• The increasing complexity of the economic contexts within which mental health services are funded and delivered
  
• The demand for cost-effectiveness evidence
  
• The rationing of access to new pharmacotherapies and psychotherapies
  
• The emergence of quality of life as an essential criterion in the assessment of health care interventions
  
• The growing awareness of the influence of stigma on shaping the long-term course of severe mental disorders
  
• The enhanced role of advocacy groups in providing information, advice and support to sufferers
  

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