Determinants and patterns of service utilization and recourse to professionals for mental health reasons

BMC Health Services Research

Jean Caron¹  Jean-Marie Bamvita²  Guy Grenier²  Marie-Josée Fleury² 

[1]Department of Psychiatry, McGill University, Douglas Hospital Research Centre, 6875 LaSalle Blvd, Montreal, Quebec H4H 1R3, Canada

[2]Douglas Hospital Research Centre, Montreal, Quebec H4H 1R3, Canada

关键词: Professionals;    Determinants;    Mental health;    Service utilization;   

Others  :  1132750
DOI  :  10.1186/1472-6963-14-161

 received in 2013-11-14, accepted in 2014-03-25,  发布年份 2014

【 摘 要 】

Background

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.

Methods

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.

Results

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.

Conclusions

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.

【 授权许可】

   
2014 Fleury et al.; licensee BioMed Central Ltd.

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