39 Income inequalities beyond access to mental health care treatment by observing a subsequent treatment record without being able to identify the reason for it (e.g. continuation of treatment, change of provider, and acute care after a relapse or recurrence). Future research could attempt to provide more comprehensive information on the type of therapies and practitioners that are part of the treatment pathway, as well as other measures of appropriateness or quality of treatment. In summary, we used detailed mental health patient- level records from the Netherlands to document patterns that are favourable to patients with higher income across the four stages of mental health treatment: they had lower therapist-assessed severity at baseline, slightly higher treatment minutes, a higher likelihood of functional improvement, and were less likely to have received additional treatment. These findings call for a better understanding of the role of the social environment and quality of care as complementary mechanisms in explaining inequalities during mental health treatment. 2
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