Determinants of treatment non-attendance among those referred to primary mental health care services in Western Sydney, Australia: a retrospective cohort study

ObjectivesRecommendations of the recent mental health reforms provided an opportunity to implement regional approaches to service provision through Primary Health Networks. This study is designed to identify the determinants of sociodemographic, diagnostic and referral-level factors and first treatment session non-attendance among those referred to primary mental health care (PMHC) services in Western Sydney, Australia.DesignThis study used routinely collected retrospective PMHC data between July 2016 and December 2018.SettingThe study was based on a geographical catchment that covers four local government areas of Blacktown, Parramatta, Cumberland and Hills Shire in Western Sydney, Australia.ParticipantsAll individuals 5 years of age or older referred to PMHC services.Primary outcome measureFirst treatment session non-attendance, following a referral to receive psychological treatments.ResultsThere were 9158 referrals received for 8031 clients, with 1769 (19.32%) referrals resulting in non-attendance to the first treatment session. Those with younger age (ORs ranging from 1.63 to 1.92), substance use (OR=1.55, 95% CI 1.17 to 2.06), poor English proficiency (OR=1.64, 95% CI 1.23 to 2.20), lower socioeconomic status (OR=1.57, 95% CI 1.34 to 1.83), psychotropic medication use (OR=1.20, 95% CI 1.06 to 1.36), and a referral by a social worker (OR=2.04, 95% CI 1.36 to 3.05), allied health (OR=1.49, 95% CI 1.03 to 2.16) or other professional (OR=1.72, 95% CI 1.30 to 2.29) were associated with a higher likelihood of first treatment session non-attendance. Those with a risk of suicide, who mainly speak a language other than English, and a previous use of PMHC services were more likely to attend their first treatment session.ConclusionYouth-specific treatment approaches, behavioural engagement strategies, facilitation of transport services for those live in deprived regions and improvements in capacity for mental health training among allied health professionals are areas of focus for primary care service and policy responses.

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Anxious and depressed women's experiences of emotional suffering and help seeking in a Rio de Janeiro favela

Ciência & Saúde Coletiva ◽

10.1590/1413-81232017221.11732016 ◽

2017 ◽

Vol 22 (1) ◽

pp. 75-86 ◽

Cited By ~ 2

Author(s):

Karen Athié ◽

Christopher Dowrick ◽

Alice Lopes do Amaral Menezes ◽

Luanda Cruz ◽

Ana Cristina Lima ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Help Seeking ◽

Rio De Janeiro ◽

Care Service ◽

Framework Analysis ◽

Community Based ◽

Social Rules ◽

Primary Mental Health Care

Abstract Taking into consideration issues such as stigma and the mental health gap, this study explores narratives of anxious and depressed women treated in a community-based primary care service in a Rio de Janeiro favela about their suffering and care. We analysed 13 in-depth interviews using questions from Kadam's study. Framework analysis studied Access, Gateway, Trust, Psychosocial Issues, and Primary Mental Health Care, as key-concepts. Vulnerability and accessibility were the theoretical references. Thematic analysis found “suffering category”, highlighting family and community problems, and “help seeking category”, indicating how these women have coped with their emotional problems and addressed their needs through health services, community resources and self-help. Women's language patterns indicated links between implicit social rules and constraints to talk about suffering, especially if related to local violence. High medical turnover and overload are barriers for establishing a positive relationship with family physicians and continuity of care is a facilitator that promotes trust, security and adherence. Concluding, to plan community-based primary mental health care of this population, cultural and social factors must be comprehended as well as the work health teams conditions.

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Guest Editorial: Primary mental health care: Service delivery and the impact on the workforce

Journal of Primary Health Care ◽

10.1071/hc09094 ◽

2009 ◽

Vol 1 (2) ◽

pp. 94

Author(s):

Helen Rodenburg ◽

Tony Dowell ◽

Kathy James

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Guest Editorial ◽

Care Service ◽

Health Care Service ◽

Mental Health Care Service ◽

Primary Mental Health Care ◽

The Impact ◽

Health Care Service Delivery

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Determinants of treatment disengagement among those at risk of suicide referred to primary mental health care services in Western Sydney, Australia

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867420963738 ◽

2020 ◽

pp. 000486742096373

Author(s):

Sithum Munasinghe ◽

Andrew Page ◽

Haider Mannan ◽

Shahana Ferdousi ◽

Brendan Peek

Keyword(s):

Mental Health ◽

Health Care ◽

At Risk ◽

Mental Health Care ◽

Early Treatment ◽

Health Care Services ◽

Treatment Cessation ◽

Care Services ◽

Primary Mental Health Care ◽

Sydney Australia

Objective: Continued engagement with primary mental health services has been associated with the prevention of subsequent suicidal behaviour; however, there are few studies that identify determinants of treatment disengagement among those at risk of suicide in primary care settings. This study investigated determinants of treatment disengagement of those at risk of suicide who were referred to primary mental health care services in Western Sydney, Australia. Method: This study used routinely collected data of those referred for suicide prevention services provided through primary mental health care services between July 2012 and June 2018. Associations between sociodemographic, diagnostic, referral- and service-level factors and treatment non-attendance and early treatment cessation were investigated using a series of multivariable generalised estimation equations. Results: There were 1654 suicidal referrals for 1444 people during the study period. Those identified with a risk of suicide were less likely to never attend treatments (16.14% vs 19.77%), but were more likely to disengage earlier from subsequent service sessions (16.02% vs 12.41%), compared to those with no risk of suicide. A higher likelihood of non-attendance to any primary mental health care service sessions was associated with those aged 25–44, lower socioeconomic status, a presentation for substance use and a referral from acute care (either emergency department or hospital). Among those who attended an initial treatment session, younger age (18–24 years) and a longer waiting time for an initial follow-up appointment were associated with a higher likelihood of early treatment cessation from primary mental health care services. Conclusion: These findings can inform potential strategies in routine primary mental health care practice to improve treatment engagement among those at risk of suicidal behaviour. Youth-specific interventions, behavioural engagement strategies and prompt access to services are policy and service priorities.

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Patterns and Predictors of Primary Mental Health Service Use Following Bushfire and Flood Disasters

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2015.23 ◽

2015 ◽

Vol 9 (3) ◽

pp. 275-282 ◽

Cited By ~ 7

Author(s):

Lennart Reifels ◽

Bridget Bassilios ◽

Matthew J. Spittal ◽

Kylie King ◽

Justine Fletcher ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Health Care Services ◽

Service Use ◽

Care Service ◽

Health Care Service ◽

Mental Health Service Use ◽

Service Usage ◽

Primary Mental Health Care

AbstractObjectiveTo examine patterns and predictors of primary mental health care service use following 2 major Australian natural disaster events.MethodsUtilizing data from a national minimum dataset, descriptive and regression analyses were conducted to identify levels and predictors of the use of the Access to Allied Psychological Services (ATAPS) program over a 2-year period following 2 major Australian bushfire and flood/cyclone disasters.ResultsThe bushfire disaster resulted in significantly greater and more enduring ATAPS service volume, while service delivery for both disasters peaked in the third quarter. Consumers affected by bushfires (IRR 1.51, 95% CI 1.20–1.89), diagnosed with depression (IRR 2.57, 95% CI 1.60-4.14), anxiety (IRR 2.06, 95% CI 1.21-3.49), or both disorders (IRR 2.15, 95% CI 1.35-3.42) utilized treatment at higher rates.ConclusionsThe substantial demand for primary mental health care services following major natural disasters can vary in magnitude and trajectory with disaster type. Disaster-specific ATAPS services provide a promising model to cater for this demand in primary care settings. Disaster type and need-based variables as drivers of ATAPS use intensity indicate an equitable level of service use in line with the program intention. Established service usage patterns can assist with estimating capacity requirements in similar disaster circumstances. (Disaster Med Public Health Preparedness.2015;9:275-282)

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