There is a relationship between socioeconomic deprivation and poor mental health outcomes. This thesis explores two separate facets associated with socioeconomic deprivation and the impact this has on mental health and wellbeing in the UK.
Chapter 1 is a systematic literature review looking at the relationship between area level deprivation and the individual’s ability to access and use mental health services. Eleven papers are reviewed and four broad themes emerged. These themes are barriers to access in the first instance, use of unplanned routes to receiving mental health care, increased economic burden of mental health care costs linked to living in more deprived areas, and how area level deprivation can hinder successful outcomes once receiving mental health interventions. All studies use administrative data to reach conclusions.
Chapter 2 is a piece of original research that explores trends in antidepressant prescribing rates across Wales during the period of April 2016 to December 2019. During this period, there was a shift in the Welfare benefit system whereby Universal Credit was introduced. Universal Credit was not introduced at a single time point; rather it was introduced on a monthly ‘roll out’ phase. Taking advantage of the natural pre/post nature of this roll out programme, an Interrupted Time Series model was applied to analyse changes in prescribing trends during a time of policy change. There is a significant increase in antidepressant prescribing rates in each Welsh county in the month when Universal Credit was introduced, and the prescribing rate continued to accelerate beyond the baseline trend over time.
Chapter 3 reflects upon how the research detailed above will influence clinical practice, and what theoretical implications the findings pose. There is also a small reflective narrative discussing some of the challenges associated with completing this piece of research.