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

2016 ◽  
Vol 12 (2) ◽  
pp. 85-98 ◽  
Author(s):  
Melanie Lindsay Straiton ◽  
Anne Reneflot ◽  
Esperanza Diaz

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.

2005 ◽  
Vol 15 (2) ◽  
pp. 137-155 ◽  
Author(s):  
Debra Rickwood

AbstractFor young people still at school, the school setting is vital to their mental health and wellbeing. Not only does the school environment have a direct and indirect impact on mental health, it provides an opportunistic setting in which to identify and respond to emerging mental health problems. To do this effectively, schools and school staff must work in collaboration with the young people themselves, their families, and other support services within the community, particularly primary health care services, including general practice. The importance of developing effective partnerships and care pathways between schools and the primary health care sector is being increasingly acknowledged, and initiatives such as MindMatters Plus GP have advanced our understanding in this area.


2008 ◽  
Vol 123 (6) ◽  
pp. 768-780 ◽  
Author(s):  
Jeff J. Guo ◽  
Terrance J. Wade ◽  
Kathryn N. Keller

Objectives. School-based health centers (SBHCs) play an increasingly major role in providing mental health services for students. This study evaluated the impact of SBHCs on mental health-care services and psychosocial health-related quality of life (HRQOL). Methods. Four SBHC intervention and two matched non-SBHC school districts were examined from 1997 to 2003. The SBHC intervention began in 2000. Data included child and parent pediatric HRQOL and Ohio Medicaid claims. A longitudinal quasi-experimental time-series repeated measures design was used for this study, involving analysis of covariance to assess health costs and regression analyses for HRQOL scores. Results. After the SBHC program, proportions of students accessing mental health-care services for urban and rural SBHC intervention schools increased 5.6% (χ2=39.361, p<0.0001) and 5.9% (χ2=5.545, p<0.0001), respectively, compared with increases of 2.6% (χ2=2.670, p=0.1023) and 0.2% (χ2=0.006, p=0.9361) for urban and rural non-SBHC schools, respectively. Using data from 109 students with mental health problems based on Medicaid claims, the study found SBHC students had significantly lower total health-care costs (F=5.524, p=0.005) and lower costs of mental health services (F=4.820, p=0.010) compared with non-SBHC students. While improvements over time in HRQOL for SBHC students compared with non-SBHC students and students from non-SBHC schools were observed, only some were statistically significant. Conclusions. SBHC programs increase the proportion of students who receive mental health services and may improve pediatric HRQOL. SBHC students with mental health problems had lower total Medicaid reimbursements compared with non-SBHC students.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.


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