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Mental health: A Particular Challenge Confronting Policy Makers and Economists

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Abstract

The first objective of this paper is to expound the particular challenge posed by the occurrence of inconsistency in the expression of preferences by mental health patients to both economists and policy makers. Since this difficulty cannot be resolved, the second aim of the paper is to identify agents who may be counted upon to identify the true patient preferences. A decision rule is developed to help identify these agents who may be family members or judges in court, who have the ability and incentive to make these decisions. No single agent is found to dominate with respect to the five dimensions of preference distinguished, constituting a major challenge to policy makers.

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Notes

  1. This generalization is risky because pertinent research seems to have focused on children and adolescents.

  2. One could define a utility function over these discrepancies to reflect e.g. a difference between a family member and a psychiatrist acting on behalf of the patient, possibly leading to qualifications in the discussion of Table 1 below. However, little is known about agent-specific utility functions.

  3. This condition is satisfied for any effort level between zero and infinity. However, imposing an upper bound such as \( e^{A} + e^{B} \le \bar{e} \) would call for Kuhn–Tucker conditions, considerably complicating the analysis as well as the comparison with Eq. (6) below pertaining to an imperfect agent. Finally, note that the crucial ratio condition of Eq. (3) holds at any effort level.

  4. As pointed out by one of the reviewers, the same issues arise when parents impose a decision on their children; they may not be their best agents in all circumstances.

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Acknowledgements

The author is grateful for comments by Richard Frank (Harvard), Bruno Lenzhofer (Villach, Austria) as well as participants in the CINCH workshop at the University of Essen (Germany) on 25/26 June 2018 and the Traveler Seminar at St. John´s University (New York) on 29 Jan. 2019. Moreover, suggestions and criticisms from three anonymous reviewers are greatly appreciated. The usual disclaimer applies.

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  1. Emeritus University of Zurich, Zurich, Switzerland

    Peter Zweifel

  2. Wulfensiedlung 24, 9530, Bad Bleiberg, Austria

    Peter Zweifel

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  1. Peter Zweifel
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Correspondence to Peter Zweifel.

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No funding of this study has been received, and there is no conflict of interest.

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Zweifel, P. Mental health: A Particular Challenge Confronting Policy Makers and Economists. Appl Health Econ Health Policy 18, 147–153 (2020). https://doi.org/10.1007/s40258-019-00479-2

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