More deprived areas need greater resources for mental health Melanie Abas, Jane Vanderpyl, Elizabeth Robinson, Peter Crampton Objective: This study set out to investigate the relationship in New Zealand between the newly developed small area index of socio-economic deprivation, NZDep96, and measures of psychiatric bed utilisation. It aims to contribute to the debate on resource allocation and to estimate the distribution of beds required in relation to levels of deprivation. Method: A cohort study of 872 persons admitted to the psychiatric in-patient unit within Counties Manukau, involving 1299 episodes of in-patient care between 1998 and 2000. The annual period prevalence of admission and the rate of total occupied bed days were calculated for the different deciles of deprivation, standardized for age and gender. Results: There was a three-fold gradient in admission prevalence and in total occupied bed days between persons living in the most and least deprived areas. Conclusions: Mental health services need to be organized and funded in ways that take account of the high use of in-patient care among those living in deprived areas. Further research is required to explore the relationship between socio-economic deprivation and use of community mental health services. Key words: health services needs and demands, health services research, hospitals Australian and New Zealand Journal of Psychiatry 2003; 37:437–444 psychiatric, mental health services, socio-economic factors. Evidence has been accumulating since the 1930s that needs for mental health care are higher among those exposed to relatively greater socio-economic deprivation [1–4]. Psychiatric service utilization correlates with individual-level socio-economic indicators, such as low social class and living alone [5,6] and with composite indices of deprivation derived from census data [7,8]. A key implication of this is the need to take area depriva- tion into account when allocating resources in mental health. In New Zealand, over 90% of secondary mental health care is provided free of charge via government funding. The national mental health strategy gives benchmarks for a range of service components, such as beds [9]. However it does not discuss the gradient required in those benchmarks in relation to deprivation. Counties Manukau District Health Board Mental Health Services operates with a smaller number of acute adult beds (11.6 per 100 000 total population, benchmark 12.8), of extended care beds (3 per 100 000, benchmark 11.2), of 24 h nurse-staffed residential places (31 per 100 000, benchmark 37.3), and of community mental health service staff (22 per 100 000, benchmark 42) than have been recommended (Sue Hallwright, Northern District Support Agency, pers. comm. 2002) [9–11]. This area also has one of the greatest concentrations in New Melanie Abas, Consultant Psychiatrist (Correspondence) Mental Health Services, Counties Manukau District Health Board, Auckland, New Zealand. Email: mabas@btinternet.com Jane Vanderpyl, Research Fellow Division of Psychiatry, University of Auckland, Auckland, New Zealand Elizabeth Robinson, Biostatistician Department of Community Health, University of Auckland, Auckland, New Zealand Peter Crampton, Senior Lecturer Department of Public Health, Wellington School of Medicine and Health Sciences, Wellington, New Zealand Received 27 August 2002; revised 17 February 2003; accepted 27 February 2003.