Economics of mental health. New challenges and new perspectives EDITORIALI Economia della salute mentale. Nuove sfide e nuove prospettive

Mental health economics research has reached a state of consolidation in the international literature. Among the studies that have now been conducted, some key topics can be identified: funding systems and possible predictors of the costs of psychiatric care; the relationship that exists between the effectiveness of a treatment and its costs (cost-effectiveness and cost-utility), both in developed and developing countries of the world; and the economic consequences of psychiatric pathologies. The first type of studies, some of which have been con- ducted in Italy (Grigoletti et al., 2006; Chiappelli et al., 2007), has enabled us to better identify efficient ways of allocating the resources and to determine which variables can most appropriately be used as predictors of service cost (Jones et al., 2007). Turning to the second topic or theme, more and more evaluations of the effectiveness of new pharmacological, psychosocial or rehabilitative interventions incorporate an analysis of the relationship that exists between effective- ness and costs. The task at hand is now not only to show treatment effects in terms of positively modifying the symptoms, quality of life and social outcome of patients, but also to establish whether allocating scare resources to that treatment is actually economically worthwhile. In fact, once shown that a new treatment is more effective but also more expensive than the comparator intervention, the choice among the two options is not always simple. It must hold into consideration how much administrators and policy-makers are prepared to pay for getting an improvement in health status (Barret & Byford, 2003). Economic evaluation of mental health care is not only the preserve of rich countries; there is increasing interest in applying the principles and methods of economic evalua- tion in developing countries too, and with good reason: first and foremost, they have a fundamentally greater short-