To estimate the 12 month and lifetime use of health services for mental health problems.
A nationwide face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are 12 month and lifetime health service use for mental health and substance use problems.
Of the population, 13.4% had a visit for a mental health reason in the 12 months before interview. Of all 12 month cases of mental disorder, 38.9% had a mental health visit to a health or non-health-care provider in the past 12 months. Of these 12 month cases, 16.4% had contact with a mental health specialist, 28.3% with a general medical provider, 4.8% within the human services sector and 6.9% with a complementary or alternative medicine practitioner. Most people with lifetime disorders eventually made contact if their disorder continued. However, the percentages seeking help at the age of onset were small for most disorders and several disorders had large percentages who never sought help. The median duration of delay until contact varies from 1 year for major depressive disorder to 38 years for specific phobias.
A significant unmet need for treatment for people with mental disorder exists in the New Zealand community, as in other comparable countries.
"Everyday functioning is significantly altered, and greater financial dependence on family and/or state resources makes SAD a societal burden
. Epidemiological data also reveal that only a small number of individuals seek and receive treatment for this condition
, as SAD sufferers can delay seeking treatment for 28 years
. Spontaneous remission of symptoms has been reported and is rare, and it is mainly by active interventions (psychological and pharmacological) that the course of SAD can be altered
[Show abstract][Hide abstract] ABSTRACT: Social anxiety disorder (SAD) is one of the most common anxiety disorders and is associated with marked impairments. However, a small proportion of individuals with SAD seek and receive treatment. Internet-administrated cognitive behavior therapy (iCBT) has been found to be an effective treatment for SAD. This trial will be the first Internet-delivered guided self-help intervention for SAD in Romania.
Participants with social anxiety disorder (N = 96) will be recruited via newspapers, online banners and Facebook. Participants will be randomized to either: a) an active treatment, or b) a waiting list control group.
The treatment will have a guided iCBT format and will last for nine weeks. Self-report questionnaires on social phobia, anxiety, depression, treatment credibility and irrational thinking will be used. All assessments will be collected pre, post and at follow-up (six months after intervention). Liebowitz Social Anxiety Scale – Self-Report version (LSAS-SR) will be the primary outcome measure and will be administrated on a weekly basis in both conditions.
The present randomized controlled trial investigates the efficacy of an Internet-administered intervention in reducing social anxiety symptoms in a culture where this form of treatment has not been tested. This trial will add to the body of knowledge on the efficacy of iCBT, and the results might lead to an increase of the accessibility of evidence-based psychological treatment in Romania.
"The community's lack of mental health literacy is concerning as the response that a drinker receives from their social network can have a substantial impact on their willingness to seek help . Being aware of when and how to encourage a drinker to seek appropriate help is an important community skill, especially as the majority of problem drinkers do not seek help . Not seeking help increases the harms associated with problem drinking, such as developing co-morbid physical and mental health problems . "
[Show abstract][Hide abstract] ABSTRACT: Background
Alcohol is a leading risk factor for avoidable disease burden. Research suggests that a drinker's social network can play an integral role in addressing hazardous (i.e., high-risk) or problem drinking. Often however, social networks do not have adequate mental health literacy (i.e., knowledge about mental health problems, like problem drinking, or how to treat them). This is a concern as the response that a drinker receives from their social network can have a substantial impact on their willingness to seek help. This paper describes the development of mental health first aid guidelines that inform community members on how to help someone who may have, or may be developing, a drinking problem (i.e., alcohol abuse or dependence).
A systematic review of the research and lay literature was conducted to develop a 285-item survey containing strategies on how to help someone who may have, or may be developing, a drinking problem. Two panels of experts (consumers/carers and clinicians) individually rated survey items, using a Delphi process. Surveys were completed online or via postal mail. Participants were 99 consumers, carers and clinicians with experience or expertise in problem drinking from Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States. Items that reached consensus on importance were retained and written into guidelines.
The overall response rate across all three rounds was 68.7% (67.6% consumers/carers, 69.2% clinicians), with 184 first aid strategies rated as essential or important by ≥80% of panel members. The endorsed guidelines provide guidance on how to: recognize problem drinking; approach someone if there is concern about their drinking; support the person to change their drinking; respond if they are unwilling to change their drinking; facilitate professional help seeking and respond if professional help is refused; and manage an alcohol-related medical emergency.
The guidelines provide a consensus-based resource for community members seeking to help someone with a drinking problem. Improving community awareness and understanding of how to identify and support someone with a drinking problem may lead to earlier recognition of problem drinking and greater facilitation of professional help seeking.
"making treatment contact for that disorder at the age at which their symptoms first developed although eventually almost all made treatment contact if their symptoms continued (median delay of treatment seeking of 7 years)(Oakley Browne et al., 2006). Similar results have been found in a US national survey with 20.7% of those with alcohol dependence making treatment contact at the age of onset and 69.8% eventually making contact with a median delay of 6 years (Wang et al., 2005a). "
[Show abstract][Hide abstract] ABSTRACT: To investigate reasons for seeking or not seeking help for alcohol problems in young adults and to report outcomes in those with problems who thought they did not need help.
A total of 1003 members of a birth cohort were interviewed at age 25 about the period since the previous interview at age 21. DSM-IV diagnoses were made from reports of alcohol problems over the previous 4 years. Treatment contact for drinking or problems associated with drinking and reasons for seeking or not seeking help were reported. Alcohol consumption was reported for the year before interview.
Alcohol-specific treatment contact was uncommon: 26 of 351 with any alcohol problems made contact (7%). Even in the subgroup with alcohol dependence, only 24% made contact (13/55). Most (19/26) sought treatment because they felt they needed it. Of those with problems who did not seek help or advice, nearly all (96%) thought they did not need help. Approximately one-quarter thought the problem would get better by itself (29%) or did not think to seek help (25%). No more than 5% reported any other attitudinal or practical reason. Outcomes in the year before interview for those who thought they did not need help showed that 75% continued to experience problems and almost all drank well above guidelines at least on their heaviest drinking occasion. Only 43% had attempted to quit or cut down on their drinking.
Alcohol-related problems were experienced by approximately one-third of these young adults but treatment contact for these problems was uncommon. Belief in ability to handle problems oneself was often not matched by action.
Australian and New Zealand Journal of Psychiatry 01/2008; 41(12):1005-12. DOI:10.1080/00048670701691218 · 3.41 Impact Factor
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