Horizontal inequity in the use of mental healthcare in Australia

Nicole Black (), David Johnston, Martin Knapp (), Michael Shields and Gloria H.Y. Wong ()
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Nicole Black: Centre for Health Economics, Monash Business School, Monash University
Martin Knapp: Health Policy Department, London School of Economics and Political Science
Gloria H.Y. Wong: School of Psychology and Clinical Language Sciences, University of Reading

No 2024-14, Working Papers from Centre for Health Economics, Monash University

Abstract: For people experiencing mental health problems, timely access to high-quality healthcare is imperative for improving outcomes. However, limited availability of services, high out-of-pocket costs, insufficient health literacy and stigmatising attitudes may mean people do not receive the necessary treatment. We analyse Australian longitudinal data to document the extent and predictors of horizontal inequity in mental healthcare use among people with a newly developed mild or moderate mental disorder. Importantly, we compare people with similar health, residing in the same area, thus controlling for differences in healthcare needs and availability of services. Results suggest that mental healthcare use is not significantly associated with household income or financial hardship. In contrast, we find significant inequities by educational attainment, with university graduates around 50% more likely to receive mental healthcare than high-school dropouts. These findings are robust across subsamples and alternative modelling approaches, including panel data models with individual fixed- effects. Additional explorations of the education gradient suggest a potential pathway through mental health-specific knowledge and attitudes.

Keywords: Mental Health; Healthcare; Inequity; Income; Education (search for similar items in EconPapers)
JEL-codes: I12 I14 (search for similar items in EconPapers)
Date: 2024-08
New Economics Papers: this item is included in nep-hea
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Journal Article: Horizontal inequity in the use of mental healthcare in Australia (2025)
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