Religious advisors' role in mental health care in the European Study of the Epidemiology of Mental Disorders survey

EA 4069, Université Paris Descartes, Paris, France.
Social Psychiatry (Impact Factor: 2.54). 10/2009; 45(10):989-98. DOI: 10.1007/s00127-009-0143-0
Source: PubMed


To study the role of religious advisors in mental health problems in six European countries and to compare it to data from the USA.
Data were derived from the European Study of the Epidemiology of Mental Disorders (ESEMeD) study, a cross-sectional study, conducted in Belgium, France, Germany, Italy, the Netherlands and Spain. 21,425 individuals, 18 and older, were interviewed with the Composite International Diagnostic Interview 3.0. Findings were compared to the National Comorbidity Survey (NCS) and replication of the NCS (NCS-R) in the US.
In ESEMeD, 0.6% of individuals (0.3% exclusively) sought help from religious advisors concerning mental health problems during the previous year, compared to 2.6% in NCS and 3.4% (for human services) in NCS-R in the US. Among those using any form of service, 6.9% consulted religious advisors (12.2% in Germany to 2.1% in Spain) compared to 18.8% in the US. Being younger (less than 25 years old), being older (more than 64) and religiosity are associated with the use of religious advisors, whereas being a student is associated with a lower probability.
Seeking help from religious advisors for mental health problems varies dramatically among ESEMeD countries. Except for Germany, organised religion in the ESEMeD countries could not be considered as an alternative.

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Available from: Xavier Briffault, Dec 16, 2014
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    • "There is some international evidence about non-specialist sources of care such as religious advisors [31] or self care [32]. Verhaak et al. [33] note that patients may not recognise that their problems have a mental health origin or may question the effectiveness of their providers. "
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    ABSTRACT: Background The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. Methods A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. Results The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose–response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. Conclusions An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for such problems compared with data from metropolitan centres. Using a measure of Provisional Service Need those with greater needs were more likely to access specialist services, even in remote regions, although a substantial proportion of those with the highest service need sought no professional help. Geographic and financial barriers to service use were identified and perception of service adequacy was relatively low, especially among those with the highest levels of distress and greatest adversity.
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    ABSTRACT: In certain countries, it is not uncommon to turn to professionals outside the conventional health care system for psychological problems. As this situation is not well documented in Europe, we assessed use of nonconventional care for mental health in 6 European countries. A cross-sectional survey was conducted in representative samples of noninstitutionalized adults in 6 European countries. Participants (n = 8796) completed a survey, which included, among other items, the Composite International Diagnostic Interview 3.0 and in-depth questions about lifetime consultations for mental health problems. Among the respondents (n = 2928) who reported having already sought help in their lifetime for psychological problems (20.0%), 8.6% turned to complementary and alternative medicine (CAM) providers, such as chiropractors and herbalists, and a similar proportion (8.4%) to religious advisers such as ministers, priests, or rabbis. Only a small proportion (2.9%) consulted only these professionals for their problems. CAM providers were more frequently used in the Netherlands (13.5%) and Germany (9.4%), while religious advisers were more often consulted in Italy (12.6%) and Germany (11.6%). Multivariate analyses confirmed differences between countries and revealed that people turning to religious advisers tended to be older, foreign born, and with alcohol problems, whereas those consulting CAM providers were younger, wealthier, and more frequently depressed. In Europe, patients who turn to CAM therapists and those who seek help from religious advisers for psychological problems are not exactly the same. In addition, these professionals are not consulted frequently in most countries, and are almost always associated with more traditional follow-up when used.
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