Mental disorders and referrals to mental health specialists by general practitioners

1999 ◽  
Vol 34 (3) ◽  
pp. 128-135 ◽  
Author(s):  
K. W. Sørgaard ◽  
I. Sandanger ◽  
T. Sørensen ◽  
G. Ingebrigtsen ◽  
O. S. Dalgard
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
General Practitioners

Workforce Deployment: Reconciling Demands and Resources

1995 ◽  
Vol 29 (3) ◽  
pp. 394-402 ◽  
Author(s):  
Gavin Andrews
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
General Practitioners ◽  
Unmet Need ◽  
Public Mental Health ◽  
Epidemiological Data ◽  
Mental Illnesses ◽  
National Mental Health

Objective: The purpose of the study was to review the information in a Consultancy prepared for the National Mental Health Policy which suggested that half of the people with serious mental illnesses were untreated, while persons with “mental problems” were being overserviced by the specialist mental health services. The fate of the large group of persons with mental disorders of mid-range severity was not addressed. Method: Epidemiological data was reconciled with the service patterns of the clinical workforce and the extent of the unmet need estimated. Results: It was estimated that 25–30% of the Australian population meet criteria for a mental disorder in any year, yet less than one third will receive treatment. Of those that are treated, three quarters will receive their treatment from general practitioners and the remaining quarter will be treated by either the public mental health services, the addiction services, or private psychiatrists. The problem is that less than one half of those with serious mental disorders and only two thirds of those with chronic and disabling disorders appear to be being treated by anyone. Even if there were no slippage of services away from these serious and chronic groups of patients, there would still be a workforce shortfall, especially in rural and remote areas. Conclusions: Strategies to remedy this shortfall that involve psychiatrists, clinical psychologists and general practitioners are noted, and the need for a National Mental Health Survey to provide accurate data is stressed.

Mental Disorders and Burden of Disease: How was Disability Estimated and is It Valid?

2001 ◽  
Vol 35 (5) ◽  
pp. 668-676 ◽  
Author(s):  
Kristy Sanderson ◽  
Gavin Andrews
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
General Practitioners ◽  
Burden Of Disease ◽  
Rating Scale ◽  
Rank Order ◽  
Mental Health Policy ◽  
Health States ◽  
Trade Off ◽  
Disability Weights

Objective: The Global Burden of Disease study found mental disorders to be the world's leading cause of disability. Few studies have examined the validity of the novel approach used to estimate disability, the person trade-off preference method. This paper describes, and examines the validity of, the burden of disease person trade-off protocol. Method: The person trade-off provides preferences for health states (how good or bad you think it is in relation to perfect health). General practitioners (n = 20) with training in mental health provided preferences for 19 mental disorders using the person trade-off method. Descriptions for the mental disorders were derived from the average symptom severity and disability observed in the Australian National Survey of Mental Health and Wellbeing. Validity was investigated by comparison with two other methods (rating scale and rank order). Results: The general practitioners found the person trade-off complex and affronting. Only a moderate concordance was observed with two validity comparisons, however, validity was significantly increased following the opportunity for group discussion among the clinicians. The disability weights were higher than those used in the global study, a possible consequence of differences in disorder descriptions. Conclusions: The present study is limited by small subject numbers and by using only one type of key informant (clinicians). While this study provided some evidence for the validity of the person trade-off, it also echoes concerns from recent commentaries about the feasibility of this method. These concerns are particularly relevant for mental disorder burden, which relies heavily on the magnitude of the disability weights. Further work is required to ensure that disability burden is validly estimated, and thus can appropriately be used to inform mental health policy.

E-health responses to common mental disorders in primary care: experiences with Ębeyondblue‘ and ĘSPHERE’

2002 ◽  
Vol 10 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Ian Hickie ◽  
Tracey Davenport ◽  
Elizabeth Scott ◽  
Hugh Morgan
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Health Systems ◽  
General Practitioners ◽  
Support System ◽  
Common Mental Disorders ◽  
Web Based

Objective: To highlight opportunities for enhancing mental health services in primary care through utilisation of e-health systems. Specifically, an information-based website (provided by ‘beyondblue: the national depression initiative’) and a web-based support system for general practitioners (provided by ‘SPHERE: a national depression project’) are described. Conclusions: Recommendations regarding potential roles for e-health systems in association with Australian primary care are outlined.

Agreement on diagnoses of mental disorder in the primary health care of Turku, Finland

1995 ◽  
Vol 10 (1) ◽  
pp. 11-16 ◽  
Author(s):  
V Lehtinen ◽  
M Joukamaa ◽  
H Karlsson ◽  
E Rouhe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Mental Disorder ◽  
General Practitioners ◽  
Health Centre ◽  
Mental Health Issue ◽  
Psychiatric Interview ◽  
Primary Health

SummaryPrimary health care is in the central position in the general sphere of mental health services. This article deals with, as a part of a joint Nordic project, the occurrence of mental disorders of patients in primary health care as based on the material (n = 1,000) collected in the health centre of Turku. The relation of the occurrence of mental disorders as diagnosed by means of a standardized psychiatric interview method (PSE) to the disorders, recognized by general practitioners (GPs) working in the health centre is also observed. It was found that one fourth of the patients had a clear mental disorder that required treatment, while studies in the general population, using the same method, reveal only 10% as having some kind of mental disorder. Three quarters of the evident mental disorders recognized by GPs were diagnosed as such also by the PSE, but the GPs were capable of recognizing only 43% of the cases identified by the PSE. On the basis of these results, the importance of the mental health issue in the basic and postgraduate training of the general practitioners must be emphasized.

scholarly journals Typology of patients who use emergency departments for mental and substance use disorders

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Marie-Josée Fleury ◽  
Guy Grenier ◽  
Jean-Marie Bamvita ◽  
Francine Ferland
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Substance Use ◽  
Mental Disorders ◽  
Health Service ◽  
Substance Use Disorders ◽  
General Practitioners ◽  
Emergency Departments ◽  
Enabling Factors ◽  
Emergency Department Use

Background Identifying profiles of people with mental and substance use disorders who use emergency departments may help guide the development of interventions more appropriate to their particular characteristics and needs. Aims To develop a typology for the frequency of visits to the emergency department for mental health reasons based on the Andersen model. Method Questionnaires were completed by patients who attended an emergency department (n = 320), recruited in Quebec (Canada), and administrative data were obtained related to sociodemographic/socioeconomic characteristics, mental health diagnoses including alcohol and drug use, and emergency department and mental health service utilization. A cluster analysis was performed, identifying needs, predisposing and enabling factors that differentiated subclasses of participants according to frequency of emergency department visits for mental health reasons. Results Four classes were identified. Class 1 comprised individuals with moderate emergency department use and low use of other health services; mostly young, economically disadvantaged males with substance use disorders. Class 2 comprised individuals with high emergency department and specialized health service use, with multiple mental and substance use disorders. Class 3 comprised middle-aged, economically advantaged females with common mental disorders, who made moderate use of emergency departments but consulted general practitioners. Class 4 comprised older individuals with multiple chronic physical illnesses co-occurring with mental disorders, who made moderate use of the emergency department, but mainly consulted general practitioners. Conclusions The study found heterogeneity in emergency department use for mental health reasons, as each of the four classes represented distinct needs, predisposing and enabling factors. As such, interventions should be tailored to different classes of patients who use emergency departments, based on their characteristics.

The WHO World Mental Health (WMH) Surveys

2009 ◽  
Vol 06 (01) ◽  
pp. 5-9 ◽  
Author(s):  
S. Aguilar-Gaxiola ◽  
J. Alonso ◽  
S. Chatterji ◽  
S. Lee ◽  
T. B. Üstün ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Treatment Effectiveness ◽  
Age Of Onset ◽  
Common Mental Disorders ◽  
Mental Health Policy ◽  
Unmet Need ◽  
Cost Effective ◽  
World Mental Health ◽  
Prevalence Estimates

SummaryThe paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.

A descriptive study of the prevalence of psychological distress and mental disorders in the Canadian population: comparison between low-income and non-low-income populations

2010 ◽  
Vol 30 (3) ◽  
pp. 148-149 ◽  
Author(s):  
J. Caron ◽  
A. Liu
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Psychological Distress ◽  
Mental Disorders ◽  
Low Income ◽  
Well Being ◽  
Descriptive Study ◽  
Canadian Community Health Survey ◽  
Vulnerable Groups ◽  
High Psychological Distress

Objective This descriptive study compares rates of high psychological distress and mental disorders between low-income and non-low-income populations in Canada. Methods Data were collected through the Canadian Community Health Survey – Mental Health and Well-being (CCHS 1.2), which surveyed 36 984 Canadians aged 15 or over; 17.9% (n = 6620) was classified within the low-income population using the Low Income Measure. The K-10 was used to measure psychological distress and the CIDI for assessing mental disorders. Results One out of 5 Canadians reported high psychological distress, and 1 out of 10 reported at least one of the five mental disorders surveyed or substance abuse. Women, single, separated or divorced respondents, non-immigrants and Aboriginal Canadians were more likely to report suffering from psychological distress or from mental disorders and substance abuse. Rates of reported psychological distress and of mental disorders and substance abuse were much higher in low-income populations, and these differences were statistically consistent in most of the sociodemographic strata. Conclusion This study helps determine the vulnerable groups in mental health for which prevention and promotion programs could be designed.

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