Perceived Need for Mental Health Care and Service Use Among Adults in Western Europe: Results of the ESEMeD Project
ABSTRACT This study assessed prevalence and correlates of perceived need for mental health care and its role in help seeking.
Data were from general population surveys conducted for the European Study of the Epidemiology of Mental Disorders. The sample consisted of adults who screened positive for specific mood and anxiety symptoms in surveys conducted in Belgium, France, Germany, Italy, The Netherlands, and Spain (N=8,796). These individuals were further assessed for mental disorders with the Composite International Diagnostic Interview 3.0. Respondents who reported voluntary use of health services to address concerns with their "emotions or mental health" or who reported a need for services for mental health reasons were considered to have perceived need.
Nine percent of the total sample perceived some need for mental health care in the past 12 months. Among those who had a mental disorder in the past 12 months, 33% had perceived need. Psychiatric morbidity was the major determinant of perceived need. Among those with perceived need, older age, nonurban residence, and residence in Germany were positively associated with use of services.
Only a third of those with a 12-month mental disorder perceived need for mental health care. Psychiatric morbidity was the main determinant of perceived need; however, other factors (being female and being older) were associated with use of health services among those with perceived need. Among those with perceived need, it is important to increase access to care for the youngest and those living in urban areas.
SourceAvailable from: Dirk Devroey[Show abstract] [Hide abstract]
ABSTRACT: Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review.01/2014; 2014:138016. DOI:10.1155/2014/138016
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ABSTRACT: Background Mental health complaints are quite common in healthcare employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers’ health surveillance (WHS) for nurses and allied health professionals. Using the waiting list group of a previous randomized controlled trial with high drop-out and low compliance to the intervention, we studied the pre-post effects of the EMH approach in a larger group of participants. Methods We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after three months were analyzed using paired t-tests and effect sizes. Results One hundred twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p=0.01) and work-related fatigue (p<0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen’s d=.23) in the participants who had logged onto an EMH intervention (20%, N=26). Conclusion The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, since we found small effects and participation in the offered EMH interventions was low, there is ample room left for improvement.12/2014; DOI:10.1016/j.shaw.2014.08.002
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ABSTRACT: Background:To inform decisions about mental health resource allocation, planners require reliable estimates of people who report service demand (i.e. people who use or want mental health services) according to their level of possible need.Methods:Using data on 6915 adults aged 16-64 years in Australia's 2007 National Survey of Mental Health and Wellbeing, we examined past-year service demand among respondents grouped into four levels of possible need: (a) 12-month mental disorder; (b) lifetime but no 12-month mental disorder; (c) any other indicator of possible need (12-month symptoms or reaction to stressful event, or lifetime hospitalisation); (d) no indicator of possible need. Multivariate logistic regression analyses examined correlates of service demand, separately for respondents in each of levels 1-3.Results:Sixteen per cent of Australian adults reported service demand, of whom one-third did not meet criteria for a 12-month mental disorder (equivalent to 5.7% of the adult population). Treatment patterns tended to follow a gradient defined by level of possible need. For example, service users with a 12-month disorder received, on average, 1.6-3.9 times more consultations than their counterparts in other levels of possible need, and had 1.9-2.2 times higher rates of psychologist consultation. Service users with a lifetime but not 12-month disorder or any other indicator of need consumed a similar average number of services to people with mild 12-month mental disorders, but received relatively fewer services involving the mental health sector. Service demand was associated with increased suicidality and psychological distress in all levels of possible need examined, and with poorer clinical and functional status for those with 12-month or lifetime disorders.Conclusions:Many Australians reporting service demand do not meet criteria for a current mental disorder, but may require services to maintain recovery following a past episode or because they are experiencing symptoms and significant psychological distress.Australian and New Zealand Journal of Psychiatry 05/2014; 48(9). DOI:10.1177/0004867414531459 · 3.77 Impact Factor