Advancing our understanding of mental health outcomes in deprived communities

Humphreys, Charlotte (2024) Advancing our understanding of mental health outcomes in deprived communities. Doctoral thesis, University of East Anglia.

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Abstract

Background Residents of deprived areas are at increased risk of experiencing poor well-being, common mental health difficulties and psychotic disorders, partially due to the social stressors present in their neighbourhoods. There is now greater recognition of the social determinants of mental health, with a focus on situating the individual and their treatment in the environment in which they live. However, unpicking social inequalities is likely to be complex, concerning the intersectionality of the different parts of an individual’s identity.

Methods A systematic review using narrative synthesis was conducted which synthesised papers measuring the impact of community-based interventions on mental health outcomes in residents of deprived areas. A quantitative study was conducted examining the intersection of area-level deprivation, ethnicity and inpatient use (defined by risk of compulsory admission, admission to a Psychiatric Intensive Care Unit, length of stay and number of admissions). This study made use of anonymised electronic health records to identify a sample of 6767 patients with psychotic disorders who were admitted to hospital for psychiatric treatment in South London between 2016-2019. Data were analysed using stratified Logistic or Negative bionomical regressions.

Results Twenty-six papers, reporting on 21 studies were included in the systematic review. Overall findings about the impact of community-based interventions were mixed, with some promise for skills-based interventions and interventions with a narrower focus in their delivery and target audience. The empirical paper found living in all areas except the least deprived and belonging to a black ethnic minority group increased patients’ risk of most inpatient-related outcomes. Living in the least deprived areas appeared to protect some ethnic minority groups from increased risk of compulsory admission, but not black British or Asian patients.

Conclusions The findings highlight the benefits of addressing social stressors for residents of deprived areas through community-based interventions and the potential consequences of failing to address these for residents with psychotic disorders who can be left at greater risk of severe symptomatology which requires inpatient hospital admission.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Nicola Veasy
Date Deposited:	12 Nov 2024 09:26
Last Modified:	12 Nov 2024 09:26
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97626
DOI:

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