Affective disorders impose a substantial individual and societal burden. Despite availability of efficacious treatments and practice guidelines, unmet need remains high. To reduce unmet need and the burden of affective disorders, information is needed on the distribution of burden across stakeholders, on barriers to reducing burden, and on interventions that effectively reduce burden at the levels of practice, community, and policy. This article provides the report of the Working Group on Overcoming Barriers to Reducing the Burden of Affective Disorders, for the National Institute of Mental Health Strategic Plan on Mood Disorders. We review the literature, identify key gaps, and recommend new research to guide national efforts to reduce the burden of affective disorders.

This study examined whether decentralization of California's public mental health system under program realignment has changed the composition of the client population, with greater attention toward inclusion of persons with a severe mental illness. Clients' demographic and clinical status were compared before and after realignment. The study sample consisted of 75,951 clients, representing 1.5 million adults who accessed the public mental health services in California during a 6-year study period. The post-realignment client population had lower functional status, more unemployment, and lower levels of education-all indicating greater functional impairment. They were more likely to suffer from an affective disorder, but they were less likely to have either a non-psychotic disorder or schizophrenia. The study found no evidence suggesting that realignment jeopardized access to the public mental health system in California, and it indicated at least the possibility that it promoted greater access by clients with greater functional impairment.

Behavioral decision theory draws on experimental research in cognitive psychology to provide a descriptively accurate model of human behavior. It shows that people systematically violate the normative assumptions of economic rationality by miscalculating probabilities and making choices based on one-economic criteria. Behavioral decision theory's ability to capture the complexity of human judgments and choices makes it a useful foundation for improving public policy analysis, design, and implementation. Originally published in 2001, this volume showcases the research of leading scholars who are working on applications of behavioral decision theory in diverse policy settings. It is designed to give policy analysts and practitioners who are non-psychologists a clearer understanding of the complexities of human judgment and choice, and suggest how to integrate behavioral decision theoretic insights into the policy sciences. This interdisciplinary volume should be insightful and useful wherever people's judgments and choices matter for policy formulation, acceptance, and effectiveness.

This book shows, from start to finish, how microeconomics can and should be used in the analysis of public policy problems. It is an exciting new way to learn microeconomics, motivated by its application to important, real-world issues. Lee Friedman's modern replacement for his influential 1984 work not only brings the issues addressed into the present but develops all intermediate microeconomic theory to make this book accessible to a much wider audience.

Friedman offers the microeconomic tools necessary to understand policy analysis of a wide range of matters of public concern--including the recent California electricity crisis, welfare reform, public school finance, global warming, health insurance, day care, tax policies, college loans, and mass transit pricing. These issues are scrutinized through microeconomic models that identify policy strengths, weaknesses, and ideas for improvements. Each chapter begins with explanations of several fundamental microeconomic principles and then develops models that use and probe them in analyzing specific public policies.

The book has two primary and complementary goals. One is to develop skills of economic policy analysis: to design, predict the effects of, and evaluate public policies. The other is to develop a deep understanding of microeconomics as an analytic tool for application--its strengths and extensions into such advanced techniques as general equilibrium models and pricing methods for natural monopolies and its weaknesses, such as behavioral inconsistencies with utility-maximization models and its limits in comparing institutional alternatives. The result is an invaluable professional and academic reference, one whose clear explanation of principles and analytic techniques, and wealth of constructive applications, will ensure it a prominent place not only on the bookshelves but also on the desks of students and professionals alike.

Decentralization of California's public mental health system under program realignment has changed the utilization and cost of community-based mental health services. This study examined a sample of 75,951 users, representing 1.5 million adults who visited California's public mental health services during a 6-year period (FY 1988-1990 and FY 1992-1994). Regression analysis was performed to examine cost and utilization reduction over time, across regions, and across psychiatric diagnoses. Overall utilization and cost of community-based mental health services dropped significantly after the implementation of realignment. They were significantly lower for (a) 24-hour services in the urban industrialized Southern Region and (b) outpatient services in the agricultural Central Region of the state. Users diagnosed with mood disorders took a greater portion, but were associated with significantly less treatment and cost than other users in the post-realignment period. When local communities bear the financial risks and rewards, they find more efficient methods of delivering community-based mental health services.

The 1960 California Master Plan for Higher Education made a number of recommendations in the area of admissions. Key was a proposed target of at least 60% of all undergraduate students being at the upper division level at the University of California and what became the California State University system. At the time, approximately 51 percent of the instruction at both UC and the State Colleges (CSU) were at the upper division. It was assumed that there was a high correlation between upper division instruction and the status of undergraduates as Juniors and Seniors. The plan, subsequent actions by the Board of Regents. and amendments to the California Education Code, reinforce the general concept that the 40/60 ratio is a minimum target, with the 40 percent a ceiling, and the 60 percent upper division a floor. This paper was developed at the request of the UC Office of the President and outlines the development of this policy and its key role in setting current UC and CSU admissions pools.