Deprivation, access, and outcomes in health psychology treatment

Abstract

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 study aimed 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 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 (CORE-OM). 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 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.