Deprivation, access and outcomes in health psychology treatment
ISSN: 1361-9322
Article publication date: 15 June 2020
Issue publication date: 14 July 2020
Abstract
Purpose
Individuals living in areas of higher deprivation are more likely to have requested mental health treatment but are less likely to have received treatment or benefitted from it. Less is known about the extent of access equality and treatment outcomes for individuals with a long-term health condition who experience mental health difficulties. The purpose of this paper is to evaluate the extent to which the neighbourhood Index of Multiple Deprivation predicted access to treatment, appointment attendance, treatment completion and clinical outcomes in a British health psychology clinic.
Design/methodology/approach
Retrospective data were used from 479 individuals referred to a health psychology clinic over 12 months. Clinical outcomes were measured using the Clinical Outcomes in Routine Evaluation – Outcome Measure. Patient data were linked with their neighbourhood Index of Multiple Deprivation decile. Data were analysed using correlation, linear regression and Fisher’s exact test.
Findings
There were no significant associations between deprivation and whether an individual attended assessment, attended treatment or completed treatment or between deprivation and patients’ clinical outcomes. Exploratory evidence indicated that individuals from higher deprivation neighbourhoods may be over-represented in clinic referrals, and individuals from lower deprivation neighbourhoods may be under-represented, compared with local population distribution estimates.
Originality/value
This evaluation provides insights into treatment outcomes and deprivation in those with physical health difficulties. Further evaluation using a larger sample and comparing referrals with local prevalence estimates of comorbid mental and physical health problems would enable greater confidence in the conclusion that no evidence of inequality on the basis of neighbourhood deprivation was found.
Keywords
Acknowledgements
Contribution. This evaluation was conceived, organised and managed by LLO and NF. Data preparation was by NF and LLO. Statistical analysis and writing of the first draft of this paper was done by LLO. All the listed authors were involved in the preparation, review and critique of the final manuscript. All the authors have approved the final manuscript for submission.Declaration of conflicting interests. The authors declare no potential conflicts of interest with respect to the evaluation, authorship and/or publication of this paper. LLO carried out this work in part fulfilment of the requirements of his Doctorate in Clinical Psychology at the University of Lincoln and the University of Nottingham.Funding. This evaluation was part funded by a grant by Health Education East Midlands, the UK.We would like to thank Drs Nima Moghaddam and Rachel Holt for their constructive feedback in regard to the focus and concept of the evaluation during its design and analysis.
Citation
Oates, L.L. and Firth, N. (2020), "Deprivation, access and outcomes in health psychology treatment", Mental Health Review Journal, Vol. 25 No. 2, pp. 139-151. https://doi.org/10.1108/MHRJ-02-2020-0010
Publisher
:Emerald Publishing Limited
Copyright © 2020, Emerald Publishing Limited