Determinants of Attitudes Toward Government Mental Health Spending for Depression
Open Access DepositedAmong mental health professionals there is a consensus that the mental healthcare system receives inadequate funding from the government. In theory, public opinion should impact government funding and policies around mental health. In Study 1, this research aims to develop a measure of attitudes and determine whether people have differing attitudes regarding funding of mental health services across basic dimensions of services: medication versus therapy, children versus adults, prevention or treatment intervention. In Study 2, this research aims to understand predictors of attitudes toward government funding for depression with predictors organized into four domains: 1) predictors related to perceived personal circumstances regarding depression and its treatment; 2) predictors related to political affiliation and beliefs about general government spending; 3) predictors related to knowledge and beliefs about depression and its treatment; and 4) predictors related to stigma and empathy regarding depression. For Study 1, 148 participants were recruited using the online data collection platform Prolific. To develop a measure of attitudes toward funding and determine whether attitudes differ across dimensions, a item pool was developed that included items corresponding to six possible targets of funding for mental health services: adult therapy, child-adolescent therapy, adult medication, child-adolescent medication, adult prevention and child prevention. Factor analysis was used to narrow down the number of items and measurement models were specified to explore whether attitudes varied meaningfully by targets. For Study 2, data for 253 participants were recruited through Prolific with the aim of having a balanced sample across socioeconomic domains including age, race/ethnicity, education and political affiliation. This study tested the relationship between predictors within the four domains and a general factor of government spending on mental health services. Additional set-wise analysis examined whether each domain contributed independently to general attitudes. Finally, exploratory analysis examined whether individual predictors might have somewhat different associations depending on funding target. The results from Study 1 indicated high correlations of attitudes toward funding across the six different dimensions of mental health services, however there was also evidence for differences. The medication measures, both child and adult medication, had the weakest loadings on the general factor. Results from Study 2 suggested that general attitudes toward funding are associated with three somewhat distinct processes aligning with the first three domains. The first is proximity to depression and treatment highlighted by a personal desire to use more mental health services if they were easier to access. The second is attitudes toward government and society highlighted by willingness to support taxation to benefit lower income individuals. The third is beliefs about depression and treatment highlighted by beliefs about effectiveness of treatments to improve symptoms of depression. Results from the set-wise analysis provided evidence that each of these domains provide independent contributions to general attitudes toward government funding of mental health services. While some specificity was found, most of the variance in attitudes was not target specific and the three processes appeared to mostly be associated with general attitudes.
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