16 Chapter 1 designs. These challenges hinder researchers’4 widespread use of quasi-experiments and also a larger uptake of these studies by policy-makers. Addressing them within research and policy environments is crucial to quasi-experiments finally being recognised and adequately positioned as an essential primary research tool in the context of the evidence creation funnel and EIDM. A third reason goes beyond the comprehensiveness and quality of the evidence needed and recognises that simply the existence of evidence will “virtually never automatically drive tangible policy and practice change” [63]. This finding is driven by the researchto-policy gap that persists between sterile research environments and the context in which decisions are made, subjected to political cycles and power interests, budgetary limitations and institutional habits. The research-to-policy gap results from a lack of alignment between the research process and the policy/action cycle, and differences between researchers and policy-makers in their characteristics, beliefs and preferences. Lack of institutional capacity and resources to promote adequate knowledge translation make this gap wider. Knowledge translation can be defined as “the exchange, synthesis, and effective communication of reliable and relevant research results”. It focuses on promoting interaction among the producers and the users of research, removing the barriers to research use, and tailoring information to different target audiences [65]. Various models of knowledge translation may rely more on the researcher side (push efforts), the policy-maker side (user-pull efforts), or both (exchange efforts). In its most advanced form, knowledge translation requires integrated efforts encompassing all the previous models, promoted by dedicated platforms created with this purpose [66]. In sum, achieving societal impact through research goes beyond the interdisciplinary approach, the appropriateness of the study design, the robustness of the methods, and the data quality. While all these are needed – and were explicitly pursued in the chapters of this thesis – an extra effort of dissemination and knowledge translation is also key in bringing the findings to those who may use them in their decision-making. Such efforts were, therefore, also part of the activities pursued during this PhD. AIM AND OUTLINE OF THE THESIS This thesis aimed to produce evidence to guide mental health policy in reducing inequalities in mental health care and outcomes. This objective was achieved by focusing on two gaps that persist within the existing knowledge. First, knowing what inequalities are in place, particularly those beyond access to care. Second, examining the effects of 4 The extent to which quasi-experiments are used and the research approaches to their use differs considerably between disciplines, with microeconomics having a longer tradition and proficiency in applying them than most health sciences.
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