TY - JOUR
T1 - Socio-economic disadvantage and resource distribution for mental health care
T2 - a model proposal and example application for Victoria, Australia
AU - Meadows, Graham
AU - Shawyer, Frances
AU - Dawadi, Shrinkhala
AU - Inder, Brett
AU - Enticott, Joanne
PY - 2021/4
Y1 - 2021/4
N2 - Objective: A spreadsheet-based model for supporting equitable mental health resource distribution in Australia was developed, based on the Australian Health Survey (AHS) psychological distress findings associated with area socio-economic disadvantage (SED). An illustrative application is presented. Method: Stratum-specific psychological-distress rates for area SED quintiles are applied to local government areas, catchment areas and local health networks (LHNs). A case study applies the model to Victoria, including examining recommendations in the Royal Commission into Victoria’s Mental Health Services (RCVMHS) 2019 interim report for increases to bed stock in two LHNs. Results: Need-adjusted demand estimates considered as a ratio of raw population proportions for catchments range between 0.6 to 1.4 in Victoria. Applying the formula to the Royal Commission recommendations suggests the proposed distribution of beds is a reasonable correction for these two LHNs and indicates next expansion priorities for more equitable distribution to other LHNs. Conclusions: The spreadsheet, adaptable for other states and territories, could complement National Mental Health Services Planning Framework outputs and assist in evaluation, for instance, determining potential supply shortages in the tele-mental-health response to COVID-19. We outline research directions including consideration of the moral bases of value judgements and identification of other variables including their use in parameterisation and calibration.
AB - Objective: A spreadsheet-based model for supporting equitable mental health resource distribution in Australia was developed, based on the Australian Health Survey (AHS) psychological distress findings associated with area socio-economic disadvantage (SED). An illustrative application is presented. Method: Stratum-specific psychological-distress rates for area SED quintiles are applied to local government areas, catchment areas and local health networks (LHNs). A case study applies the model to Victoria, including examining recommendations in the Royal Commission into Victoria’s Mental Health Services (RCVMHS) 2019 interim report for increases to bed stock in two LHNs. Results: Need-adjusted demand estimates considered as a ratio of raw population proportions for catchments range between 0.6 to 1.4 in Victoria. Applying the formula to the Royal Commission recommendations suggests the proposed distribution of beds is a reasonable correction for these two LHNs and indicates next expansion priorities for more equitable distribution to other LHNs. Conclusions: The spreadsheet, adaptable for other states and territories, could complement National Mental Health Services Planning Framework outputs and assist in evaluation, for instance, determining potential supply shortages in the tele-mental-health response to COVID-19. We outline research directions including consideration of the moral bases of value judgements and identification of other variables including their use in parameterisation and calibration.
KW - distributive justice
KW - health disparities
KW - mental health services
KW - socio-economic status
UR - http://www.scopus.com/inward/record.url?scp=85092303488&partnerID=8YFLogxK
U2 - 10.1177/1039856220963921
DO - 10.1177/1039856220963921
M3 - Article
C2 - 33031703
AN - SCOPUS:85092303488
SN - 1039-8562
VL - 29
SP - 157
EP - 162
JO - Australasian Psychiatry
JF - Australasian Psychiatry
IS - 2
ER -