International Journal of Mental Health Systems - Latest Comments

Author Response to comment on the Methodology Used in Sri Lankan Data Collection

Shoba Raja — 2011-12-19T15:53:23Z

The article is not a comprehensive summary of all the country finance studies. We selected only certain pieces of data to report on. The reason for this is the space constraints of producing a synthesis and also the need for a single set of variables to compare across all the countries. The quantitative data used from the Sri Lanka study related to the overall mental health budget, which was taken from key informant estimates.

A clarification of the methodology used in Sri Lankan data collection for the above study

Ruchira Kitsiri — 2011-05-26T23:58:08Z

I would like to comment on methods used to gather Sri Lanka mental healthcare financing information. As reported in the Sri Lanka section (page 6of 14- PDF version)of this paper under the subheading 'Public Funding of Mental Health'.

The authors state...

"All quantitative data for Sri Lanka is taken from estimates relayed by government key informants.

The researcher was not able to review actual government budgets to confirm these numbers.

According to key informants in the health ministry, the total national ring-fenced budget for mental health in Sri Lanka in 2008/09 was $8,473,392. "

Clarification...

These statements are simply not true and I feel do not report the research methodology correctly compromising the quality and the validity of the paper and the information presented in it.

Only the data provided in the 'Table 1: Mental Health Funding for Preventing and Promotion in Sri Lanka 2008/2009' were obtained from Key informant interviews.

Other data including 'government health budgets' and 'ring fenced budget for public mental hospitals' of Sri Lanka that is compared with the other three countries and Kerala state of India given in the 'Table 3: Mental Health Financing Data Cross Area Results (USD)' were collected through secondary document reviewe of budget estimates published by the Ministry of Healthcare and Nutrition of Sri Lanka.

The full Sri Lanka report is available at http://www.basicneeds.org/download/PUB%20-%20Financing%20Mental%20Health%20Care%20in%20Sri%20Lanka%20-%20BasicNeeds%20Sri%20Lanka%202009.pdf

Annex 5 of this report lists the budgetary and other documents that were reviewed in order to obtain the information.

Volume of visits v number of separate individual patients s

Eileen McGinn — 2009-02-10T04:10:59Z

This is an interesting study of the rate of and possible reasons for the increase in the volume of visits to EDs for psychiatric patients at four sites with differing types of population changes over a long 11 to 12 year period. Tracking the volume of visits as was done in this study is instructive. However, as the authors note toward the end of the article, more visits many not correlate with a larger population or even with a larger number of individual patients if a relatively few patients make many or more visits than most other patients. So a higher volume of visits is not directly tied to size or increase in population. More visits to the ED may reflect types of illnesses, effectiveness of treatment and many other socioeconomic characteristics. It is even possible that the prevalence of MI decreased while the number of visits grew, if the treatment is not very good or there is not adequate support in the community. Or the number of patients may have increased due to an increased population but they were adequately cared for and did not attend the ED. The increase may be due to a certain class of drugs or combinations of drugs or an increase in certain other characteristics (elderly men, living alone, unemployed, etc.). The authors do point this out in the article but it may not be very clear to everyone.