Socio-economic disadvantage and resource distribution for mental health care: a model proposal and example application for Victoria, Australia

Abstract

Objective: A spreadsheet-based model for supporting equitable mental health resource distribution in Australia was developed, based on the Australian Health Survey (AHS) psychological distress findings associated with area socio-economic disadvantage (SED). An illustrative application is presented. Method: Stratum-specific psychological-distress rates for area SED quintiles are applied to local government areas, catchment areas and local health networks (LHNs). A case study applies the model to Victoria, including examining recommendations in the Royal Commission into Victoria’s Mental Health Services (RCVMHS) 2019 interim report for increases to bed stock in two LHNs. Results: Need-adjusted demand estimates considered as a ratio of raw population proportions for catchments range between 0.6 to 1.4 in Victoria. Applying the formula to the Royal Commission recommendations suggests the proposed distribution of beds is a reasonable correction for these two LHNs and indicates next expansion priorities for more equitable distribution to other LHNs. Conclusions: The spreadsheet, adaptable for other states and territories, could complement National Mental Health Services Planning Framework outputs and assist in evaluation, for instance, determining potential supply shortages in the tele-mental-health response to COVID-19. We outline research directions including consideration of the moral bases of value judgements and identification of other variables including their use in parameterisation and calibration.

Mental health systems modelling for evidence-informed service reform in Australia

“…Systems dynamic modelling has also been used to provide decision support tools to national and state policy makers and regional planners to forecast future population mental health trajectories and support better allocation of funding and resources. Stratified modelling drawing on population health survey findings can provide guidance as to relative service need between areas of catchment responsibility, for instance estimating variability occasioned by differences in levels of socioeconomic disadvantage (Meadows et al, 2021; Enticott et al, 2016).…”

“…Such models aim to estimate the mental health system resourcing needed to deliver these services for the overall projected demand, such as workforce, facilities and funding (Asamani et al, 2021). Needs-based planning models generally develop and combine these specific inputs with relatively simple mathematical approaches (Meadows et al, 2020), but could also be used as a framework for incorporating more complex modelling techniques for each model input, such as demand projections. A prominent Australian example of a needs-based planning model is the National Mental Health Service Planning Framework (NMHSPF) (Diminic et al, 2022).…”