Relationship between national mental health expenditure and quality of care in longer-term psychiatric and social care facilities in Europe: Cross-sectional study

Abstract

Background It is not known whether increased mental health expenditure is associated with better outcomes. Aims To estimate the association between national mental health expenditure and (a) quality of longer-term mental healthcare, (b) service users' ratings of that care in eight European countries. Method National mental health expenditure (per cent of health budget spent on mental health) was calculated from international sources. Multilevel models were developed to assess associations with quality of care and service user experiences of care using ratings of 171 facility managers and 1429 service users. Results Significant positive associations were found between mental health spend and (a) six of seven quality of care domains; and (b) service user autonomy and experiences of care. Conclusions Greater national mental health expenditure was associated with higher quality of care and better service user experience.