Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-29T02:09:19.440Z Has data issue: false hasContentIssue false

Equity in mental health

Published online by Cambridge University Press:  18 May 2011

Roshni Mangalore
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A, 2AE. (United Kingdom)
Martin Knapp*
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A, 2AE. (United Kingdom)
*
Address for correspondence: Professor M. Knapp, Personal Social Services Research Unit, London School of Economics, Houghton Street, London, WC2A 2AE (United Kingdom). E-mail: [email protected]

Summary

Aim – The aim of this paper is to discuss the study of equity in mental health contexts. Methods – We review major principles and theories of distributive justice, covering various disciplines such as ethics, philosophy, economics, medicine and sociology. Recent literature on empirical analysis of inequalities in the mental health field is also reviewed. Results – The review of literature reveals a general lack of debate on equity principles in relation to mental health. Robust empirical evidence on inequalities in the field is also scarce. Conclusions – There is need for better exposition of the relevance of different equity principles for mental health policy and practice. There is also a need for developing standardised methods for the empirical analysis of equity, to examine the distribution of psychiatric morbidity and use of services by income, socioeconomic group, ethnicity, gender and place of residence, and, of course, to examine how equity can be promoted.

Declaration of Interest: This work was funded by the Department of Health programme grant to the PSSRU.

Type
Special Articles
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Algeria, M, Bijl, R.V., Lin, E.Walters, E.E. & Kessler, R.C. (2000). Income differences in persons seeking outpatient treatment for mental disorders. Archives of General Psychiatry 57, 383391.CrossRefGoogle Scholar
Andres, A.R. (2004). Determinants of self-reported mental health using the British Household Panel Survey. Journal of Mental Health Policy and Economics 1, 99106.Google Scholar
Bebbington, P., Brugha, T, Meltzer, H., Jenkins, R. & Ceresa, C. (2003a). Neurotic disorders and the receipt of psychiatric treatment. International Review of Psychiatry 15, 108114.CrossRefGoogle ScholarPubMed
Bebbington, P., Meltzer, H., Brugha, T., Farrell, M., Jenkins, R., Ceresa, C. & Lewis, G. (2003b). Unequal access and unmet need: neurotic disorders and the use of primary care services. International Review of Psychiatry 15, 115122.CrossRefGoogle ScholarPubMed
Boardman, J., Henshaw, C. & Willmott, S. (2004). Needs for mental health treatment among general practice attenders. British Journal of Psychiatry 185, 318327.CrossRefGoogle ScholarPubMed
Culyer, A. J. (1991). Equity in Health care. University of Toronto: Toronto.Google Scholar
Culyer, A.J. & Wagstaff, A. (1991). Need, equality and social justice, Discussion paper 90, Centre for Health Economics: University of York.Google Scholar
Daniels, N. (1985). Just Health Care. Cambridge University Press: Cambridge.CrossRefGoogle ScholarPubMed
Elster, J. (1992). Local Justice: How Institutions Allocate Scarce Goods and Burdens. Russel Sage: New York.Google Scholar
Feinberg, J. (1970). The nature and value of rights. Journal of Value Enquiry 4, 243257.CrossRefGoogle Scholar
Fryers, T., Melzer, D. & Jenkins, R. (2003). Social inequalities and the common mental disorders – a systematic review of the evidence. Social Psychiatry and Psychiatric Epidemiology 38, 229237.CrossRefGoogle ScholarPubMed
Jenkins, R., Lewis, G., Bebbington, P., Brugha, T., Farrell, M., Gill, B. & Meltzer, H. (2003). The National Psychiatric Morbidity Surveys of Great Britain - initial findings from the Household Survey. International Review of Psychiatry 15, 2942.CrossRefGoogle ScholarPubMed
Koppel, S. & McGuffin, P. (1999). Socio-economic factors that predict psychiatric admissions at a local level. Psychological Medicine 29, 12351241.CrossRefGoogle Scholar
Le Grand, J. (1987). Equity, health and health care. In Three Essays on Equity (Suntory Toyota International Centre for Economics and Related Disciplines Welfare State Project). Discussion Paper No. 23, London School of Economics and Political Science: London.Google Scholar
Lewis, G., Bebbington, P., Brugha, T., Farrell, M., Gill, B., Jenkins, R. & Meltzer, H. (2003). Socio-economic status, standard of living and neurotic disorder. International Review of Psychiatry 15, 9196.CrossRefGoogle ScholarPubMed
Lorant, V., Deliege, D., Eaton, W., Robert, A., Philippot, P. & Ansseau, M. (2003). Socioeconomic inequalities in depression: a meta-analysis. American Journal of Epidemiology 157, 98112.CrossRefGoogle ScholarPubMed
Lovell, K. & Richards, D. (2000). Multiple access points and levels of entry (MAPLE): ensuring choice, accessibility and equity for CBT Services. Behavioural and Cognitive Psychotherapy 28, 379391.CrossRefGoogle Scholar
Macinko, J.A. & Starfield, B. (2002). Annotated bibliography of equity in health, 1998-2001. International Journal of Equity in Health 1, 139.CrossRefGoogle Scholar
Meich, R. A., Caspi, A., Moffit, T.E., Bradley, R., Wright, E. & Silva, P.A. (1999). Low socioeconomic status and mental disorders: a longitudinal study of selection and causation during young adulthood. American Journal of Sociology 104, 10961121.CrossRefGoogle Scholar
Melzer, D., Fryers, T., Jenkins, R., Brugha, T. & McWilliams, B. (2003). Social position and the common mental disorders with disability: estimates from the National Psychiatric Survey of Great Britain. Social Psychiatry and Psychiatric Epidemiology 38, 238243.CrossRefGoogle ScholarPubMed
Miller, D. (1976). Social Justice. Clarendon Press: Oxford.Google Scholar
Mooney, G. H. (1987). What does equity in health mean? World Health Statistics Quarterly 40(4), 296303.Google ScholarPubMed
Nord, E. (2005). Concerns for the worst off: fair innings versus severity. Social Science and Medicine 60, 257263.CrossRefGoogle Scholar
Nozick, R. (1974). Anarchy, State and Utopia. Blackwell: Oxford.Google Scholar
Olsen, J.A. (1997). Theories of justice and their implications for priority setting in health care. Journal of Health Economics 16, 625639.CrossRefGoogle ScholarPubMed
Rawls, J. (1973). A Theory of Justice. Oxford University Press: Oxford.Google Scholar
Richardson, J. & McKie, J. (2005). Empiricism, ethics and orthodox economic theory: what is the appropriate basis for decision-making in the health sector. Social Science and Medicine 60, 265275.CrossRefGoogle ScholarPubMed
Rosenheck, R.A. (1999). Principles for priority setting in mental health services and their implications for the least well off. Psychiatric Services 50, 653658.CrossRefGoogle ScholarPubMed
Sen, A. (1973). On Economic Inequality. Clarendon Press: Oxford.CrossRefGoogle Scholar
Sen, A. (1997). On Economic Inequality, extended edition. Clarendon Press: Oxford.Google Scholar
Starfield, B. (2001). Improving equity in health: a research agenda. International Journal of Health Services 31 (3), 5456.CrossRefGoogle ScholarPubMed
Sturm, R. & Gresenz, C.R. (2002). Relations of income inequality and family income to chronic medical conditions and mental health disorders: national survey. British Medical Journal 324, 15.CrossRefGoogle ScholarPubMed
Thornicroft, G. (1991). Social deprivation and rates of treated mental disorder: developing statistical models to predict psychiatric service utilisation. British Journal of Psychiatry 158, 475484.CrossRefGoogle ScholarPubMed
Thornicroft, G. & Tansella, M. (1999). Translating ethical principles into outcome measures for mental health service research. Psychological Medicine 29, 761767.CrossRefGoogle ScholarPubMed
Tien, L. (1992). Determinants of equality and equity for special populations served by public mental health systems. Hospital and Community Psychiatry 43, 11041108.Google ScholarPubMed
Van Doorslaer, E., Koolman, X. & Jones, A.M. (2004). Explaining income-related inequalities in doctor utilisation in Europe. Health Economics 13, 629647.CrossRefGoogle ScholarPubMed
Wailoo, A. & Anand, P. (2005). The nature of procedural preferences for health-care rationing decisions. Social Science and Medicine 60. 223236.CrossRefGoogle ScholarPubMed
Weich, S. & Lewis, G. (1998). Material standard of living, social class and the prevalence of the common mental disorders in Great Britain. Journal of Epidemiology Community Health 52, 814.CrossRefGoogle ScholarPubMed