Amartya Sen’s multidimensional capability approach focuses on the importance of freedoms to be or... more Amartya Sen’s multidimensional capability approach focuses on the importance of freedoms to be or do things people have reason to value. It is an alternative to standard utilitarian welfarism, the theoretical approach to quality-adjusted life years (QALYs) and cost-utility analyses. Despite the limitations of the utility approach in capturing non-health benefits and broader welfare inequalities, there have been very limited applications of the capability approach in the mental health context where these issues are imperative. We report the development and application of a multidimensional instrument, the OxCAP-MH, which aims to operationalise the capability approach for outcome measurement in mental health research. The study was carried out as part of an ongoing programme on community coercion experienced by service users with severe and enduring mental illness being treated using Community Treatment Orders. Capabilities data were collected at baseline in the OCTET RCT for 333 ‘revolving door’ mental health service users who were in involuntary hospital treatment at the time of recruitment in England (2008e2011). The research focused on the identification of capabilities domains most affected by mental illness and their association with socio-demographic and clinical factors and other measures of well-being such as the EQ-5D and Global Assessment of Functioning (GAF) scales. The OxCAP-MH item response rate was 90%e68%. There were significant correlations between service users’ overall capability scores and the GAF, EQ-5D VAS and EQ-5D-3L utilities (corr ¼ 0.249, 0.514, 0.415, respectively). The most affected capability domains were: ‘Daily activities’, ‘Influencing local decisions’, ‘Enjoying recreation’, ‘Planning one’s life’ and ‘Discrimination’. Age had a mixed effect, while female service users and those with a primary diagnosis of schizophrenia or longer illness duration reported significantly lower capability scores. The results support the feasibility and validity of directly measuring human capabilities for the mentally ill and the potential for applying the approach to outcome measurement.
The paper provides an overview and assessment of an emerging literature on the psychology and beh... more The paper provides an overview and assessment of an emerging literature on the psychology and behavioural economics of poverty. We particularly highlight poverty experiences, role of neighbourhoods, poverty dynamics and transmission, child poverty and disability and personal finance. In addition we consider psychology and policy responses by looking and autonomy and empowerment, and poverty reduction programs. Our central thesis is that the detailed knowledge of individual experiences, cognitions and social factors in psychology and related social science complements the traditional economic emphasis on structural factors and policy instruments in a way that is exemplified by emerging work in behavioural economics. We conclude it is increasingly recognised that poverty reduction policies which are informed by behavioural insights may, as a result, be more effective
Sometimes seen as the touchstone of formal theories of rational choice, transitive preferences ha... more Sometimes seen as the touchstone of formal theories of rational choice, transitive preferences have become the centre of a decision theoretic controversy that is of import to both economic theorists and philosophers. Empirically, there is mounting evidence based on observations of choice behaviour under controlled laboratory conditions that agents do not have preferences consistent with even the weakest forms of transitivity (see, for instance, Grether and Plott (1979), Korhonen et al. (1990) and Bradbury and Ross (1990)). Whilst it is understandable that researchers might be sceptical about the significance of individual empirical studies, it is also true that the frequent replication of these findings has had a noticeable impact on the development of decision theory in the 1980s. From a technical viewpoint there are a number of mathematical representation and uniqueness theorems (generalisations of utility theory) which dispense with the transitivity assumption (e.g. Morrison (1962), Tversky (1969), Bell (1982), Fishburn (1982), and Loomes and Sugden (1982)).
The paper contributes to the operationalisation of the capabilities approach to welfare economics... more The paper contributes to the operationalisation of the capabilities approach to welfare economics by developing and analyzing data on the freedoms of adults in Argentina. Specifically, it reports on the development and delivery of a survey instrument for measuring capabilities, calculates for each respondent a Nehring–Puppe type index of capabilities and examines the distribution of index scores. The main analytic part of the paper then goes on to develop a generalized linear latent and mixed model (GLLAMM) for assessing the impact of capabilities on life satisfaction, in which allowance is made for (i) unobserved heterogeneity and (ii) possible endogeneity, by introducing latent individual effects and by instrumenting capability variables using income and other socio-economic variables. Our empirical results show that empathy, self-worth, goal autonomy, discrimination, safety and stress are statistically significant determinants of life satisfaction, in a decreasing order of importance. The paper concludes by suggesting that, if replicated, the findings have profound implications for the conceptualisation and evaluation of economic progress.
There has been significant interest and often a hostile response by scholars, commentators and po... more There has been significant interest and often a hostile response by scholars, commentators and political activists to news that the UK government, among others, is seeking to elevate happiness or wellbeing as an explicit policy goal. It is difficult to adjudicate between the various arguments surrounding the appropriate role for government in this area as they often take very different starting points, either metatheoretical or disciplinary. In seeking to steer a course through these arguments we take the distinction between ‘wicked’ and ‘tame’ problems as a reference point , arguing that wellbeing should be categorised as the former. The seminal discussion of this distinction (Rittel and Webber 1973) resonates sharply with current debates on wellbeing and indeed is located within similar debates in the past. In developing our arguments we ground them in relation to empirical research on developments in the UK, where the connection between wellbeing and public policy is seen as rela...
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Papers by Paul Anand
utility approach in capturing non-health benefits and broader welfare inequalities, there have been very limited applications of the capability approach in the mental health context where these issues are imperative. We report the development and application of a multidimensional instrument, the OxCAP-MH, which
aims to operationalise the capability approach for outcome measurement in mental health research. The
study was carried out as part of an ongoing programme on community coercion experienced by service users with severe and enduring mental illness being treated using Community Treatment Orders. Capabilities data were collected at baseline in the OCTET RCT for 333 ‘revolving door’ mental health service
users who were in involuntary hospital treatment at the time of recruitment in England (2008e2011). The research focused on the identification of capabilities domains most affected by mental illness and their association with socio-demographic and clinical factors and other measures of well-being such as the EQ-5D and Global Assessment of Functioning (GAF) scales. The OxCAP-MH item response rate was 90%e68%. There were significant correlations between service users’ overall capability scores and the GAF, EQ-5D VAS and EQ-5D-3L utilities (corr ¼ 0.249, 0.514, 0.415, respectively). The most affected capability domains were: ‘Daily activities’, ‘Influencing local decisions’, ‘Enjoying recreation’, ‘Planning one’s life’ and ‘Discrimination’. Age had a mixed effect, while female service users and those with a primary diagnosis of schizophrenia or longer illness duration reported significantly lower capability scores. The results support the feasibility and validity of directly measuring human capabilities for the mentally ill and the potential for applying the approach to outcome
measurement.
role of neighbourhoods, poverty dynamics and transmission, child poverty and disability and personal finance. In addition we consider psychology and policy responses by looking
and autonomy and empowerment, and poverty reduction programs. Our central thesis is that the detailed knowledge of individual experiences, cognitions and social factors in psychology
and related social science complements the traditional economic emphasis on structural factors and policy instruments in a way that is exemplified by emerging work in behavioural economics. We conclude it is increasingly recognised that poverty reduction
policies which are informed by behavioural insights may, as a result, be more effective
controlled laboratory conditions that agents do not have preferences consistent with even the weakest forms of transitivity (see, for instance, Grether and Plott (1979), Korhonen et al. (1990) and Bradbury and Ross (1990)). Whilst it is understandable that researchers might be sceptical about the significance of
individual empirical studies, it is also true that the frequent replication of these findings has had a noticeable impact on the development of decision theory in the 1980s. From a technical viewpoint there are a number of mathematical
representation and uniqueness theorems (generalisations of utility theory) which dispense with the transitivity assumption (e.g. Morrison (1962), Tversky (1969), Bell (1982), Fishburn (1982), and Loomes and Sugden (1982)).
Nehring–Puppe type index of capabilities and examines the distribution of index scores. The main analytic part
of the paper then goes on to develop a generalized linear latent and mixed model (GLLAMM) for assessing the impact of capabilities on life satisfaction, in which allowance is made for (i) unobserved heterogeneity and (ii) possible endogeneity, by introducing latent individual effects and by instrumenting capability variables using income and other socio-economic variables. Our empirical results show that empathy, self-worth, goal autonomy, discrimination, safety and stress are statistically significant determinants of life satisfaction, in
a decreasing order of importance. The paper concludes by suggesting that, if replicated, the findings have
profound implications for the conceptualisation and evaluation of economic progress.