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How much does mental health discrimination cost: valuing experienced discrimination in relation to healthcare care costs and community participation

Published online by Cambridge University Press:  06 June 2014

S. Evans-Lacko ,
S. Clement ,
E. Corker ,
E. Brohan ,
L. Dockery ,
S. Farrelly ,
S. Hamilton ,
V. Pinfold ,
D. Rose  and
C. Henderson
...Show all authors
S. Evans-Lacko*
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
S. Clement
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
E. Corker
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
E. Brohan
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
L. Dockery
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
S. Farrelly
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
S. Hamilton
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
V. Pinfold
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
D. Rose
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
C. Henderson
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
G. Thornicroft
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
P. McCrone
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London E5 8AF, UK
*
*Address for correspondence: Dr S. Evans-Lacko, Health Service and Population Research Department P029, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
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Abstract

Aims.

This study builds on existing research on the prevalence and consequences of mental illness discrimination by investigating and quantifying the relationships between experienced discrimination and costs of healthcare and leisure activities/social participation among secondary mental health service users in England.

Methods.

We use data from the Mental Illness-Related Investigations on Discrimination (MIRIAD) study (n = 202) and a subsample of the Viewpoint study (n = 190). We examine experiences of discrimination due to mental illness in the domains of personal relationships, community activities, and health care, and how such experienced discrimination relates to patterns of service use and engagement in leisure activities.

Results.

Our findings show that the cost of health services used for individuals who reported previous experiences of discrimination in a healthcare setting was almost twice as high as for those who did not report any discrimination during the last 12 months (Relative Risk: 1.73; 95% Confidence Interval (CI): 1.39, 2.17) and this was maintained after controlling for symptoms and functioning. Experienced discrimination in healthcare (Relative Risk: 0.83; 95% CI: 0.81, 0.84) or in relationships (Relative Risk: 0.89; 95% CI: 0.87, 0.91), however, was associated with lower participation in, and hence lower costs of, leisure activities. Individuals who reported any discrimination in a healthcare setting had, on average, £434 higher costs associated with health service use while reported discrimination in the community was associated with increased leisure costs of £32.

Conclusions.

These findings make an important initial step towards understanding the magnitude of the costs of mental health-related discrimination.

Keywords

Health economicsmental health servicesmental illnessstigma
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 24 , Issue 5 , October 2015 , pp. 423 - 434
Copyright
Copyright © Cambridge University Press 2014 

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