Identifying and measuring service use data for youth in need of mental health care

2011 ◽  
Vol 38 (S 01) ◽  
Author(s):  
M Woolderink ◽  
A Paulus ◽  
S Evers
2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D C Fuhr ◽  
C Ataturk ◽  
M McGrath ◽  
Z Ilkkursun ◽  
A Woodward ◽  
...  

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.


Author(s):  
Andrea Tortelli ◽  
Florence Perquier ◽  
Maria Melchior ◽  
François Lair ◽  
Fabien Encatassamy ◽  
...  

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.


2009 ◽  
Vol 24 (4) ◽  
pp. 216-224 ◽  
Author(s):  
Dirk Heider ◽  
Sebastian Bernert ◽  
Hans-Helmut König ◽  
Herbert Matschinger ◽  
Theresa Hogh ◽  
...  

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.


2020 ◽  
Vol 63 (1) ◽  
Author(s):  
N. Stulz ◽  
W. Kawohl ◽  
M. Jäger ◽  
S. Mötteli ◽  
U. Schnyder ◽  
...  

Abstract Background In line with previous findings, in a recent randomized controlled trial (RCT), we found that home treatment (HT) for acute mental health care can reduce (substitute) hospital use among severely ill patients in crises. This study examined whether the findings of the RCT generalize to HT services provided under routine care conditions. Methods We compared patients who received HT during the RCT study phase with patients who received the same HT service after it had become part of routine mental health services in the same catchment area. Sociodemographic and clinical characteristics as well as service use (HT and hospital bed days) were compared between the RCT and the subsequent routine care study period. Results Compared to patients who received HT during the RCT, routine care HT patients were more often living with others, less often admitted compulsorily, more often diagnosed with anxiety and stress-related disorders (ICD-10 F4) and less often diagnosed with schizophrenia spectrum disorders (F2). When compared to patients who were exclusively treated on hospital wards, involvement of the HT team in patients’ care was associated with a clear-cut reduction of hospital bed days both during the RCT and under routine care conditions. However, unlike during the RCT study period, involvement of HT was associated with longer overall treatment episodes (inpatient + HT days) under routine care conditions. Conclusions HT seems to reduce the use of hospital bed days even under routine care conditions but is at risk of producing longer overall acute treatment episodes.


CNS Spectrums ◽  
2005 ◽  
Vol 10 (2) ◽  
pp. 132-140 ◽  
Author(s):  
Fran H. Norris ◽  
Margarita Alegria

ABSTRACTFindings from research on psychiatric epidemiology, disaster effects, discrepancies in service use, and cross-cultural psychology are reviewed to generate guidelines for culturally responsive postdisaster interventions. Ethnicity and culture influence mental health care at various points: on need for help; on availability and accessibility of help; on help-seeking comfort (stigma, mistrust), and on the probability that help is provided appropriately. There are aspects of disaster mental health practice that may ameliorate many of barriers that contribute to ethnic disparities in service use. It is proposed that interventions should give greater attention to socially engaged emotions and functioning. To promote disaster recovery, practitioners are advised to: assess community needs early and often; provide easily accessible services; work collaboratively and proactively to reduce stigma and mistrust and engage minorities in care; validate and normalize distress and help-seeking; value interdependence as well as independence as an appropriate developmental goal; promote community action; and advocate for, facilitate, or conduct treatment and evaluation research. Notwithstanding the pain and stress they cause, disasters create opportunities to de-stigmatize mental health needs and build trust between providers and minority communities.


2009 ◽  
Vol 60 (8) ◽  
pp. 1051-1058 ◽  
Author(s):  
Miquel Codony ◽  
Jordi Alonso ◽  
Josué Almansa ◽  
Sebastian Bernert ◽  
Giovanni de Girolamo ◽  
...  

2013 ◽  
Vol 64 (9) ◽  
pp. 863-870 ◽  
Author(s):  
Lian-Yu Chen ◽  
Rosa M. Crum ◽  
Silvia S. Martins ◽  
Christopher N. Kaufmann ◽  
Eric C. Strain ◽  
...  

1997 ◽  
Vol 170 (4) ◽  
pp. 317-320 ◽  
Author(s):  
M. J. Commander ◽  
S. P. Sashi Dharan ◽  
S. M. Odell ◽  
P. G. Surtees

BackgroundIn addition to clinical and service factors, planners need to take account of the influence of demographic variables, especially ethnicity, on access to mental health care.MethodEstimated prevalence rates were calculated from epidemiological surveys undertaken in three settings: psychiatric services, primary care and the general population. Associations between demographic factors and service use were examined using the pathways to care model.ResultsConsiderable differences in access to mental health care were found, particularly according to ethnicity. The major impediment to Asians accessing care occurred at the interface between primary and secondary care, whereas the most striking feature for Blacks was the poor level of case recognition by GPs.ConclusionsIn order to improve the uptake of mental health care, new initiatives should target those who are most likely to be unwell but least likely to access services. Purchasers and providers need to address differential patterns of use when developing and reviewing services.


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