Cost-effective use of Rational Emotive Behavior Therapy in a public mental health service

With the advanced deinstitutionalization of the treatment of the mentally ill, the public mental health services in many parts of Australia are facing serious difficulties in providing adequate community-based treatment to the large numbers of individuals in need. Overreliance on medication and a diminishing supply of suitably trained therapists may result in an increasing proportion of patients being denied the benefit of optimal treatment and care which should include evidence-based psychological and behavioral approaches. In this communication we describe a day program, designed and implemented in Perth, Western Australia, which combines individual and group therapy provision, and is closely integrated with both primary care and the specialist mental health services. The program provides an alternative to in-patient admission and is cost-effective by reducing the demand for acute hospital beds. It is acceptable to patients and produces measurable improvements in symptoms, functioning and subjective well-being. Address correspondence to Anthony Mander, ENHANCE, Inner City Mental Health Service, Royal Perth Hospital, Box X2213, Perth 6000, Western Australia.