A standard solution te
doctor receives low satisfaction score and is not professionally rewarded, even if this response is professionally most ethical)
A standard solution technique utilized in game theory is Nash equilibrium, where the
A standard solution technique utilized in game theory is Nash equilibrium, where the players converge to a common strategy, where no agent can achieve a more favorable outcome by switching actions. Observing where a Nash equilibrium exists in a difficult situation can help inform decisions. This can lead to cooperation and trust, which is vital in a healthcare environment.
We apply the Nash Equilib
We apply the Nash Equilibrium technique to our opioid prescription decision above: If the patient has real pain, the rational choice for the doctor is to treat the patient. If the patient has fake pain, it is still in the doctor's best interest to treat the patient so that the doctor elicits a good satisfaction rating. Otherwise, a patient's low satisfaction score could result in reputation loss and reduced income. Thus, a doctor will prescribe opioids regardless of whether the patient needs them, and the patient addicted to opioids will demand these opioids for short-term satisfaction notwithstanding that their long-term use may eventually harm the patient's health and society at large. Such an outcome will lead to wasted resources and poor outcomes. The mutual best response, i.e., Nash Equilibrium outcome for this game is for the patient to present with real pain, and for the Doctor to prescribe narcotics, with payoffs in the form (Patient, Doctor) -> (Satisfied, High Satisfaction score & Professionally Rewarded).
The situation where the patient has ‘Fake Pain’ and the doctor ‘Prescribes narcotics’ appears the same as the described Nash Equilibrium. however, there are deeper differences that cause this situation to not be a Nash Equilibrium. Doctors are bound to a code of medical ethics and regulatory restrictions, so prescribing addictive drugs to someone not in need can lead to deeper and long term consequences, such as fueling the opioid epidemic. In such a situation, the patient will end up unsatisfied as their health condition worsens because of opioid addiction and the doctor's reputation could become jeopardized.
Mental health economics incorporates a vast array of subject matters, ranging from pharmacoeconomics to labor economics and welfare economics. Mental health can be directly related to economics by the potential of affected individuals to contribute as human capital. In 2009 Currie and Stabile published "Mental Health in Childhood and Human Capital" in which they assessed how common childhood mental health problems may alter the human capital accumulation of affected children. Externalities may include the influence that affected individuals have on surrounding human capital, such as at the workplace or in the home. In turn, the economy also affects the individual, particularly in light of globalization. For example, studies in India, where there is an increasingly high occurrence of western outsourcing, have demonstrated a growing hybrid identity in young professionals who face very different sociocultural expectations at the workplace and in at home.
Mental health economics presents a unique set of challenges to researchers. Individuals with cognitive disabilities may not be able to communicate preferences. These factors represent challenges in terms of placing value on the mental health status of an individual, especially in relation to the individual's potential as human capital. Further, em
Mental health economics presents a unique set of challenges to researchers. Individuals with cognitive disabilities may not be able to communicate preferences. These factors represent challenges in terms of placing value on the mental health status of an individual, especially in relation to the individual's potential as human capital. Further, employment statistics are often used in mental health economic studies as a means of evaluating individual productivity; however, these statistics do not capture "presenteeism", when an individual is at work with a lowered productivity level, quantify the loss of non-paid working time, or capture externalities such as having an affected family member. Also, considering the variation in global wage rates or in societal values, statistics used may be contextually, geographically confined, and study results may not be internationally applicable.
Though studies have demonstrated mental healthcare to reduce overall healthcare costs, demonstrate efficacy, and reduce employee absenteeism while improving employee functioning, the availability of comprehensive mental health services is in decline. Petrasek and Rapin (2002) cite the three main reasons for this decline as (1) stigma and privacy concerns, (2) the difficulty of quantifying medical savings and (3) physician incentive to medicate without specialist referral. Evers et al. (2009) have suggested that improvements could be made by promoting more active dissemination of mental health economic analysis, building partnerships through policy-makers and researchers, and employing greater use of knowledge brokers.