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.
[Show abstract][Hide abstract] ABSTRACT: The majority of disaster survivors suffering from psychiatric disorders do not utilize mental health services. Only one study to date has explored postdisaster service use after Hurricane Sandy, and the disaster literature is further limited by a lack of attention to survivors' perceived need for services. We drew on data from a population-based sample of adults living in New York City neighborhoods that were most severely affected by Hurricane Sandy (N = 454). Less than 10 % of participants reported service needs (7.8 %) and service use (4.4 %) since the hurricane, 5.9 % were classified as having unmet needs (i.e., needs without use), and 2.5 % as using services without needs. Predictors of unmet mental health service needs included younger age, male gender, higher education, and exposure to more disaster-related stressors. The results suggest that efforts to reduce unmet postdisaster service needs could focus on reaching survivors with these characteristics.
Community Mental Health Journal 09/2015; DOI:10.1007/s10597-015-9947-4 · 1.03 Impact Factor
"Regardless of the proportion, we know that most people with a mental disorder do not attempt (Chen & Dilsaver, 1996) or die by suicide (Druss, Zhao, Von Esenwein, Morrato, & Marcus, 2011; Malzberg, 1932). We also know that the stigma of mental illness and cultural ideals of individualism in the US (Codony et al., 2009) may preclude treatment for many people with mental illness, particularly males; therefore, suicide prevention efforts must extend beyond the identification and treatment of mental illness. Contributors to suicide, independent of mental illness, include life events, such as a conflict with a partner, close friend, neighbor, or relative; illness; unemployment; job problems; and financial trouble (Foster, Gillespie, Mc- Clelland, & Patterson, 1999; Heikkinen, Aro, & Lonnqvist, 1994). "
[Show abstract][Hide abstract] ABSTRACT: Suicides among men aged 35-64 years increased by 27% between 1999 and 2013, yet little research exists to examine the nature of the suicide risk within this population. Many men do not seek help if they have mental health problems and suicides may occur in reaction to stressful circumstances.
We examined the precipitating circumstances of 600 suicides without known mental health or substance abuse (MH/SA) problems and with a recent crisis. Whether these suicides occurred within the context of an acute crisis only or in the context of chronic circumstances was observed.
Using data from the National Violent Death Reporting System and employing mixed-methods analysis, we examined the circumstances and context of a census of middle-aged male suicides (n = 600) in seven states between 2005 and 2010.
Precipitating circumstances among this group involved intimate partner problems (IPP; 58.3%), criminal/legal problems (50.7%), job/financial problems (22.5%), and health problems (13.5%). Men with IPP and criminal/legal issues were more likely than men with health and/or job/financial issues to experience suicide in the context of an acute crisis only.
Suicides occurring in reaction to an acute crisis only or in the context of acute and chronic circumstances lend themselves to opportunities for intervention. Further implications are discussed.
Crisis The Journal of Crisis Intervention and Suicide Prevention 06/2015; DOI:10.1027/0227-5910/a000329 · 1.09 Impact Factor
"This ratio is higher than that of previous studies. Usually the percentage of persons with a mental disorder seeking healthcare services hovers between 33 and 40 percent
[8,48-50]. The proportion of individuals with mental disorders among our full sample (13.3%) was also higher than those found in the 2002 Canadian Community Health Survey of Mental Health and Well-Being (CCHS 1.2) for Canada (9.5%) and for all the provinces (between 6.7% and 11.3%)
[Show abstract][Hide abstract] ABSTRACT: This study has a dual purpose: 1) identify determinants of healthcare service utilization for mental health reasons (MHR) in a Canadian (Montreal) catchment area; 2) determine the patterns of recourse to healthcare professionals in terms of frequency of visits and type of professionals consulted, and as it relates to the most prevalent mental disorders (MD) and psychological distress.
Data was collected from a random sample of 1,823 individuals interviewed after a two-year follow-up period. A regression analysis was performed to identify variables associated with service utilization and complementary analyses were carried out to better understand participants' patterns of healthcare service utilization in relation to the most prevalent MD.
Among 243 individuals diagnosed with a MD in the 12 months preceding an interview, 113 (46.5%) reported having used healthcare services for MHR. Determinants of service utilization were emotional and legal problems, number of MD, higher personal income, lower quality of life, inability of individuals to influence events occurring in their neighborhood, female gender and, marginally, lack of alcohol dependence in the past 12 months. Emotional problems were the most significant determinant of healthcare service utilization. Frequent visits with healthcare professionals were more likely associated with major depression and number of MD with or without dependence to alcohol or drugs. People suffering from major depression, psychological distress and social phobia were more likely to consult different professionals, while individuals with panic disorders relied on their family physician only. Concerning social phobia, panic disorders and psychological distress, more frequent visits with professionals did not translate into involvement of a higher number of professionals or vice-versa.
This study demonstrates the impact of emotional problems, neighborhood characteristics and legal problems in healthcare service utilization for MHR. Interventions based on inter-professional collaboration could be prioritized to increase the ability of healthcare services to take care especially of individuals suffering from social phobia, panic disorders and psychological distress. Others actions that could be prioritized are training of family physicians in the treatment of MD, use of psychiatric consultants, internet outreach, and reimbursement of psychological consultations for individuals with low income.
BMC Health Services Research 04/2014; 14(1):161. DOI:10.1186/1472-6963-14-161 · 1.71 Impact Factor
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