Sara Evans-Lacko

Sara Evans-Lacko is a mental health services researcher with a particular interest in the role of health services and social support in the prevention and treatment of mental illness. Her research addresses key issues in global mental health using interdisciplinary methods integrating insights from public health, psychiatry and economics. Her current projects develop and evaluate interventions to improve access to care and support, reduce stigma and disrupt the dynamic between mental health and poverty which generates and reproduces inequalities over the lifespan. She has a PhD in Health Policy and Management, from the Johns Hopkins Bloomberg School of Public Health.

Title of the speech

What we count, what we miss: rethinking mental health service evaluation

Abstract

Mental health needs, service models and data environments are changing, with increasing use of digital tools, hybrid modes of delivery and new opportunities to link information across systems. Over the same period, social and economic inequalities have widened in many settings, and structural barriers continue to shape who receives support, what kind of care is offered and how long people are able to remain engaged. In this context, there is a growing need to reconsider what we evaluate and why. In this talk, I will focus on how implementation and engagement are assessed in relation to mental health services, including questions of reach, acceptability, sustained participation and quality of delivery. Drawing on examples from digital and in-person interventions, I will discuss approaches to examining whether people not only gain access to care but are able to use it in ways that fit their everyday constraints. I will then consider how structural and cross-sector policies in areas such as education, employment and social protection can be conceptualised and evaluated as part of the broader mental health service environment, including attention to education, work and other life chances trajectories.