Shortfall in mental health service utilisation
Shortfall in mental health service utilisation
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DOI：
10.1192/bjp.179.5.417
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发表时间：
2001-11-01
影响因子：
10.5
通讯作者：
Carter, G
中科院分区：
文献类型：
--
作者：
Andrews, G;Issakidis, C;Carter, G
背景在大多数发达国家，精神障碍的治疗覆盖率很低。为探讨发达国家精神障碍治疗覆盖率低的原因，采用澳大利亚国家调查和《世界卫生报告》中的数据。就诊的概率因诊断而异：90%的人患有精神分裂症，这是外部因素造成的；60%的人患有抑郁症；15%的人患有药物使用和人格障碍。咨询的概率因性别、年龄、婚姻状况和残疾而异，从25-54岁、残疾和已婚的女性中的73%到没有这些风险因素的男性中的9%。那些没有咨询，但有残疾或合并症的人说，他们“更愿意自己管理”。来自五个国家的数据显示，没有证据表明总体卫生支出、自付费用或卫生系统的反应能力会影响总体咨询率。结论社会、态度和诊断变量导致了差异。资金方面则不然。公众教育精神障碍的认识和治疗，以及提供者提供有效的治疗，可能会弥补这一不足。
Background Treatment coverage for mental disorders is poor in most developed countries. Aims To explore some reasons for the poor treatment coverage for mental disorders in developed countries,Method Data were taken from Australian national surveys and from the World Health Report.Results Only one-third of people with a mental disorder consulted. Probability of consulting varied by diagnosis: 90% for schizophrenia, which is accounted for by external factors; 60% for depression; and 15% for substance use and personality disorders. The probability of consulting varied by gender, age, marital status and disability, from 73% among women aged 25-54 years, disabled and once married to 9% among males without these risk factors. Those who did not consult but were disabled or comorbid said that they "preferred to manage themselves". Data from five countries showed no evidence that overall health expenditure, out-of-pocket cost or responsiveness of the health system affected the overall consulting rates.Conclusions Societal, attitudinal and diagnostic variables account for the variation. Funding does not. Public education about the recognition and treatment of mental disorders and the provision of effective treatment by providers might remedy the shortfall.Declaration of interest None, Funding detailed in Acknowledgements.