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Identifying the key indicators of Parity of Esteem

What did we do?

Parity of esteem is a borrowed phrase from political policy and used within mental health policy, which aims to create equality between physical and mental health, but despite policy guidance and recommendations, the lack of clarity has merely created confusion.

 

The study aimed to explore parity of esteem and provide some guidance for policy and future research.

 

 

Why was it important?

Firstly, there is an unacceptable large premature mortality gap for people with mental illness.  Secondly, there is also an acute shortage of high-quality mental health crisis care. Lastly, there is a failure to prioritise mental health promotion and prevention in public health strategies.

 

 

How did we do it?

We relied on three different approaches:

 

  1. A review of the published evidence about parity of esteem
  2. A study using remote interviews (Zoom, TEAMS or telephone) with 27 participants (mental health care providers, physical health care providers, policy-makers, commissioners, charity workers, lecturers, public health professionals and political party members)
  3. A discussion day with 34 users of mental health services who offered their views to professionals

 

 

What we found?

  • Parity of esteem is a highly complex term and parity may be something that is difficult to achieve. For example, healthcare consists of various systems (leadership and governance, financing, service delivery, the workforce, information and research and technologies and medical products) interacting and creating an effect on the other to create the complete picture. This is where complexity arises. Just increasing financing will not solve the challenges in addressing parity between physical and mental health.

 

  • Discussion group members said healthcare professionals frequently failed to ‘ask the right questions’ and this led to challenges for families and for people using mental health services. The research identified barriers to access in terms of physically accessing services and finding them acceptable, appropriate and effective. For example, experiencing a mental health crisis and a longer wait for a bed in mental health care compared to physical health.

 

  • Staff training for both mental and physical health increased inequity and the potential for discrimination. Acute care staff needed training in cultural competence and mental health awareness in order to reduce discrimination and increase effective diagnoses. Mental health staff needed general training in physical health care in order to improve the holistic health of patients and knowledge of when to refer to other specialities.

 

  • Placing more support in the community, instead of housing people in secure facilities may be one answer for mental health, but how this may occur effectively needs careful thought.

 

  • Cultural competence teaching for staff, alongside insight into inequity and the different challenges people face in their everyday lives, may assist in reducing discrimination. For example, access to adequate housing, education, employment and healthcare, which are often unequally distributed.

 

Please check out this video which details the key findings

 

 

 

Downloadable resources

 

 

Who we worked with

 

 

 

More information

 

 

 

 

Programme Manager

Gill Rizzello

gill.rizzello@manchester.ac.uk 

 

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