Monitoring mental health reform in a Canadian inner city.
This ecological study investigated whether the relationship between social disadvantage and hospitalization for psychoses changed during a time of social and economic stressors in an urban setting. Hospital separation rates were compared in the census years 1991 and 1996. Rates were 66% higher in the lowest income areas compared to the richest areas; but this relationship did not change over time. Instead, rates for psychoses increased by about 15% over time. These findings may be due to an increase in the need, a change in the level of resources or in coding practices. As hospital separation data are collected systematically in many countries, they can be used to monitor the progress of mental health reform. Variations in an area may signify that resources need to be redistributed more equitably and/or at a faster pace.
Rhodes
Anne E
AE
Suicide Studies and Inner City Health Research Units, St. Michael's Hospital, 30 Bond Street, Toronto, Ont., Canada M5B 1W8. rhodesa@smh.toronto.on.ca
Agha
Mohammad
M
Creatore
Marisa
M
Glazier
Richard
R
D000328:Adult; D005260:Female; D018166:Health Care Reform; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario; D011618:Psychotic Disorders / Q000628:therapy; D012959:Socioeconomic Factors; D014504:Urban Health