Cost-benefit studies in psychiatry
Review articleOpen access

AbstractIT has been axiomatic for scientific psychiatry to beat its breast periodically about the relative lack of adequate research to answer the rather fundamental question: Does psychotherapy help? That deficit, although still painfully the case, has been narrowed by studies in increasing number and sophistication.1–4 The answer to the question above is still largely undetermined but there are gross impressions emerging which should lead us to at least tentative optimism.5But as the work goes on in evaluation of psychotherapy, a new plaintive cry is being increasingly heard. We are now being urged to address ourselves to cost-effectiveness or cost-benefit studies. How much does it cost to get what?As is often the case when a concept gains popularity, it can quickly become reified and people behave as though the concept is magic. This has already begun with the concept “cost-benefit”. Having experienced the shattering effects of shifting fiscal priorities, the mental health establishment has hoisted a new banner. It is with an eye to this new magnificat that this paper is addressed.We shall first consider the concept of outcome research as applied to psychotherapy and to mental health delivery systems. Throughout these discussions we shall attempt to remain focused on those factors that are necessary for such studies and the inherent problems associated with this interest.

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