{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:50:24Z","timestamp":1754157024600,"version":"3.41.2"},"reference-count":24,"publisher":"Emerald","issue":"9\/10","license":[{"start":{"date-parts":[[2010,10,19]],"date-time":"2010-10-19T00:00:00Z","timestamp":1287446400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,10,19]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-heading\">Purpose<\/jats:title><jats:p>This paper aims to describe the application of system dynamics to enhance traditional cost benefit analysis (CBA) in planning a significant expansion of therapy capacity for mental health treatment in the UK. The aim of the initiative is to benefit the health of individuals, reduce costs to society and the exchequer and increase employment.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Design\/methodology\/approach<\/jats:title><jats:p>The paper describes a conventional CBA and comments on its merits and limitations. The development and use of a system dynamics model of the situation is then described, together with how this complements and supports the conventional analysis and its outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Findings<\/jats:title><jats:p>By focussing analysis on the dynamics of people flows over time, simulation is shown to assist understanding of the issue and its potential benefits. The numbers of patients expected to benefit is shown to depend on the treatment capacity, on the sources of people presenting, the number and type of treatment channels and their parameters, the success of treatment, the provision for patients moving between treatment channels, the dynamics of the labour market and employment opportunities.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p>The paper is totally original and has provided decision support to a large investment on which implementation has begun. The overall methodological conclusion is that dynamic factors are often left out of CBA because they cause too much complexity for decision makers, whereas system dynamics allows these factors to be included without masking the clarity of the case. The paper suggests that CBA and system dynamics are very complementary.<\/jats:p><\/jats:sec>","DOI":"10.1108\/03684921011081213","type":"journal-article","created":{"date-parts":[[2010,10,30]],"date-time":"2010-10-30T07:08:18Z","timestamp":1288422498000},"page":"1645-1658","source":"Crossref","is-referenced-by-count":5,"title":["Dynamic cost benefit analysis for mental health reform"],"prefix":"10.1108","volume":"39","author":[{"given":"Eric","family":"Wolstenholme","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Monk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Todd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"140","reference":[{"key":"key2022030920482227200_b1","doi-asserted-by":"crossref","unstructured":"Dangerfield, B.C. (1999), \u201cSystem dynamics applications to European health care issues\u201d, The Journal of the Operational Research Society, Vol. 50 No. 4, pp. 345\u201053 (System Dynamics for Policy, Strategy and Management Education).","DOI":"10.2307\/3010452"},{"key":"key2022030920482227200_b2","unstructured":"Hirsch, G., Homer, J., McDonnell, G. and Milstein, B. (2005), \u201cAchieving health care reform in the United States: towards a whole system understanding\u201d, paper presented at the International System Dynamics Conference, Boston, MA."},{"key":"key2022030920482227200_b4","doi-asserted-by":"crossref","unstructured":"Homer, J.B. and Hirsch, G.B. (2006a), \u201cSystem dynamics modelling for public health: background and opportunities\u201d, American Journal of Public Health, Vol. 96, pp. 452\u20108.","DOI":"10.2105\/AJPH.2005.062059"},{"key":"key2022030920482227200_b5","doi-asserted-by":"crossref","unstructured":"Homer, J.B. and Hirsch, G.B. (2006b), \u201cSystem dynamics modelling for public health: background and opportunities, opportunities and demands in public health systems\u201d, American Journal of Public Health, Vol. 96 No. 3.","DOI":"10.2105\/AJPH.2005.062059"},{"key":"key2022030920482227200_b3","doi-asserted-by":"crossref","unstructured":"Homer, J.B., Hirsch, G., Minniti, M. and Pierson, M. (2004), \u201cModels for collaboration: how system dynamics helped a community organize cost\u2010effective care for chronic illness\u201d, System Dynamics Review, Vol. 20, pp. 199\u2010222.","DOI":"10.1002\/sdr.295"},{"key":"key2022030920482227200_b6","unstructured":"Homer, J.B., Milstein, G.B., Dietz, W., Buchner, D. and Majestic, D. (2006), \u201cObesity population dynamics: exploring historical growth and plausible futures in the US\u201d, paper presented at the 24th International Conference of the System Dynamics Society, Nijmegen, July 26."},{"key":"key2022030920482227200_b7","unstructured":"Homer, J.B., Milstein, G.B., Wile, K., Pratibhu, P., Farris, R. and Orenstein, D. (2008), \u201cModelling the local dynamics of cardiovascular health: risk factors, context, and capacity\u201d, Preventing Chronic Disease, Vol. 5 No. 2."},{"key":"key2022030920482227200_b8","doi-asserted-by":"crossref","unstructured":"Jones, A.P., Homer, J.B., Murphy, D.L., Essien, J.D.K., Milstein, B. and Seville, D.A. (2006), \u201cUnderstanding diabetes population dynamics through simulation modelling and experimentation\u201d, American Journal of Public Health, Vol. 96 No. 3, pp. 488\u201094.","DOI":"10.2105\/AJPH.2005.063529"},{"key":"key2022030920482227200_b9","unstructured":"Lacey, P. (2005), \u201cFutures through the eyes of a health system simulator\u201d, paper presented to the International System Dynamics Conference, Boston, MA."},{"key":"key2022030920482227200_b10","doi-asserted-by":"crossref","unstructured":"Lane, D.C., Monefeldt, C. and Rosenhead, J.V. (2000), \u201cLooking in the wrong place for healthcare improvements: a system dynamics study of an accident and emergency department\u201d, Journal of the Operational Research Society, Vol. 51 No. 5, pp. 518\u201031.","DOI":"10.1057\/palgrave.jors.2600892"},{"key":"key2022030920482227200_b11","unstructured":"Milstein, B., Jones, A., Homer, J., Murphy, D., Essien, J. and Seville, D. (2007), \u201cCharting plausible futures for diabetes prevalence: a role for system dynamics simulation modelling\u201d, Preventing Chronic Disease, Vol. 4 No. 3, pp. 1\u20108."},{"key":"key2022030920482227200_b12","unstructured":"NICE (2004), \u201cDepression: management of depression in primary and secondary care \u2013 NICE guidance\u201d, National Clinical Practice Guideline Number 23, National Institute for Clinical Excellence, London, December."},{"key":"key2022030920482227200_b14","unstructured":"Observer Leader (2006), The Depression Report: A New Deal for Depression and Anxiety Disorders, The London School of Economics and Political Science, Centre for Economic Performance's Mental Health Study Group, London, June."},{"key":"key2022030920482227200_b15","doi-asserted-by":"crossref","unstructured":"Roysten, G., Dost, A., Townsend, J. and Turner, H. (1999), \u201cUsing system dynamics to help develop and implement policies and programmes in health care in England\u201d, System Dynamics Review, Vol. 15 No. 3, pp. 293\u2010313.","DOI":"10.1002\/(SICI)1099-1727(199923)15:3<293::AID-SDR169>3.0.CO;2-1"},{"key":"key2022030920482227200_b16","doi-asserted-by":"crossref","unstructured":"Taylor, K. and Dangerfield, B. (2005), \u201cModelling the feedback effects of reconfiguring health services\u201d, JORS, Vol. 56, pp. 658\u201075.","DOI":"10.1057\/palgrave.jors.2601862"},{"key":"key2022030920482227200_b13","unstructured":"The NHS Confederation (2005), \u201cThe potential of system dynamics \u2013 a new era for strategic planning\u201d, The NHS Confederation Future Healthcare Network, Leading Edge Series, Issue 10, The NHS Confederation, London."},{"key":"key2022030920482227200_b17","doi-asserted-by":"crossref","unstructured":"Wolstenholme, E.F. (1993), \u201cA case study in community care using systems thinking\u201d, Journal of the Operational Research Society, Vol. 44 No. 9, pp. 925\u201034.","DOI":"10.1057\/jors.1993.160"},{"key":"key2022030920482227200_b18","unstructured":"Wolstenholme, E.F. (1996), \u201cA management flight simulator for community care\u201d, in Cropper, S. (Ed.), Enhancing Decision Making in the NHS, Open University Press, Milton Keynes."},{"key":"key2022030920482227200_b19","doi-asserted-by":"crossref","unstructured":"Wolstenholme, E.F. (1999), \u201cA patient flow perspective of UK health service\u201d, System Dynamics Review, Vol. 15 No. 3, pp. 253\u201073.","DOI":"10.1002\/(SICI)1099-1727(199923)15:3<253::AID-SDR172>3.0.CO;2-P"},{"key":"key2022030920482227200_b23","doi-asserted-by":"crossref","unstructured":"Wolstenholme, E.F., Monk, D., McKelvie, D. and Arnold, S. (2008a), \u201cCoping but not coping in health and social care \u2013 masking the reality of running organisations well beyond safe design capacity\u201d, System Dynamics Review, January, 50th Anniversary Celebratory Edition.","DOI":"10.1002\/sdr.390"},{"key":"key2022030920482227200_b21","unstructured":"Wolstenholme, E.F., Monk, D., McKelvie, D. and Smith, G. (2007a), \u201cInfluencing and interpreting health and social care policy in the UK\u201d, in Qudrat\u2010Ullah, H., Spector, M.J. and Davidsen, P.I. (Eds), Complex Decision Making: Theory and Practice, Springer, New York, NY."},{"key":"key2022030920482227200_b24","unstructured":"Wolstenholme, E.F., McKelvie, D., Monk, D., Todd, D. and Brady, C. (2008b), \u201cEmerging opportunities for system dynamics in UK health and social care \u2013 the market\u2010pull for systemic thinking\u201d, Proceedings of the 2007 System Dynamics Conference, Athens, Greece."},{"key":"key2022030920482227200_b22","unstructured":"Wolstenholme, E.F., Monk, D., McKelvie, D., Gillespie, P. and O'Rourke, D. (2007b), \u201cReallocating mental health resources in the Borough of Lambeth, London, UK\u201d, Proceedings of the 2007 System Dynamics Conference, Boston, MA, USA."},{"key":"key2022030920482227200_b20","unstructured":"Wolstenholme, E.F., Repper, D., Monk, D., Todd, D. and McKelvie, D. (2006), \u201cReforming mental health services in the UK \u2013 using system dynamics to support the design and implementation of a stepped care approach to depression in North West England\u201d, Proceedings of the 2006 System Dynamics Conference, Nijmegen, The Netherlands."}],"container-title":["Kybernetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.emeraldinsight.com\/doi\/full-xml\/10.1108\/03684921011081213","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/03684921011081213\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/03684921011081213\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T23:27:08Z","timestamp":1753399628000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/k\/article\/39\/9-10\/1645-1658\/269229"}},"subtitle":[],"editor":[{"given":"Markus","family":"Schwaninger","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2010,10,19]]},"references-count":24,"journal-issue":{"issue":"9\/10","published-print":{"date-parts":[[2010,10,19]]}},"alternative-id":["10.1108\/03684921011081213"],"URL":"https:\/\/doi.org\/10.1108\/03684921011081213","relation":{},"ISSN":["0368-492X"],"issn-type":[{"type":"print","value":"0368-492X"}],"subject":[],"published":{"date-parts":[[2010,10,19]]}}}