Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T07:03:39.217Z Has data issue: false hasContentIssue false
  • English
  • Français

Social deprivation and mental health. Replicability and applicability in the Italian context of the resource allocation methods developed in the United Kingdom

Published online by Cambridge University Press:  18 May 2011

Giuseppe Tibaldi ,
Gyles Glover ,
Giuseppe Costa ,
Alessio Petrelli  and
Carmine Munizza
Giuseppe Tibaldi*
Affiliation:
Centro Studi e Ricerche in Psichiatria, ASL Torino 4, Torino
Gyles Glover
Affiliation:
Center for Public Mental Health, University of Durham, United Kingdom
Giuseppe Costa
Affiliation:
Servizio Sovrazonale di Epidemiologia ASL 5 e Università degli Studi di Torino, Torino
Alessio Petrelli
Affiliation:
Servizio Sovrazonale di Epidemiologia ASL 5 e Università degli Studi di Torino, Torino
Carmine Munizza
Affiliation:
Centro Studi e Ricerche in Psichiatria, ASL Torino 4, Torino
*
Address for correspondence: Dr. G. Tibaldi, Centro Studi e Ricerche in Psichiatria, ASL 4, Via Leoncavallo 2, 10154 Torino. Fax:+39-011-852.936 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

Aims — Most of the available evidence on the relationship between socioeconomic indicators of social deprivation and patterns of use of mental health services has been produced in the United Kingdom, where the Ministry of Health has developed a resource allocation formula based upon the results of those studies. The main aim of the paper is to evaluate the replicability in the Italian context of such research, and of the resulting allocation strategies. Methods — Detailed description of the resource allocation method currently adopted in the United Kingdom, whose main purpose consists in reaching the best balance between available funding and patterns of need. Detailed description of resource allocation processes in Italy; discussion of the main methodological and statistical limitations restraining the replicability of the British formula in the Italian context. Conclusions — There is a growing interest in Italy towards the introduction of evidence-based methods in health decision making, in order to correct the overwhelming influence of political issues. What is needed is a better understanding of the relationship between higher levels of equity in health services access, and their effects in terms of better outcomes.

Declaration of Interest: the current paper has been developed within a Research Programme funded by the Agenzia Regionale per i Servizi Sanitari, Regione Piemonte (Deliberazione n. 54 del 31.07.02). None of the authors received any additional source of funding for the development of this paper as well as for the related research activities.

Keywords

mental health servicessocial deprivationresource allocationneed for services.
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 15 , Issue 3 , September 2006 , pp. 211 - 218
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

BIBLIOGRAFIA

Beecham, J. & Johnson, S. (2000). The European Socio-Demographic Schedule (ESDS): Rationale, principles and development. In Assessing Mental Health in Europe (ed. Beecham, J. and Munizza, C.). Acta Psychiatrica Scandinavica, Supplementum No. 405, vol. 102, pp. 33–41.Google Scholar
Beecham, J. & Munizza, C. (Eds.) (2000). Assessing Mental Health in Europe. Acta Psychiatrica Scandinavica, Supplementum No. 405. Munksgaard: Copenhagen.Google Scholar
Bhugra, D. (1993). Unemployment, poverty and homelessness. In Principles of Social Psychiatry (ed. Bhugra, D. and Leff, J.), pp 355–382. Blackwell: Oxford.Google Scholar
Bindman, J., Glover, G., Goldberg, D. & Chisholm, D. (2000). Expenditure on mental health care by English health authorities: a potential cause of inequity. British Journal of Psychiatry 177, 267–274.CrossRefGoogle ScholarPubMed
Bonizzato, P. & Tello, J.E. (2003). Disuguaglianze socio-economiche e salute mentale. I. Concetti, teorie e interpretazioni. Epidemiologia e Psichiatria Sociale, 12, 205–218.CrossRefGoogle Scholar
Buckingham, K., Bebbington, A., Campbell, S., Dennis, C., Evans, G., Freeman, P., Martin, N. & Olver, L. (1996). Interim Needs Indicators for Community Health Services. Canterbury, Kent, Personal Social Services Research Unit, University of Kent: Kent.Google Scholar
Buszewicz, M. & Phelan, M. (1994). Schizophrenia and the environment. British Journal of Hospital Medicine 52, 149–154.Google ScholarPubMed
Carr-Hill, R., Hardiman, G., Martin, S., Peacock, S., Sheldon, T. & Smith, P. (1994). A Formula for Distributing NHS Revenues Based on Small Area Use of Hospital Beds. Centre for Health Economics, York University: York.Google Scholar
Cooper, B. (2005a). Immigration and schizophrenia: the social causation revisited. British Journal of Psychiatry 186, 361–363.CrossRefGoogle ScholarPubMed
Cooper, B. (2005b). Schizophrenia, social class and immigrant status: the epidemiological evidence. Epidemiologia e Psichiatria Sociale 14, 137–144.CrossRefGoogle ScholarPubMed
DOH (2003a). A Brief History of Resource Allocation in the NHS 1948–98. Advisory Committee on Resource Allocation. Retrieved September 28, 2003. from http://www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/FinanceAndPlanning/Allocations/Allocations Article/fs/en?CONTENT_ID=4108515&chk=tlhmGo.Google Scholar
DOH (2003b). Details of the resource allocation process for the English national health service including spreadsheets showing the calculational stages for years from 1999/2000. Retrieved September 28. 2003. from htttp://dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/Fi nance AndPlanning/Alloc at ions/Allocation s Article/fs/en?CONTENT_ID=4108515&chk=t1hmGo.Google Scholar
Dohrenwend, B.P., Levav, I., Shrout, P.E., Schwartz, S., Naveh, G., Link, B.G., Skodol, A. & Stueve, ( 1998). Ethnicity, socioeconomic status and psychiatric disorders. In Adversity, Stress and Psychopathology (ed. Dohrenwend, B.P.). pp. 285–318. Oxford University Press. New York.CrossRefGoogle Scholar
Eaton, W. (1974). Residence, social class and schizophrenia. Journal of Health and Social Behaviour 15. 289–299.CrossRefGoogle ScholarPubMed
Faris, R. & Dunham, H. (1939). Mental Disorders in Urban Areas. University of Chicago Press: Chicago.Google Scholar
Geronimus, A.T. & Bound, J. (1998). Use of census-based aggregate variables to proxy for socio-economic group: evidence from national samples. American Journal of Public Health 148, 475–486.Google Scholar
Glover, G. (1999). How much each Health Authority is allocated for mental health care. British Journal of Psychiatry 175, 402–406.CrossRefGoogle ScholarPubMed
Glover, G. (2003). Money for mental health care in 2003/4. Psychiatric Bulletin 27, 126–129.CrossRefGoogle Scholar
Harrison, J., Barrow, S. & Creed, F. (1995). Social deprivation and psychiatric admission rates among different diagnostic groups. British Journal of Psychiatry 167. 456–462.CrossRefGoogle ScholarPubMed
Hollingshead, A.B. & Redlich, F.C. (1958). Social Class and Mental Illness: a Community Study. Wiley: New York.CrossRefGoogle Scholar
Jarman, B. (1983). Identification of under privileged areas. British Medical Journal 286, 1705–1709.CrossRefGoogle Scholar
Jarman, B. (1984). Underprivileged areas: validation and distribution of scores. British Medical Journal 289, 1587–1592.CrossRefGoogle ScholarPubMed
Jarman, B. & Hirsch, S. (1992). Statistical models to predict district psychiatric morbidity. In Measuring Mental Health Needs (ed. Thornicroft, G., Brewin, C. and Wing, J.), pp. 62–80. Gaskell: London.Google Scholar
Jarman, B., Hirsch, S., White, P. & Driscoll, R. (1992). Predicting psychiatric admission rates. British Medical Journal 304, 1146–1151.CrossRefGoogle ScholarPubMed
Lorant, V., Deliège, D., Eaton, W., Robert, A., Philippot, P. & Ansseau, M. (2003). Socioeconomic inequalities in depression: a meta-analysis. American Journal of Epidemiology 157. 98–112.CrossRefGoogle ScholarPubMed
Lorant, V., Kunst, A.E., Huisman, M., Costa, G. & Mackenbach, J. (2005) Socio-economic inequalities in suicide: a European comparative study. British Journal of Psychiatry 187. 49–54.CrossRefGoogle ScholarPubMed
Maclntyre, S., Ellaway, S. & Cummins, A. (2002). Place effect on health: how can we conceptualise, operationalise and measure them? Social Science and Medicine 55, 125–139.CrossRefGoogle Scholar
Morgenstern, H. (1998). Ecologie studies. In Modern Epidemiology. 2nd ed. (eds. Rothman, K.J. and Greenland, S.), pp. 459–480. Lippincott: Philadelphia.Google Scholar
Muntaner, C., Eaton, W., Miech, R. & O'Campo, P. (2004) Socioeconomic position and major mental disorders Epidemiologie Reviews 26, 53–62.CrossRefGoogle ScholarPubMed
Office of Population Census and Surveys (1981). Census 1981. HMSO: London.Google Scholar
Office of Population Census and Surveys (1991). Census 1991. HMSO: London.Google Scholar
Office of Population Census and Surveys (1995). OPCS Surveys of Psychiatric Morbidity in Great Britain. Reports 1–8. HMSO: London.Google Scholar
Oliver, A. & Mosialos, E. (2004). Equity of access to health care: outlining the foundations for action. Journal of Epidemiology & Community Health 58(8). 655–658.CrossRefGoogle ScholarPubMed
Petrelli, A., Gnavi, R., Marinacci, C. & Costa, G. (2006). Socioeconomic inequalities in coronary heart disease in Italy. A multilevel population based study. Social Science and Medicine 63(2). 446–456.CrossRefGoogle ScholarPubMed
Platt, F., Micciolo, R. & Tansella, M. (1992). Suicide and unemployment in Italy: description, analysis and interpretation of recent trends. Social Science and Medicine 34, 1191–1201.CrossRefGoogle ScholarPubMed
Pritchard, V. (1992). Is there a link between suicide in young men and unemployment? A comparison of the UK with other European Community countries. British Journal of Psychiatry 160, 750–756.CrossRefGoogle Scholar
Sabbadini, L.L. & Costa, G. (Eds.) (2004). Informazione Statistica e Politiche per la Promozione della Salute. Istituto Nazionale di Statistica: Roma.Google Scholar
Salvador-Carulla, L., Tibaldi, G., Johnson, S., Scala, E., Romero, C. & Munizza, C. (2005). Patterns of mental health service utilisation in Italy and Spain. An investigation using the European Service Mapping Schedule. Social Psychiatry and Psychiatric Epidemiology 40, 149–159.CrossRefGoogle ScholarPubMed
Smith, P., Sheldon, T.A., Carr-Hill, R.A., Martin, S., Peacock, S. & Hardman, G. (1994). Allocating resources to health authorities: results and policy implications of small area analysis of use of inpatient services. British Medical Journal 22, 309, 1050–1054.CrossRefGoogle Scholar
Soobader, M., Ledere, F.B., Hadden, W. & Maury, B. (2001). Using aggregate geographic data to proxy individual socio-economic status: does size matter? American Journal of Public Health 91, 632–636.Google ScholarPubMed
Tello, J.E. & Bonizzato, P. (2003). Disuguaglianze socio-economiche e salute mentale. II. Aspetti metodologici e revisione della letteratura. Epidemiologia e Psichiatria Sociale 12. 253–271.CrossRefGoogle Scholar
Tello, J.E., Jones, J., Bonizzato, P., Mazzi, M.A., Amaddeo, F., & Tansella, M. (2005a). A census-based Socio-Economie Status (SES) index as a tool to examine the relationship between mental health services use and deprivation. Social Science and Medicine 61, 2096–2105.CrossRefGoogle Scholar
Tello, J.E., Mazzi, M.A., Tansella, M., Bonizzato, P. & Amaddeo, F. (2005b). Does socioeconomic status (SES) affect the use of community- based services? Acta Psychiatrica Scandinavica 112, 215–223.CrossRefGoogle Scholar
ten Have, M., te Grotenhuis, M., Meertens, V., Scheepers, P., Beekman, A.T.F. & Vollebergh, W. (2003). Upward trends in the use of community mental health and social work services in the Netherlands between 1979 and 1995: are particular socio-demographic groups responsible? Acta Psychiatrica Scandinavica 108. 447–454.CrossRefGoogle Scholar
Thornicroft, G. (1991). Social deprivation and rates of treated mental disorder: developing statistical models to predict psychiatric service utilisation. British Journal of Psychiatry 158, 475–484.CrossRefGoogle ScholarPubMed
Thornicroft, G., Margolius, O. & Jones, D. (1992). The TAPS project: new long-stay psychiatric patients and social deprivation. British Journal of Psychiatry 161. 621–624.CrossRefGoogle ScholarPubMed
Tibaldi, G., Munizza, C., Pasian, S., Johnson, S., Salvador-Carulla, L., Zucchi, S., Cesano, S., Testa, C., Scala, E. & Pinciaroli, L. (2005). Indicators predicting of mental health service utilisation in Piedmont. Italy: Standardised comparison of in-patient and community care in eighteen small health areas. Journal of Mental Health Policy and Economics 8. 95–106.Google Scholar
Toniolo, F., Cislaghi, C., Corbello, F. & Tediosi, F. (2003). Alcune considerazioni relative al “modello Fiuggi” per il riparto tra le Regioni delle risorse sanitarie. Politiche Sanitarie v3, 82–93.Google Scholar
Wainwright, N.W.J. & Surteees, P.G. (2004). Area and individual circumstances and mood disorder prevalence British Journal of Psychiatry 185, 227–232.CrossRefGoogle ScholarPubMed
Warr, P. (1987). Work, Unemployment and Mental Health. Clarendon Press: Oxford.Google Scholar