Skip to main content
×
×
Home

On poverty, politics and psychology: the socioeconomic gradient of mental healthcare utilisation and outcomes

  • Jaime Delgadillo (a1), Miqdad Asaria (a2), Shehzad Ali (a3) and Simon Gilbody (a4)
Summary

Since 2008, the Improving Access to Psychological Therapies (IAPT) programme has disseminated evidence-based interventions for depression and anxiety problems. In order to maintain quality standards, government policy in England sets the expectation that 50% of treated patients should meet recovery criteria according to validated patient-reported outcome measures. Using national IAPT data, we found evidence suggesting that the prevalence of mental health problems is greater in poorer areas and that these areas had lower average recovery rates. After adjusting benchmarks for local index of multiple deprivation, we found significant differences between unadjusted (72.5%) and adjusted (43.1%) proportions of underperforming clinical commissioning group areas.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      On poverty, politics and psychology: the socioeconomic gradient of mental healthcare utilisation and outcomes
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      On poverty, politics and psychology: the socioeconomic gradient of mental healthcare utilisation and outcomes
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      On poverty, politics and psychology: the socioeconomic gradient of mental healthcare utilisation and outcomes
      Available formats
      ×
Copyright
Corresponding author
Dr Jaime Delgadillo, Department of Health Sciences, University of York, York YO10 5DD, UK. Email: jaime.delgadillo@nhs.net
Footnotes
Hide All

See invited commentary, pp. 431–432, this issue.

Declaration of interest

None.

Footnotes
References
Hide All
1 Clark, DM, Layard, R, Smithies, R, Richards, DA, Suckling, R, Wright, B. Improving access to psychological therapy: initial evaluation of two UK demonstration sites. Behav Res Ther 2009; 47: 910–20.
2 Clark, DM. Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: the IAPT experience. Int Rev Psychiatr 2011; 23: 318–27.
3 Health and Social Care Information Centre. Quarterly Improving Access to Psychological Therapies Data Set Reports, England – Final Q2 2014–15 summary statistics and related information, Experimental statistics. HSCIC 2015 (http://www.hscic.gov.uk/catalogue/PUB16739).
4 Department of Health. Closing the Gap: Priorities for Essential Change in Mental Health. Department of Health, 2014 (www.gov.uk/government/uploads/system/uploads/attachment_data/file/281250/Closing_the_gap_V2_-_17_Feb_2014.pdf).
5 Gyani, A, Shafran, R, Layard, R, Clark, DM. Enhancing Recovery Rates in IAPT Services: Lessons from Analysis of the Year One Data. University of Reading, London School of Economics and Kings College London, 2011.
6 Payne, RA, Abel, GA. UK indices of multiple deprivation – a way to make comparisons across constituent countries easier. Health Stat Q 2012; 53: 116.
7 Muntaner, C, Eaton, WW, Miech, R, O'Campo, P. Socioeconomic position and major mental disorders. Epidemiol Rev 2004; 26: 5362.
8 Saxon, D, Fitzgerald, G, Houghton, S, Lemme, F, Saul, C, Warden, S, et al. Psychotherapy provision, socioeconomic deprivation, and the inverse care law. Psychother Res 2007; 17: 515–21.
9 Grant, K, McMeekin, E, Jamieson, R, Fairful, A, Miller, C, White, J. Individual therapy attrition rates in a low-intensity service: a comparison of cognitive behavioural and person-centred therapies and the impact of deprivation. Behav Cogn Psychother 2012; 40: 245–9.
10 Hawley, LD, Leibert, TW, Lane, JA. The relationship between socioeconomic status and counseling outcomes. Prof Couns 2014; 4: 390403.
11 Falconnier, L. Socioeconomic status in the treatment of depression. Am J Orthopsychiatry 2009; 79: 148–58.
12 Kroenke, K, Spitzer, RL, Williams, JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–13.
13 Spitzer, RL, Kroenke, R, Williams, JB, Lowe, B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166: 1092–7.
14 van der Lem, R, Stamsnieder, PM, van der Wee, NJA, van Veen, T, Zitman, FG. Influence of sociodemographic and socioeconomic features on treatment outcome in RCTs versus daily psychiatric practice. Soc Psychiatry Psychiatr Epidemiol 2013; 48: 975–84.
15 Firth, N, Barkham, M, Kellett, S, Saxon, D. Therapist effects and moderators of effectiveness and efficiency in psychological wellbeing practitioners: a multilevel modelling analysis. Behav Res Ther 2015; 69: 5462.
16 Royal College of Psychiatrists. Second Round of the National Audit of Psychological Therapies for Anxiety and Depression (NAPT). Healthcare Quality Improvement Partnership, 2013.
17 Delgadillo, J, McMillan, D, Leach, C, Lucock, M, Gilbody, S, Wood, N. Benchmarking routine psychological services: a discussion of challenges and methods. Behav Cogn Psychother 2014; 42: 1630.
18 Asimakopoulos, G, Al-Ruzzeh, S, Ambler, G, Omar, RZ, Punjabi, P, Amrani, M, et al. An evaluation of existing risk stratification models as a tool for comparison of surgical performances for coronary artery bypass grafting between institutions. Eur J Cardio-Thorac 2003; 23: 935–42.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×
Type Description Title
PDF
Supplementary materials

Delgadillo et al. supplementary material
Supplementary Figure S1

 PDF (50 KB)
50 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 56 *
Loading metrics...

Abstract views

Total abstract views: 201 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 22nd April 2018. This data will be updated every 24 hours.

On poverty, politics and psychology: the socioeconomic gradient of mental healthcare utilisation and outcomes

  • Jaime Delgadillo (a1), Miqdad Asaria (a2), Shehzad Ali (a3) and Simon Gilbody (a4)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *