Citation

Lorant V. Psychiatr. Danub. 2006; 18(Suppl 1): 126.

Affiliation

Public Health School, Faculty of Medicine, Universite Catholique de Louvain, Clos chapelle aux champs 30.41, 1200 Bruxelles, Belgium. lorant@sesa.ucl.ac.be.

Copyright

(Copyright © 2006, Facultas Universitatis Studiorum Zagrabiensis - Danube Symposion of Psychiatry)

DOI

unavailable

PMID

16964093

Abstract

Socio-economic inequalities among suicide victims have long been observed in several countries. In a recent review of 10 European countries or cities, socio-economic inequalities in suicide appeared pervasive, at least among men. However, despite this consistent and persistent finding, public policies have been reticent in addressing this issue. Why is this so? Three possible replies are addressed here: lack of evidence, lack of value, lack of instrument. First, at a micro-level, we assessed the quality of the evidence of the impact of socio-economic status (SES) on suicide. Is SES to be considered as a mere risk factor vs. a causal determinant of suicide? We present and discuss the causation-selection framework and their recent empirical results regarding suicide and mental disorder. Our second point addresses the issue of value. Indeed, clinicians care for patients (presumably whatever their socio-economic groups) while public health policy makers design their intervention for whole populations. What is therefore the rationale for considering socio-economic status in mental health policies? Using the concepts of horizontal equity, vertical equity, procedural and consequential social justice, we discuss the rationale for public policies to consider socio-economic status in their design. Empirical evidence is then provided to support the relevance of such social justice concepts for public policies. Finally, we describe the policy stages in taking socio-economic inequality seriously into account as well as policy instruments to tackle inequalities in suicide or mental disorder.

Language: en