1.58 Clinical Characteristics and Service Use in Two Federally Qualified Health Care Centers With Embedded Mental Health Teams

Abstract Introduction Turkey hosts the highest number of Syrian refugees in Europe. Refugees are often vulnerable to situational forms of psychosocial distress as a consequence of exposure to war and violence which may result in more profound mental health problems if no treatment is sought. The aim of this study is to report evidence on mental health and psychosocial support (MHPSS) needs, access and barriers to MHPSS care among Syrians refugees living in Istanbul, Turkey. Methods A cross-sectional survey was conducted among Syrian refugees aged 18 years or over in Istanbul (Sultanbeyli) between February and May 2018. Data among 1’678 Syrian refugees were collected on mental health outcomes using the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) and the Hopkins Symptoms Checklist (HSCL-25) for depression and anxiety. We also collected data on health care utilization, barriers to seeking and continuing care as well as knowledge and attitudes towards mental health. Descriptive analyses were used. Results The prevalence of PTSD, depression and anxiety was 19.6%, 34.7% and 36.1% respectively. The treatment gap was 89% for PTSD, 90% for anxiety and 88% for depression. 249 respondents (15%) screened positive for either PTSD, depression or anxiety in our survey and self-reported emotional/behavioural problems since arriving in Sultanbeyli. Several structural and attitudinal barriers for not seeking care were reported. Conclusions To overcome the treatment gap, mental health care programmes need to be more responsive to the needs of Syrian refugees. Barriers to seeking and continuing care can be overcome by providing MHPSS services in the community which facilitate access to care. Community-based programmes of care should be supported by activities which increase awareness about mental health issues and tackle negative attitudes towards mental illness. Key messages This study provides the first nationally representative data on the mental health of Syrian refugees in Turkey, and shows that refugees have high mental health needs. Syrian refugees do not seek mental health care despite availability of mental health services in the community.

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Decreased mental health care utilization following a psychosocial intervention in caregivers of hematopoietic stem cell transplant patients

Mental Illness ◽

10.1108/mi.2014.5120 ◽

2014 ◽

Vol 6 (1) ◽

pp. 9-13

Author(s):

Rita Ouseph ◽

Calvin Croy ◽

Crystal Natvig ◽

Teresa Simoneau ◽

Mark L. Laudenslager

Keyword(s):

Mental Health ◽

Health Care ◽

Support Group ◽

Service Use ◽

Hematopoietic Stem Cell Transplant ◽

Stem Cell Transplant ◽

Care Utilization ◽

Cell Transplant ◽

Hematopoietic Stem ◽

Transplant Patients

Caregivers are known to experience increased morbidity when compared to noncaregivers. Does an intervention targeting caregiver distress affect their health care utilization? One hundred forty-eight caregivers of allogeneic hematopoietic stem cell transplant patients were randomized to treatment as usual (TAU) or a psychoeducation, paced respiration, and relaxation (PEPRR) intervention. Assessments of caregivers' service utilization were collected at baseline and 1, 3, and 6 months post-transplant. During the first 30 days after patient transplant, caregiver medical and mental health professional service use decreased while support group attendance peaked. Mixed model regressions showed a significant decrease in mental health service use by the PEPRR group (P=0.001). At six months caregivers in TAU had predicted marginal probabilities of mental health services utilization over 10 times as high as caregivers in PEPRR (18.1% vs 1.5%). Groups failed to differ in medical service (P=0.861) or support group (P=0.067) use. We can conclude that participation in PEPRR compared to TAU was associated with reduced mental health service utilization. Caregiver psychosocial support services are critical to improve caregiver outcomes.

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Anxiety disorders in a public mental health system: Clinical characteristics and service use patterns

Journal of Affective Disorders ◽

10.1016/j.jad.2007.02.021 ◽

2007 ◽

Vol 104 (1-3) ◽

pp. 179-183 ◽

Cited By ~ 2

Author(s):

Julie Loebach Wetherell ◽

Daniel S. Kim ◽

Laurie A. Lindamer ◽

Steven R. Thorp ◽

William Hawthorne ◽

...

Keyword(s):

Mental Health ◽

Anxiety Disorders ◽

Health System ◽

Mental Health System ◽

Clinical Characteristics ◽

Service Use ◽

Public Mental Health ◽

Public Mental Health System ◽

Use Patterns

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Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249397 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9397

Author(s):

Andrea Tortelli ◽

Florence Perquier ◽

Maria Melchior ◽

François Lair ◽

Fabien Encatassamy ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Asylum Seekers ◽

Service Use ◽

Pathways To Care ◽

Treatment Level ◽

Stable Housing ◽

Increased Risk ◽

Provision Of Care

Background: Migrants, and particularly asylum seekers, are at increased risk of psychiatric disorders in comparison with natives. At the same time, inequalities in access to mental health care are observed. Methods: In order to evaluate whether the Parisian public psychiatric system is optimally structured to meet the needs of this population, we examined data on mental health and service use considering three different levels: the global system treatment level, a psychiatric reception center, and mobile teams specializing in access to psychiatric care for asylum seekers. Results: We found higher treatment rates among migrants than among natives (p < 0.001) but inequalities in pathways to care: more mandatory admissions (OR = 1.36, 95% CI: 1.02–1.80) and fewer specialized consultations (OR = 0.56, 95% CI: 0.38–0.81). We observed a mismatch between increased need and provision of care among migrants without stable housing or seeking asylum. Conclusions: Inequalities in the provision of care for migrants are observed in the Parisian public psychiatric system, particularly for those experiencing poor social and economic conditions. There is a need to facilitate access to mental health care and develop more tailored interventions to reduce discontinuity of care.

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eMental health service use among Australian youth: a cross-sectional survey framed by Andersen's model

Australian Health Review ◽

10.1071/ah19095 ◽

2020 ◽

Vol 44 (6) ◽

pp. 891

Author(s):

Teghan Leech ◽

Diana S. Dorstyn ◽

Wenjing Li

Keyword(s):

Mental Health ◽

Health Care ◽

Young Adults ◽

Help Seeking ◽

Service Use ◽

Information Services ◽

The Internet ◽

Online Support ◽

Online Help ◽

Mental Health Information

ObjectiveYoung adults aged 18–24 years often delay or avoid seeking help for their mental health concerns. eMental health, the use of the Internet to deliver mental health information, services and care, offers a low-cost, easy-access option. However the factors that influence online help-seeking among this cohort remain unclear. MethodsAndersen’s healthcare utilisation model was adapted to examine correlates of eMental health use among Australian youth. In all, 161 young adults completed an online survey comprising sociodemographic questions, online feature preferences, the Actual and General Help-seeking Questionnaires, Berkman–Syme Social Network Index, General Self-Efficacy Scale, Service Obstacles Scale and Depression, Anxiety and Stress Scales. ResultsAlmost 70% of young people reported having previously accessed some form of online support for their personal or emotional problems. This included informal information via social media and formalised counselling services. Notably, perception of service satisfaction was low. Hierarchical logistical regression identified two significant predisposing factors to subsequent online help-seeking: prior face-to-face service use and living or cohabitating with others. ConclusionseMental health is accessed by young people in Australia, yet more needs to be done to better integrate this service model into the healthcare system. This includes training and education for consumers and professionals about existing, effective programs. What is known about this topic?eMental health platforms can bridge the gap between technology and conventional mental health care. Despite its rapidly expanding evidence base, the implementation of eMental health into the Australian healthcare system remains slow. More work needs to be done to elucidate the factors underlying preferences for online help-seeking. What does this paper add?Young adult perspectives on the delivery of mental health information, services and care via the Internet are examined in accordance with a major conceptual model, namely Andersen’s behavioural model of health services use. The majority of those surveyed reported having accessed some form of online support for an emotional issue, although dissatisfaction with the quality of this support was expressed. Andersen’s model can guide future research in this area and potentially help target eMental health initiatives to individual service users’ needs. What are the implications for practitioners?eMental health interventions offer an alternative for young adults who have difficulty accessing traditional mental health care services, but are also an adjunct to those experiencing mild to moderate symptoms of mental illness. Practitioners can introduce young adults to eMental health by discussing the benefits and limitations and by providing information about available and secure online programs delivered by trusted service providers.

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Direct medical mental health care costs of schizophrenia in France, Germany and the United Kingdom – Findings from the European Schizophrenia Cohort (EuroSC)

European Psychiatry ◽

10.1016/j.eurpsy.2008.12.013 ◽

2009 ◽

Vol 24 (4) ◽

pp. 216-224 ◽

Cited By ~ 21

Author(s):

Dirk Heider ◽

Sebastian Bernert ◽

Hans-Helmut König ◽

Herbert Matschinger ◽

Theresa Hogh ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

United Kingdom ◽

Mental Health Care ◽

Service Use ◽

Unit Cost ◽

United States Dollar ◽

The United Kingdom ◽

Day Clinic ◽

Use Of Services

AbstractObjectivesTo quantify and compare the resource consumption and direct costs of medical mental health care of patients suffering from schizophrenia in France, Germany and the United Kingdom.MethodsIn the European Cohort Study of Schizophrenia, a naturalistic two-year follow-up study, patients were recruited in France (N = 288), Germany (N = 618), and the United Kingdom (N = 302). Data about the use of services and medication were collected. Unit cost data were obtained and transformed into United States Dollar Purchasing Power Parities (USD-PPP). Mean service use and costs were estimated using between-effects regression models.ResultsIn the French/German/UK sample estimated means for a six-month period were respectively 5.7, 7.5 and 6.4 inpatient days, and 11.0, 1.3, and 0.7 day-clinic days. After controlling for age, sex, number of former hospitalizations and psychopathology (CGI score), mean costs were 3700/2815/3352 USD-PPP.ConclusionsService use and estimated costs varied considerably between countries. The greatest differences were related to day-clinic use. The use of services was not consistently higher in one country than in the others. Estimated costs did not necessarily reflect the quantity of service use, since unit costs for individual types of service varied considerably between countries.

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Socioeconomic status and primary health service use for mental health problems among immigrants with short and long lengths of stay

International Journal of Migration Health and Social Care ◽

10.1108/ijmhsc-01-2015-0001 ◽

2016 ◽

Vol 12 (2) ◽

pp. 85-98 ◽

Cited By ~ 1

Author(s):

Melanie Lindsay Straiton ◽

Anne Reneflot ◽

Esperanza Diaz

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Services ◽

Service Use ◽

Mental Health Problems ◽

Health Problems ◽

Content Type ◽

Care Services ◽

Primary Health ◽

The Relationship

Purpose – High socioeconomic status (SES) is associated with better health and lower use of health care services in the general population. Among immigrants, the relationship appears less consistent. The purpose of this paper is to determine if the relationship between income level (a proxy for SES) and use of primary health care services for mental health problems differs for natives and five immigrant groups in Norway. It also explores the moderating effect of length of stay (LoS) among immigrants. Design/methodology/approach – Using data from two registers with national-level coverage, logistic regression analyses with interactions were carried out to determine the association between income level and having used primary health care services for mental health problems. Findings – For Norwegian men and women there was a clear negative relationship between income and service use. Interaction analyses suggested that the relationship differed for all immigrant groups compared with Norwegians. When stratifying by LoS, income was not associated with service use among recently arrived immigrants but was negatively associated among immigrants staying more than two years (with the exception of Pakistani and Iraqi women). Research limitations/implications – Country of origin and LoS should be considered when applying measures of SES in immigrant health research. Social implications – There may be an initial transition period for recently arrived immigrants where competing factors mask the association between SES and service use. Originality/value – This study benefits from nationwide coverage, eliminating self-selection biases. It demonstrates the complexity of the relationship between SES and health care use.

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Knowledge and Attitude of Family Doctors Regarding the Provision of Psychological Health Care in Primary Health Care Centers in Baghdad Al-Karkh

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v17i1.230 ◽

2021 ◽

Vol 17 (1) ◽

pp. 19-25

Author(s):

Hassanein M. Joudah ◽

Reem J. Al Haydari ◽

Sally Alaa Witwit

Keyword(s):

Mental Health ◽

Health Care ◽

Psychological Health ◽

Care Center ◽

Family Health ◽

Family Doctors ◽

Health Care Center ◽

Knowledge And Attitudes ◽

Knowledge And Attitude ◽

Health Care Centers

Background: Mental health is integrated into PHC as a strategy of WHO to fill the gap in mental health treatment. Part of this strategy needs a level of task shifting so that mental health care is provided by different level of PHC workers and not only specialists such as psychiatrists and psychologists. Objectives: To assess the knowledge and attitudes of family doctors regarding the provision of psychological health in PHCC and if there is an association between the certificates of these family doctors and their Knowledge and attitudes to psychological health. Subjects and Methods: A cross-sectional descriptive study with analytic elements was conducted in 8 family health care centers in Baghdad city/Al-Karkh. Data was collected via questionnaire form which consists of three domains: Domain one includes sociodemographic data, domain two was about knowledge and consists of (7) questions and domain three consisted of (12) questions about the attitude of physicians regarding mental health. A convenient sample of (83) family health care physicians were included in the current study. Results: The mean age of participants was 42 years (range: 27 – 53). The results revealed that 22.9% of participants were male, 77.1% were female. The percentage of mental illness seen by the physicians daily in the health care center was (15.7%). Physicians with higher degree certificates obtained higher knowledge scores in comparison to residents or practitioners as well as the females reported a significantly higher score of knowledge in comparison to males. Moreover, higher scores of positive attitudes were found. Conclusion: Family Physicians with higher certificates have more knowledge and attitude than other certificates.

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