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Population-based indices for the funding of mental health care: a review and implications
- Authors:
- TULLOCH Simon, PRIEBE Stefan
- Journal article citation:
- Journal of Public Mental Health, 9(2), June 2010, pp.15-22.
- Publisher:
- Emerald
Population-based indices of needs have an influence on mental health care funding. Over the last 30 years, a number of needs indices have been developed that utilise sociodemographic and service utilisation data to calculate a proxy indicator of population-based need. This approach is used because indicators of socio-economic disadvantage expressed as weighted deprivation show a strong relationship with mental health morbidity. This paper reviews the existing population-based indices of mental health needs in the UK: the Underprivileged Areas score; the York Index; the Mental Illness Needs Index; the Psychiatric Needs Index; the Indices of Multiple Deprivation; and the Local Index of Needs. It illustrates the application of these indices using east London as an example, and considers the methodological and conceptual limitations of these indices. Although none of the current indices provide a definitive picture, commissioners and providers may find them to be a useful source of contextual information, which may be useful in combination. In England, this is particularly relevant in the light of the increased liberalisation of commissioning services and changes in the funding process.
The Debt and Mental Health Evidence Form: a tool for health professionals and lenders dealing with customers with self-reported mental health problems
- Authors:
- FITCH Chris, CHAPLIN Robert, TULLOCH Simon
- Journal article citation:
- Psychiatrist (The), 34(3), March 2010, pp.95-100.
- Publisher:
- Royal College of Psychiatrists
British adults with mental disorders are 3 times more likely to report being in debt than those without mental disorders. Organisations that are owed money do not adequately consider information provided about customers’ mental health, and difficulties often arise when creditors request information from health professionals. Recent UK guidelines for creditors and money advisors on working with indebted customers with mental health problems have therefore called for a standardised approach which overcomes these difficulties and which also meets legal requirements for communicating and processing sensitive personal data. This paper describes the development of a standardised clinical information form which helps health professionals provide clear and relevant information about individuals who believe mental disorders affect their ability to repay debt and have consented to creditor organisations or money advisors approaching professionals for evidence. A 6-question form was drafted and sent out to 3 stakeholder groups for evaluation. Overall, 35 responses were received from creditors/money advisors, 28 from mental health professionals and 29 from service users/carers. These responses were used to revise the questions on the basis of concerns expressed by stakeholders about sharing diagnostic data, providing prognoses, and the risk of creditor misunderstanding. This form shows potential for standardising communication between health professionals, creditors, money advisors, and people reporting mental health and debt problems. The results of a pilot study are awaited.