Health Policy 88 (2008) 359–370 Available online at www.sciencedirect.com Eliciting preferences for resource allocation in mental health care in Ireland Eamon O’Shea ∗ , Brenda Gannon, Brendan Kennelly Department of Economics, NUI Galway and Irish Centre for Social Gerontology, Ireland Abstract The proportion of total health care expenditure devoted to mental health care in Ireland, at just below 7%, is low relative to other countries. There have been few studies that have examined the relationship between public preferences for different kinds of health care expenditure and priority setting as undertaken by policy-makers and governments. This paper examines citizen’s rankings and willingness to pay for a community-based mental health care programme in Ireland relative to two other programmes: cancer and elderly care. Respondents rank cancer as the most important programme, followed by elderly care and then mental health care. The contingent valuation survey demonstrated that people are willing to make significant tax contributions to new community-based services for people with mental health problems, counteracting the view sometimes expressed that people do not care at all about mental health care provision. However, the survey also found that people tend to value additional spending on mental health care lower than cancer and elderly care programmes. © 2008 Published by Elsevier Ireland Ltd. Keywords: Willingness to pay; Mental health care; Priority setting 1. Introduction Resource allocation for health care in most countries tends to be incremental, influenced more by histori- cal and political patterns than rational decision-making calculus. This can lead to sub-optimal use of limited health care resources. In particular, high technology clinical interventions tend to receive more funding than personal and community care programmes, particu- ∗ Corresponding author at: National University of Ireland, Newcas- tle Road, Galway, Ireland. Tel.: +353 91512332; fax: +353 91524130. E-mail addresses: eamon.oshea@nuigalway.ie (E. O’Shea), brenda.gannon@nuigalway.ie (B. Gannon), brendan.kennelly@nuigalway.ie (B. Kennelly). larly in relation to mental health. These disparities can be widened if consultants and hospitals at the high technology end of health care production have a dis- proportionate influence over the allocation of health care budgets, as is the case in Ireland. Priority setting in health care should, however, incorporate some con- sideration of the relative needs of all of the population, including some exploration of the value of different programmes and services to citizens. Historically, in Ireland, funding for mental health care has not matched need and when spending has occurred it has largely been to support residential care provision. Overall, the proportion of total health care expenditure devoted to mental health care in Ireland, at just below 7%, is below that of other 0168-8510/$ – see front matter © 2008 Published by Elsevier Ireland Ltd. doi:10.1016/j.healthpol.2008.03.018