Google Scholar 

  • Sawyer, L., Azorin, J.-M., Chang, S., Rinciog, C., Guiraud-Diawara, A., Marre, C., et al. (2014). Cost-effectiveness of asenapine in the treatment of bipolar I disorder patients with mixed episodes. Journal of Medical Economics, 17(7), 508–519.

    Article  PubMed  Google Scholar 

  • Shirk, C. (2008). Medicaid and mental health services. National Health Policy Forum. George Washington University.

    Google Scholar 

  • Simon, G. E., Katon, W. J., Lin, E. H., Rutter, C., Manning, W. G., Von Korff, M., et al. (2007). Cost-effectiveness of systematic depression treatment among people with diabetes mellitus. JAMA Psychiatry, 64(1), 65–72.

    Google Scholar 

  • Simon, G. E., Katon, W. J., VonKorff, M., Unutzer, J., Lin, E. H., Walker, E. A., et al. (2001). Cost-effectiveness of a collaborative care program for primary care patients with persistent depression. American Journal of Psychiatry, 158(10), 1638–1644.

    Article  PubMed  Google Scholar 

  • Snedecor, S. J., Botteman, M. F., Schaefer, K., Sarocco, P., Barry, N., & Pickard, A. S. (2010). Economic outcomes of eszopiclone treatment in insomnia and comorbid major depressive disorder. The Journal of Mental Health Policy and Economics, 13(1), 27–35.

    PubMed  Google Scholar 

  • Soni, A. (2012). Trends in use and expenditures for depression among U.S. adults age 18 and older, civilian noninstitutionalized population, 1999 and 2009. Rockville, MD: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey.

    Google Scholar 

  • Stensland, M. D. (2010). Costs associated with attempted suicide among individuals with bipolar disorder. Journal of Mental Health Policy and Economics, 13(2), 87–92.

    PubMed  Google Scholar 

  • Substance Abuse and Mental Health Services Administration. (2012). Mental health, United States, 2010. Rockville, MD: Substance Abuse and Mental Health Services Administration, HHS.

    Google Scholar 

  • Substance Abuse and Mental Health Services Administration. (2013). A Standard Framework for Levels of Integrated Healthcare. SAMHSA-HRSA.

    Google Scholar 

  • Substance Abuse and Mental Health Services Administration. (2013). Behavioral Health Barometer: United States, 2013. Retrieved July 2014, from Substance Abuse and Mental Health Services Administration: http://store.samhsa.gov/shin/content/SMA13-4796/SMA13-4796National.pdf

  • Substance Abuse and Mental Health Services Administration. (2013c). Behavioral health, United States, 2012. Rockville, MD: Substance Abuse and Mental Health Services Administration, HHS.

    Google Scholar 

  • Swanson, J. W., Frisman, L. K., Robertson, A. G., Lin, H.-J., Trestman, R. L., Shelton, D. A., et al. (2013). Costs of criminal justice involvement among persons with serious mental illness in Connecticut. Psychiatric Services, 64(7), 630–637.

    Article  PubMed  Google Scholar 

  • Travis, J. (2005). Families and children of offenders who return home. Federal Probation Journal, 69, 31.

    Google Scholar 

  • Trupin, E., Walker, S. C., Burden, H., & Roberts, M. H. (2013). Court diversion for juveniles with mental health disorders. Virtual Mentor, 15(10), 866–872.

    Article  PubMed  Google Scholar 

  • Unützer, J., Schoenbaum, M., Katon, W. J., Fan, M.-Y., Pincus, H. A., Hogan, D., et al. (2009). Healthcare costs associated with depression in medically ill Fee-for-service medicare participants. Journal of the American Geriatrics Society, 57(3), 506–510.

    Article  PubMed  Google Scholar 

  • Vick, B., Jones, K., & Mitra, S. (2012). Poverty and severe psychiatric disorder in the U.S.: Evidence from the medical expenditure panel survey. Journal of Mental Health Policy and Economics, 15(2), 83–96.

    PubMed  Google Scholar 

  • VonKorff, M., Katon, W. J., Lin, W. H., Ciechanowski, P., Peterson, D., Ludman, E. J., et al. (2011). Functional outcomes of multi-condition collaborative care and successful ageing: Results of randomised trial. British Medical Journal, 343, d6612.

    Article  Google Scholar 

  • Wang, P. S., Patrick, A., Avorn, J., Azocar, F., Ludman, E., McCulloch, J., et al. (2006). The costs and benefits of enhanced depression care to employers. Archives of General Psychiatry, 63(1345-1353).

    Google Scholar 

  • Warner, V., Weissman, M. M., Fendrich, M., Wickramaratne, P., & Moreau, P. (1992). The course of major depression in the offspring of depressed parents. Incidence, recurrence, and recovery. Archives of General Psychiatry, 49(10), 795–801.

    Article  PubMed  Google Scholar 

  • Weissman, M. M., Bland, R. C., Canino, G. J., Faravelli, C., Greenwald, S., Hwu, H.-G., et al. (1996). Cross-national epidemiology of major depression and bipolar disorder. JAMA, 276(4), 293–299.

    Article  PubMed  Google Scholar 

  • White, C. R., O’Brien, K., Pecora, P. J., English, D., Williams, J. R., & Phillips, C. M. (2009). Depression among alumni of foster care: Decreasing rates through improvement of experiences in care. Journal of Emotional and Behavioral Disorders, 17(1), 38–48.

    Article  Google Scholar 

  • Wiley-Exley, E., Domino, M. E., Maxwell, J., & Levkoff, S. E. (2009). Cost-effectiveness of integrated care for elderly depressed patients in the PRISM-E study. Journal of Mental Health Policy and Economics, 12(4), 205–213.

    PubMed  Google Scholar 

  • World Health Organization. (2001). Mental health: A call for action by world health ministers (Ministerial Round Tables 2001, 54th World Health Assembly). Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2008). Integrating mental health care into primary care. Geneva: World Health Organization.

    Google Scholar 

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Authors and Affiliations

  1. School of Community Health Sciences (0274), University of Nevada, Reno, Reno, NV, 89557-0274, USA

    Erin Grinshteyn

  2. Department of Economics, College of Business, University of Nevada, Reno, Reno, NV, 89557-0016, USA

    Jeanne Wendel

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  1. University of Nevada, Reno, Nevada, USA

    William O'Donohue

  2. Department of Psychology and Counseling, University of Central Arkansas, Conway, Arkansas, USA

    Alexandros Maragakis

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Grinshteyn, E., Wendel, J. (2016). Behavioral Health Conditions: Direct Treatment Costs and Indirect Social Costs. In: O'Donohue, W., Maragakis, A. (eds) Quality Improvement in Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-319-26209-3_2

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