Public and private psychiatry: Can they work together and is it worth the effort?

Objective: Partnerships in mental health care, particularly between public and private psychiatric services, are being increasingly recognized as important for optimizing patient management and the efficient organization of services. However, public sector mental health services and private psychiatrists do not always work well together and there seem to be a number of barriers to effective collaboration. This study set out to investigate the extent of collaborative 'shared care' arrangements between a public mental health service and private psychiatrists practising nearby. It also examined possible barriers to collaboration and some possible solutions to the identified problems. Method: A questionnaire examining the above factors was sent to all public sector mental health clinicians and all private psychiatrists in the area. Results: One hundred and five of the 154 (68.2%) public sector clinicians and 103 of the 194 (53.1%) private psychiatrists returned surveys. The main barriers to successful collaboration identified by members of both sectors were: 'Difficulty communicating' endorsed by 71.4% of public clinicians and 72% of private psychiatrists, 'Confusion of roles and responsibilities' endorsed by 62.9% and 66%, respectively, and 'Different treatment approach' by 47.6% and 45.6%, respectively. Over 60% of private psychiatrists identified problems with access to the public system as a barrier to successful shared care arrangements. It also emerged, as hypothesized, that the public and private systems tend to manage different patient populations and that public clinicians in particular are not fully aware of the private psychiatrists' range of expertise. This would result in fewer referrals for shared care across the sectors. Conclusions: A number of barriers to public sector clinicians and private psychiatrists collaborating in shared care arrangements were identified. The two groups surveyed identified similar barriers. Some of these can potentially be addressed by changes to service systems. Others require cultural shifts in both sectors. Improved communications including more opportunities for formal and informal meetings between people working in the two sectors would be likely to improve the understanding of the complementary sector's perspective and practice. Further changes would be expected to require careful work between the sectors on training, employment and practice protocols and initiatives, to allow better use of the existing services and resources.

Individual and household willingness to pay for public goods

The issue of whether willingness to pay (WTP) for the benefits generated by a public good should be elicited on an individual or on a household basis is addressed. Differences between individual and household WTP may arise when members of the household are mutually altruistic. It is shown that, for general specifications of altruism, household WTP is less than the sum of household members' individual WTP. Implications for the choice between household and individual measures of WTP are considered, and issues in the elicitation of household WTP are addressed.

Policies for saving a rare Australian glider: economics and ecology

This paper considers the economics of conserving a species with mainly non-use value, the endangered mahogany glider. Three serial surveys of Brisbane residents provide data on the knowledge of respondents about the mahogany glider. The results supply information about the attitudes of respondents to the mahogany glider, to its conservation and relevant public policies, and about variations in these factors as the knowledge of participants of the mahogany glider alters. Similarly, data are provided and analysed about the willingness to pay of respondents to conserve the mahogany glider and how it changes. Population viability analysis is applied to estimate the required habitat area for a minimum viable population of the mahogany glider to ensure at least a 95% probability of its survival for 100 years. Places are identified in Queensland where the requisite minimum area of critical habitat can be conserved. Using the survey results as a basis, the likely willingness of groups of Australians to pay for the conservation of the mahogany glider is estimated and consequently their willingness to pay for the minimum required area of its habitat. Methods for estimating the cost of protecting this habitat are outlined. Australia-wide benefits are estimated to exceed the costs. Establishing a national park containing the minimum viable population of the mahogany glider is an appealing management option. This would also be beneficial in conserving other endangered wildlife species and ecosystems. Therefore, additional economic benefits to those estimated on account of the mahogany glider itself can be obtained. (C) 2004 Elsevier Ltd. All rights reserved.

Graphic satire and public life in the age of terror

This paper investigates media representations of international insecurity through a selection of newspaper cartoons from some of the major daily Australian broadsheets. Since 2001, cartoonists such as Bruce Petty, John Spooner and Bill Leak (in The Age and The Australian) have provided an ongoing and vehement critique of the Australian government’s policies of ‘border protection’, the ‘war on terror’ and the words of mass distraction associated with Australia joining the war in Iraq. Cartoonists are often said to represent the ‘citizen’s perspective’ of public life through their graphic satire on the editorial pages of our daily newspapers. Increasingly, they can also be seen to be fulfilling the role of public intellectuals, defined by Richard A. Posner as ‘someone whose place it is publicly to raise embarrassing questions, to confront orthodoxy and dogma, to be someone who cannot easily be co-opted by governments and corporations’. Cartoonists enjoy an independence and freedom from censorship that is rarely extended to their journalistic colleagues in the print media and it is this independence that is the vital component in their being categorised as public intellectuals. Their role is to ‘question over and over again what is postulated as self-evident, to disturb people’s mental habits, to dissipate what is familiar and accepted, to re-examine rules and institutions’ (Posner, 2003: 31). With this useful — if generalised — definition in mind, the paper considers how cartoonists have contributed to debates concerning international insecurity in public life since 2001.

Dynamic processes in contingent valuation: A case study involving the mahogany glider

This paper reports the results of an experiment involving a sample of 204 members of the public who were assessed on three occasions about their willingness to pay for the conservation of the mahogany glider. They were asked this question prior to information being provided to them about the glider and other focal wildlife species; after such information was provided, and finally after participants had had an opportunity to see live specimens of this glider. The mean willingness to pay of the relevant samples are compared and found to show significant variations. Theories are considered that help explain the dynamics of these variations. Serious concerns are raised about the capacity of information provision to reveal ‘true’ contingent valuations of public goods.

An initial assessment of policies for saving a rare Australian glider: Experimental results, economics and ecology

Reviews the ecological status of the mahogany glider and describes its distribution, habitat and abundance, life history and threats to it. Three serial surveys of Brisbane residents provide data on the knowledge of respondents about the mahogany glider. The results provide information about the attitudes of respondents to the mahogany glider, to its conservation and relevant public policies and about variations in these factors as the knowledge of participants of the mahogany glider alters. Similarly data is provided and analysed about the willingness to pay of respondents to conserve the mahogany glider. Population viability analysis is applied to estimate the required habitat area for a minimum viable population of the mahogany glider to ensure at least a 95% probability of its survival for 100 years. Places are identified in Queensland where the requisite minimum area of critical habitat can be conserved. Using the survey results as a basis, the likely willingness of groups of Australians to pay for the conservation of the mahogany glider is estimated and consequently their willingness to pay for the minimum required area of its habitat. Methods for estimating the cost of protecting this habitat are outlined. Australia-wide benefits seem to exceed the costs. Establishing a national park containing the minimum viable population of the mahogany glider is an appealing management option. This would also be beneficial in conserving other endangered wildlife species. Therefore, additional economic benefits to those estimated on account of the mahogany glider itself can be obtained.

Book review of: Choice, Behavioural Economics and Addiction Ruby Vuchinich & Nick Heather, eds

The body of work contained in Choice, Behavioural Economics and Addiction is the result of a conference held at the University of Alabama in Birmingham, 2002. The purpose of the conference was to bring together highly accredited international authors in the field of addiction research pertaining to behavioural choice theories. The conference provided a forum where these theories and their empirical implications could be discussed and debated. This book represents the conference proceedings and as such is a combination of journal articles that each relevant author has published plus additional comments from allocated reviewers.

The public's knowledge of and support for conservation of Australia's Tree-Kangaroos

After providing some brief background on Dendrolagus species in Australia, two consecutive surveys of Brisbane’s residents are used to assess public knowledge of tree-kangaroos and the stated degree of support for their conservation in Australia. The responses of participants in Survey I are based on their pre-survey knowledge of wildlife. The same additional set of participants completed Survey II after being provided with information on all the wildlife species mentioned in Survey I. Changes in the attitudes of respondents and their degree of support for the protection and conservation of Australia’s tree-kangaroos are measured, including changes in their contingent valuations and stated willingness to provide financial support for such conservation. Reasons for wanting to protect tree-kangaroos are specified and analyzed. Furthermore, changes that occur in the relative importance of these reasons with increased knowledge are also examined. Support for the conservation of tree-kangaroos is found to increase with the additional knowledge supplied. Furthermore, support for the conservation of Australia’s less well-known tropical mammals is shown to increase relative to better known mammals (icons) present in temperate areas, such as koalas and red kangaroos with this increased knowledge. Possible implications of the results for government conservation policies in Australia are examined.

Wildlife damage, insurance/compensation for farmers and conservation: Sri Lankan elephants as a case

The interference with agriculture has been recognised as the main cause for the current conflict between farmers and wild elephants in Sri Lanka, as elsewhere in the Asian elephant range. Thus compensating farmers for the damages caused by elephants is essential, if this endangered species is to survive in the long run. This paper explores the practicality of establishing an improved publicly funded insurance/compensation scheme to recompense farmers for the elephant damages. It does so by analysing results from two contingent valuation surveys undertaken in Sri Lanka. We find that possible public support of farmers plus urban dwellers significantly exceeds the financial requirement of the insurance scheme proposed in this study for perpetuity. The article also shows that it is often inappropriate from an economic viewpoint to analyse crop insurance as if it only involves the insurance of a private good because important positive externalities can arise from ‘crop’ damages by wildlife, e.g. elephants. The use of agricultural land by some species is essential for their long-term survival and this is often positively valued by the community as a whole.

Dynamic processes in the contingent valuation of an endangered mammal species

Reports experimental results involving 204 members of the public who were asked their willingness to pay for the conservation of the mahogany glider Petaurus gracilis on three occasions: prior to information being provided to them about the glider and other wildlife species; after such information was provided, and after participants had an opportunity to see live specimens of this endangered species. Variations in the mean willingness to pay are analysed. Concerns arise about whether information provision and experience reveal ‘true’ contingent valuations of public goods and about the choice of the relevant contingent valuation measure.

Optimal price regulation in a growth model with monopolistic suppliers of intermediate goods

In this paper we investigate the trade-off faced by regulators who must set a price for an intermediate good somewhere between the marginal cost and the monopoly price. We utilize a growth model with monopolistic suppliers of intermediate goods. Investment in innovation is required to produce a new intermediate good. Marginal cost pricing deters innovation, while monopoly pricing maximizes innovation and economic growth at the cost of some static inefficiency. We demonstrate the existence of a second-best price above the marginal cost but below the monopoly price, which maximizes consumer welfare. Simulation results suggest that substantial reductions in consumption, production, growth, and welfare occur where regulators focus on static efficiency issues by setting prices at or near marginal cost.

Noise trader risk and the welfare effects of privatization

Excessive volatility of asset prices like that generated in the 'noise trader' model of De Long et al. is one factor that plausibly might contribute to an explanation of the equity premium. We extend the De Long et al. model to allow for privatization of publicly-owned assets and assess the welfare effects of such privatization in the presence of excess volatility arising from noise traders' mistaken beliefs.

The public's knowledge of and support for conservation of Australia's tree-kangaroos and other animals

After providing background on Dendrolagus species in Australia, two consecutive surveys of Brisbane's residents are used to assess public knowledge of tree-kangaroos and the stated degree of support for their conservation in Australia. The responses of participants in Survey I are based on their pre-survey knowledge of wildlife. The same set of participants completed Survey II after being provided with additional information on all the wildlife species mentioned in Survey I. Changes in the attitudes of respondents and their degree of support for the protection and conservation of Australia's tree-kangaroos are measured, including changes in their contingent valuations and stated willingness to provide financial support for such conservation. Reasons for wanting to protect tree-kangaroos are specified and analysed. Furthermore, changes that occur in the relative importance of these reasons with increased knowledge are also examined. Support for the conservation of tree-kangaroos is found to rise with the additional knowledge supplied about all species and is compared with variations in support for protection of other mammals. Support for the conservation of Australia's less well known tropical mammals is found to increase relative to better known mammals (icons) present in temperate areas, such as koalas and red kangaroos. Possible implications of the results for government conservation policies in Australia are examined.