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The Impact of Integrating Mental and General Health Services on Mental Health's Share of Total Health Care Spending in Alberta

Dr. Block, Mr. Slomp, and Ms.Patterson are with the Alberta Mental Health Board, Edmonton. Dr. Jacobs, Ms. Yim, and Dr. Ohinmaa are with the Institute of Health Economics, Edmonton. Dr. Jacobs is also with the Faculty of Medicine and Denistry, and Dr. Ohinmaa is also with the School of Public Health, University of Alberta, Edmonton. Dr. Dewa is with the Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto. Send correspondence to Dr. Ohinmaa at the School of Public Health, University of Alberta, 13-103 Clinical Sciences Bldg., Edmonton, Alberta, Canada T6G 2G3 (e-mail: arto.ohinmaa{at}ualberta.ca).

OBJECTIVE: In April 2003 the Alberta government integrated specialized mental health services, formerly organized independently, with the health regions, which are responsible for general health services. The objective of this article is to determine whether the transfer was associated with an increase or decrease in the share of resources in the region allocated to mental health care relative to total spending for health care. METHODS: The measure of the share for mental health care is the total costs for mental health care resources as a percentage of total health care spending. Resources and spending examined were those that were actually or potentially under the regions' control. Annual costs for mental health services in the province were obtained for a seven-year period (fiscal year [FY] 2000 through FY 2006) from provincial utilization records for all residents in the province. Unit costs were assigned to each visit. The trend in the share measure was plotted for each year. RESULTS: The share for mental health care increased overall from FY 2000 (7.6%) to FY 2003 (8.2%), but returned to pre-FY 2003 levels in the three years after the transfer (7.6%). CONCLUSIONS: Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.

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