The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65975

Norah Mulvaney-Day, PhD, Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon Street, 4th floor, Somerville, MA 02143, (617) 503-8448, nmulvaney-day@charesearch.org

Evaluating the societal impact of serious mental illness (SMI) requires comprehensive estimates of direct and indirect costs not only for the individual with illness but also the family, providers and the community. The purpose of this study was to collect information on direct expenses and assess the willingness to pay (WTP) approach as a measure of indirect effects for a random sample of persons (n=628) who have family members with SMI.

A mail survey was developed and administered nationally to members of the National Alliance for the Mentally Ill (NAMI). Survey development procedures included a cognitive evaluation, a group pretest with members of the target group, and expert review. The questionnaire collected information on 30-day respondent expenses on behalf of the family member, as well as the respondent’s WTP for an effective medication for the family member.

Cost data revealed that 67.2% of the sample contributed some level of financial support in the last 30 days. Significant correlations between WTP and income, savings, education and 30-day expenses supported the internal consistency of the WTP value. Consistency checks with 30-day expenses found that some respondents were willing to pay less than they were already spending for their family member, indicating high levels of economic distress for some families.

This study is the first to use WTP as a means of understanding the impact of SMI on families. The WTP technique is an effective means of exploring the impact of reduced budgets across a wide range of stakeholders in mental health.

Learning Objectives:

• Step 1: Participants in this session will acquire information about measuring mental health outcomes within an economic framework. The survey development procedures used in this study will be reviewed. The author will discuss concrete steps to cope with challenges in measuring willingness to pay using a mail survey and in the mental health field. Finally, the economic impact of serious mental illness on the family will be quantified.
• Step 2: As a result of this session, participants will be able to evaluate the usefulness of the WTP technique to answer questions of policy relevance in the mental health field, particularly across stakeholder groups. Participants will be able to identify the difference between direct and indirect costs, and describe the economic impact of serious mental illness on the family.
• Step 3: At the conclusion of the session, the participant will be able to: outline the steps in a successful survey development process when using WTP in mental health; identify three areas in the current budgetary crisis that could be better understood using WTP techniques; identify three stakeholders in mental health that could benefit from using this measurement technique; and list ten categories of expenses that are important to measure when quantifying the economic impact of serious mental illness on the family.

Keywords: Cost Issues, Mental Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.