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Improving mental health outcomes: achieving equity through quality improvement
Alan J Poots1, Stuart A Green, Emmi Honeybourne
1Address reprint requests to: Alan J. Poots; a.poots@imperial.ac.uk.
Summary
A quality improvement initiative increased access to psychological therapy. Despite initial differences in depression severity, patient outcomes were equitable across all socioeconomic groups, showing no evidence of inequity in mental health service delivery.
Area of Science:
- Health Services Research
- Mental Health Services
- Quality Improvement Science
Background:
- Quality improvement (QI) initiatives can enhance access to psychological therapy services.
- Investigating the equity of patient outcomes is crucial after service improvements.
Purpose of the Study:
- To assess the equity of patient outcomes in a psychological therapy service post-QI initiative.
- To determine if increased access led to disparities in mental health treatment effectiveness.
Main Methods:
- Retrospective service evaluation of health outcomes.
- Analysis using ANOVA, chi-squared tests, and Statistical Process Control.
- Social marketing interventions increased patient referrals.
Main Results:
- Patients from high deprivation areas presented with more severe depression.
- Similar improvements in depression scores (ΔPHQ9) were observed across all deprivation levels.
- Proportions achieving meaningful improvement were consistent across deprivation categories and initiative phases.
Conclusions:
- QI methods successfully improved access to mental health services.
- No evidence of inequity in clinical outcomes was found, irrespective of patient deprivation level.
- The service demonstrated equitable outcomes despite increased patient access.
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