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Appl Health Econ Health Policy. 2019 Jun 7. doi: 10.1007/s40258-019-00479-2. [Epub ahead of print]

Mental health: A Particular Challenge Confronting Policy Makers and Economists.

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Emeritus University of Zurich, Zurich, Switzerland.
, Wulfensiedlung 24, 9530, Bad Bleiberg, Austria.


The first objective of this paper is to expound the particular challenge posed by the occurrence of inconsistency in the expression of preferences by mental health patients to both economists and policy makers. Since this difficulty cannot be resolved, the second aim of the paper is to identify agents who may be counted upon to identify the true patient preferences. A decision rule is developed to help identify these agents who may be family members or judges in court, who have the ability and incentive to make these decisions. No single agent is found to dominate with respect to the five dimensions of preference distinguished, constituting a major challenge to policy makers.


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