Mental Health Systems Compared: Great Britain, Norway, Canada, and the United States

The primary objective of this book is to provide comprehensive descriptions and make comparative evaluations of each of the mental health systems of four Western, industrialized countries. The countries selected illustrate a continuum from a highly centralized and publicly financed, national health service in Great Britain to a predominantly decentralized and more privately financed market of mental health services in the United States. In between these two contrasting types are examples of national health services and insurance programs in Norway and Canada. Contributing experts from each country begin their chapters with an overview of the geographic, demographic, political, economic, and cultural contexts in which their mental health systems are situated. Thereafter, they (a) present national data to estimate the need for mental health services, (b) describe national mental health policies and programs designed to meet their population’s need, (c) indicate how mental health services are organized and delivered, and (d) discuss how their system is financed and provided resources. A common chapter outline facilitates comparisons among all four systems on relevant evaluation criteria: (a) access and equity, (b) quality and efficacy, (c) cost and efficiency, (d) financing and fairness, (e) protection and participation, and (f) population relevance. In the final section of each chapter, the authors provide recommendations for improved performance of their mental health system. In the initial chapter, the editor provides an overview, introduces the four countries selected, and defines the evaluation criteria applied by all contributing authors. The final two chapters address convergence and divergence among the four systems and provide recommendations for improvement and for future comparative studies. The intended audience includes mental health policymakers, program administrators and managers; teachers of graduate level courses related to professional training and public health policy and financing; researchers, mental health professionals, and advocacy groups.