Parity of Esteem: Equity between physical and mental health?
The term "parity of esteem" concerns equity between physical and mental health. However, despite policy guidance and recommendations, the lack of clear definition associated with this term contributes to increased uncertainty about its meaning.
In 2022, researchers from the NIHR Applied Research Collaboration Greater Manchester and the University of Manchester conducted a study, which aimed to explore parity between physical and mental health and to outline perceived barriers and facilitators to parity. They conducted interviews with 27 participants drawn from physical and mental health services, policy development and third sector organisations, along with discussion groups and a review of published evidence to identify perceptions of the meaning of “parity of esteem”.
A central theme from the analysis findings highlighted the frequent failure of healthcare professionals to ask the relevant questions, resulting in difficulties for both families and individuals using mental health services. The study identified barriers to access, in terms of physically accessing services and finding them acceptable, appropriate and effective. For instance, the research highlights longer waiting times for mental health care during a crisis compared to physical health care.
Marginalised groups experience multiple forms of discrimination when they have mental health problems. Any form of difference from the majority population; being black, or any ethnic minority (BAME), disabled, lesbian, gay, bi- sexual, trans-sexual, queer+ (LGBTQ+) is not celebrated and then having mental health problems as well creates numerous intersecting areas of discrimination which becomes difficult to manage.
Lack of resources and skill diversity within healthcare teams also plays a pivotal role in creating inequalities. Furthermore, staff require training in cultural competence alongside insights into inequity and the different challenges people face to reduce discrimination and increase effective diagnoses.
Various themes, which emerged from the interviews, indicated a widening gap in equity between mental and physical health. The disparity in funding between mental and physical health services, reduced staffing levels, lack of therapeutic environments, inadequate training and patchy availability of services all reinforced the challenges of parity between physical and mental health.
Evidence from the Parity of esteem and systems thinking: a theory informed qualitative inductive thematic analysis research paper published in BMC Psychiatry suggests that embedding new competencies, infrastructures and practices within an effective learning healthcare system is required to move parity of esteem from rhetoric to reality.
Watch this animation video to learn more about Parity of Esteem.
Read the research paper in full here.
Read the final report and more information about the Parity of Esteem Project here.
Published 24/08/2023