Abstract
The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses, such as psychosis, are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressing socioeconomic disadvantage in mental health cohorts. This paper, thus, examines the complex relationship between socioeconomic disadvantage, family/social supports, physical health, and health service utilization in a community sample of 402 participants diagnosed with psychosis. The paper utilizes quantitative data collected from the 2010 Survey of High Impact Psychosis research project conducted in a socioeconomically disadvantaged region of Adelaide, SA, Australia. Participants (42% female) provided information about socioeconomic status, education, employment, physical health, contact with family and friends, and health service utilization. The paper highlights that socioeconomic disadvantage is related to increased self-reported use of emergency departments, decreased use of general practitioners for mental health reasons, higher body mass index, less family contact, and less social support. In particular, the paper explores the multifaceted relationship between socioeconomic disadvantage and poor health confronting individuals with psychosis, highlighting the complex link between socioeconomic disadvantage and poor health. It emphasizes that mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage. The paper also stresses that the development of health policy and practice that seeks to redress the socioeconomic and health inequalities created by this disadvantage be an important focus for mental health services. Such health policy would provide accessible treatment programs and linked pathways to illness recovery and diminish the pressure on the delivery of health services. Consequently, the development of policy and practice that seeks to redress the socioeconomic and health inequalities created by disadvantage should be an important focus for the improvement of mental health services.
Highlights
Socioeconomic disadvantage is associated with a higher prevalence of and a higher mortality from most diseases, the major chronic diseases such as heart disease [1, 2]
The Survey of High Impact Psychosis (SHIP) sample recruited in South Australia comprised 402 participants who screened positive for psychosis
Mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage
Summary
Socioeconomic disadvantage is associated with a higher prevalence of and a higher mortality from most diseases, the major chronic diseases such as heart disease [1, 2]. The concept of socioeconomic disadvantage can apply to individuals or populations who reside in low-income circumstances, and who struggle to supply themselves and their families with food, clothing, and shelter. This disadvantage can take multiple forms, including limited job security, poor social networks, low selfesteem, poverty, and fatalism [3]. As socioeconomic disadvantage can include difficulties in accessing government income and social supports, such disadvantage is heightened for people with psychosis whose complex health needs require access to such services. The links between psychosis and socioeconomic disadvantage have been identified across diverse cultural, social, and demographic contexts. There is a need for information to enable the planning of and resource allocation for services where people with a psychotic illness present [10]
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