title: Allocation of resources and psychosis.
abstract: OBJECTIVE
  This commentary reviews current expenditure on psychosis in Australia, identifies discretionary expenditure that could be used more efficiently, discusses the factors influencing resource allocation and intervention selection decisions, and suggests priorities for change.
  
  
  METHODS
  Cost-of-illness findings from the Low Prevalence Disorders Study (LPDS), and related service use and psychosocial data, are used to highlight patterns of expenditure on psychosis and potential resource allocation issues. Arguments are also presented suggesting that mental health resource allocation in Australia should be informed primarily by treatment efficiency, equity and humanitarian considerations, not differences in the global burden of disease. However, our evidence-base about the effectiveness and costs associated with individual treatments, programmes, and organizational structures is also shown to be limited.
  
  
  CONCLUSIONS
  The patterns of service use and expenditure on psychosis suggest certain imbalances, including an over-reliance on hospitalization, low levels of supported community accommodation, and inadequate provision of evidence-based psychosocial treatments, rehabilitation and supported employment programmes. We need to identify and develop efficient interventions and programmes, re-orientate our services to better utilize those interventions, increase community awareness, improve monitoring of outcomes and costs, and undertake timely evaluations at multiple levels, from the individual to the societal perspective.
authors.affiliation: Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Neil
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Lewin
authors.forename: Vaughan J
authors.initials: VJ
authors.lastname: Carr
mesh_terms: D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D015276:Health Care Rationing / Q000191:economics*; D005102:Health Expenditures; D006801:Humans; D008605:Mental Health Services / Q000191:economics*; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D015397:Program Evaluation; D011618:Psychotic Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D040841:Resource Allocation / Q000191:economics*