Abstract
Societies face the challenge of providing appropriate arrangements for individuals who need living support due to their mental disorders. We estimate the effects of eligibility to the Dutch supported housing program (Beschermd Wonen), which offers a structured living environment in the community as an intermediate alternative to independent housing and inpatient care. For this, we use exogenous variation in eligibility based on conditionally random assignment of applications to assessors, and the universe of applications to supported housing in the Netherlands, linked to rich administrative data. Supported housing eligibility increases the probability of moving into supported housing and decreases the use of home care, resulting in higher total care expenditures. This increase is primarily due to the costs of supported housing, but potentially also higher consumption of curative mental health care. Supported housing eligibility reduces the total personal income and income from work. Findings do also suggest lower participation in the labor market by the individuals granted eligibility, but the labor participation of their parents increases in the long-run. Our study highlights the trade-offs of access to supported housing for those at the margin of eligibility, informing the design of long-term mental health care systems around the world.
| Original language | English |
|---|---|
| Pages (from-to) | 115-133 |
| Number of pages | 19 |
| Journal | Health Economics (United Kingdom) |
| Volume | 31 |
| Issue number | S2 |
| Early online date | 19 Aug 2022 |
| DOIs | |
| Publication status | Published - Oct 2022 |
Bibliographical note
Funding Information:Francisca Vargas Lopes, Sam Harper and Tom Van Ourti were funded by the Erasmus University Rotterdam Initiative Smarter Choices for Better Health, and Bastian Ravesteijn by the Nederlandse Organisatie voor Wetenschappelijk Onderzoek (Dutch Research Council) grant VI.Veni.191E. The authors would like to thank Statistics Netherlands and CIZ for granting access to data, provided through a remote access facility. As stipulated in the data agreement, Statistics Netherlands pre-viewed the findings of this project prior to publication to ensure that privacy sensitive, individual-specific information is not revealed. The authors would also like to thank Scott Cunningham, Bart-Willem Lenders, Johan Mackenbach, Carlos Riumallo Herl, Jaap van Weeghel, Eduard Suari, Martijn Oude Wolcherink, Diana Roeg, Alice Hammink and the seminar participants at Lola Health Economics Study Group 2021, 2021 Essen Economics of Mental Health workshop and European Health Economics Association PhD Conference 2021 Rotterdam for the useful comments and suggestions.
Funding Information:
Francisca Vargas Lopes, Sam Harper and Tom Van Ourti were funded by the Erasmus University Rotterdam Initiative Smarter Choices for Better Health, and Bastian Ravesteijn by the Nederlandse Organisatie voor Wetenschappelijk Onderzoek (Dutch Research Council) grant VI.Veni.191E. The authors would like to thank Statistics Netherlands and CIZ for granting access to data, provided through a remote access facility. As stipulated in the data agreement, Statistics Netherlands pre‐viewed the findings of this project prior to publication to ensure that privacy sensitive, individual‐specific information is not revealed. The authors would also like to thank Scott Cunningham, Bart‐Willem Lenders, Johan Mackenbach, Carlos Riumallo Herl, Jaap van Weeghel, Eduard Suari, Martijn Oude Wolcherink, Diana Roeg, Alice Hammink and the seminar participants at Lola Health Economics Study Group 2021, 2021 Essen Economics of Mental Health workshop and European Health Economics Association PhD Conference 2021 Rotterdam for the useful comments and suggestions.
Publisher Copyright:
© 2022 The Authors. Health Economics published by John Wiley & Sons Ltd.
