PhD Defence Francisca Vargas Lopes

Mental disorders pose an extremely high burden to society, both in terms of their direct effects on health but also societal welfare losses. This burden is distributed unequally and strongly impacts groups of low socioeconomic status (SES). Also unequal is the access and utilization of mental health services, which should be concentrated among those who most need treatment. This thesis aimed to produce evidence to guide mental health policy in reducing inequalities in mental health care and outcomes.

The objective was achieved by addressing two different knowledge gaps. The first research question, descriptive by nature, aimed to complement the existing knowledge about inequalities in the mental health field, which covers disparities in mental health status and access to mental health care but extremely limited in describing inequalities during mental health treatment and patient outcomes. The second research question focused on identifying mental health related interventions, programs and policies that impact the existing inequalities. To address this question, I have relied on quasi-experimental methods to causally evaluate interventions linked to key policy levers in granting access to mental health support: coverage, eligibility, and availability. I have conducted the evaluations applying an equity lens by measuring differential effects by socioeconomic status or focusing on interventions that impact vulnerable groups.