Tackling Neglect and Mental Health Reform in a Devolved System of Welfare Governance

Bibliographic Data

ID2115235
AuthorsJoan Costa-Font (0000-0001-7174-7919, London School of Economics and Political Science), Luis Salvador-Carulla, Luis Salvador‐Carulla (0000-0002-5742-9866, Universidad de Cádiz), Juan M Cabases, Juan Manuel Cabasés Hita (0000-0003-0207-4137, Universidad de Navarra), Jordi Alonso (0000-0001-8627-9636, Municipal Institute for Medical Research), David Mcdaid (0000-0003-0744-2664, European Observatory on Health Systems and Policies)
Year2011
Volume40
Issue2
Pages295-312
Publication date2011-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Social Policy (JOURNAL)
Journal identifiersISSN: 0047-2794 • E-ISSN: 1469-7823
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0047279410000553
OpenAlexW2155562889
LanguageEN
Citations received5
References cited34

A system of devolved welfare governance, it is argued, increases participation in welfare services. However, limited empirical evidence has been reported on how it influences welfare reform. This paper draws upon evidence from the mental health system in Spain, where health care is devolved to the regional states (autonomous communities), to examine whether policy reform of neglected policy areas may be triggered through heightened policy awareness and better participation of interested stakeholders. We find that regional devolution has helped to scale up mental health in some of Spain's autonomous regions relative to support for other services. Evidence suggests that whilst fragmentation and certain historical legacies remain path dependent, regional devolution has indeed enhanced experimentation, reform and policy innovation in mental health care. However, the expansion of mental health care coverage has been constrained by the lack of a clear definition of public coverage, as well as the need to meet the demands of evidence-based policy in an era of cost-containment. Inequalities in access to mental health care remain; they are compounded by the stigma and discrimination experienced by people with mental health problems, which is a common challenge for all health systems in Europe

Business · Corporate governance · Devolution (biology) · Economic growth · Economics · Health care · Mental health · Neglect · Political science · Psychiatry · Public economics · Sociology · Welfare · Welfare reform · Employment and Welfare Studies · Global Health Care Issues · Medicine · Nursing · Public Administration · Social Policy and Reform Studies · Health Policy