“Good and equitable health” – a critical analysis of equity discourses in Swedish regional action plans for mental health

The goal of Swedish public health policy is to create conditions that enable good and equitable health and eliminate avoidable health inequities. Although previous research emphasizes the importance of considering inequities in mental health promotion and policy, and although researchers and policy makers emphasize the importance of a system-approach to mental health, there seems to be an ambiguity in how the concept of equity is understood. Therefore, the aim of this study was to critically examine equity and inequity discourses in Swedish regional action plans for mental health. A critical discourse analysis based on Foucault's discourse theory was used to reveal discursive practices of inequity. Twenty-two regional action plans for mental health were analyzed. The analysis identified three discourse strands: the vague language of equity, the inequitable people, and education as a pathway to equity, all of which are entangled through the individualization of equity. Overall, the equity discourse was interpreted as representing a naturalistic and liberal view on equity. This could be understood as contributing to upholding the system of inequities rather than dismantling it. There is a need for clarification about the considered causes of mental health inequities as well as possible solutions.