Mental illness in Ireland: simulating its geographical prevalence and the role of access to services

Abstract

Traditionally, Ireland has reported high rates of admissions to acute psychiatric facilities for mental illness in general. However, data limitations mean that there has been no research on the role of access and proximity on rates of admissions to acute psychiatric facilities. The Simulation Model of the Irish Local Economy (SMILE) produces synthetic small-area-level microdata on self-reported rates of depression. The National Psychiatric Inpatient Reporting System (NPIRS) contains spatially referenced data on admissions to acute psychiatric services (both public and private) by diagnosis. Combining the NPIRS and SMILE datasets using propensity score-matching techniques produces a small-area profile of individuals with depression that includes those who have accessed an acute psychiatric facility as well as those who have not. Linking the NPIRS and SMILE datasets allows one to examine the differential characteristics that lead individuals with depression to seek acute psychiatric services and, importantly, to see if access to these services is a confounding factor. Our finding is that access, as measured in terms of road distance, has a significant positive impact on individuals with depression using an acute psychiatric facility.