Falling through the cracks: care of the chronically mentally ill in the United States, Germany, and the United Kingdom.
In comparing the development and strength of community-based services for the chronically mentally ill in the United States, Germany, and the United Kingdom, I analyze how the structure of each country's general medical system has influenced services for the chronically mentally ill and the extent to which more universal medical care systems are associated with stronger community-based systems for the mentally ill. Community-based services are frail and inadequate in all three countries, in each country for different reasons. The specifics of organization of the health care system seem less important in shaping these outcomes than the status of mental health care as a national priority.
Hollingsworth
E J
EJ
University of Wisconsin, Madison.
D002908:Chronic Disease; D003156:Community Mental Health Services / Q000191:economics / Q000458:organization & administration / Q000600:supply & distribution; D003363:Cost Control; D003695:Delivery of Health Care; D005381:Financing, Organized; D005858:Germany; D005102:Health Expenditures; D006291:Health Policy; D006295:Health Resources; D006280:Health Workforce; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006798:Housing; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008329:Managed Care Programs; D001523:Mental Disorders / Q000188:drug therapy / Q000628:therapy; D011632:Public Assistance / Q000191:economics; D012946:Social Welfare / Q000191:economics; D013222:State Medicine / Q000191:economics; D006113:United Kingdom; D014481:United States; D014837:Voluntary Health Agencies