Financing Mental Health Facilities During the Economic Recession: Evidence from the Private Finance Initiative Policy in the United Kingdom.

The economic crisis in Europe raised several complications in addressing infrastructure needs in public-based healthcare systems. In Western Europe, governments’ budget constraints, together with collateral healthcare-related issues such as ageing population, reduced the capability to develop modern and efficient infrastructure as well as technological upgrade of existing ones. Mental health facilities represent a peculiar aspect in this context, as pathologies require a unique treatment when compared to other medical services. Long-term hospitalization, day-by-day assistance, soft-approach therapies are specific features triggering the necessity of separate facilities for mental health treatment, or at least a distinct management within a general hospital. From an economic point of view, public-private partnerships (PPPs) could help decision-makers in tackling healthcare investment shortage, making the related infrastructure market appealing for private financing and management. As outlined in this commentary, the experience from the Private Finance Initiative (PFI) in the United Kingdom represents a step-stone for privately-financed mental health facilities, with over 8,000 beds generated in the last 15 years, both in separate structures and in general hospitals. An analysis of this model demonstrate some benefits in terms of availability and efficiency have been reached, but concerns remain terms of value for money and side-services delivery.