Factors related to utilization of services for mental health reasons in Montreal, Canada

Abstract

This study examines factors related to the utilization of services for mental health reasons by Montreal residents. Data were drawn from telephone interviews. A random sample of 893 respondents completed a questionnaire on service utilization and the Diagnostic Interview Schedule Self Administered to assess DSM-III-R psychiatric disorders. Results indicate that 12.8% of the population had used such services in the past year. Medical doctors and psychiatrists, whose services are free of charge under universal health coverage, were consulted, respectively, by 4.1% and 2.0% of respondents. Psychologists, whose services are not free, were seen by 3.4% of respondents. In all, 42.0% of respondents who presented a current diagnosis used services in the past year. The highest proportion of users (48.0%) was found among respondents who presented both current and lifetime diagnoses and among respondents with comorbidity. The choice of caregiver was related also to pattern of disorders: respondents with current and comorbid disorders tended to consult general practitioners, while respondents with lifetime disorders or with lifetime and current disorders favoured specialized care. In line with other studies, self-perception of mental health, gender and marital status were related to utilization; unlike other studies, attitudes and age were not. It is argued that particularities found in this study stem not only from methodological considerations, but also from the configuration of the mental health system in Quebec, where the greater availability of psychologists may facilitate service utilization.

General Practice and Mental Health Care: Determinants of Outpatient Service Use

“…As with previous studies, respondents consulted mostly with a family physician for mental health reasons. 1,10,[42][43][44][45][46] The prevalence rates observed for past year service use for mental health reasons, as well as by provider type, were slightly lower than those reported in a recent study in the Joint Canada-US Survey of Health. 47,48 Regarding the breakdown of services used for mental health reasons, there seemed to be an equal number of respondents consulting only a family physician, a family physician and another professional, and a professional other than a family physician in the past year.…”

Use of health services for major depressive and anxiety disorders in Finland

“…In our final analysis of health care usage by MDD or anxiety disorder subjects, no other sociodemographic factor other than living alone remained statistically significant. At least three previous studies [Lin et al, 1996;Lefebvre et al, 1998;Bijl and Ravelli, 2000] report higher service usage among single householders and unmarried people. Other studies have found either no such association [Sherbourne, 1988;Golding et al, 1990;Phillips and Murrell, 1994] or an increasing use of mental health services but not primary health services [Ten Have et al, 2002].…”

“…However, it is similarly well established by epidemiological studies worldwide that about half of the subjects suffering from severe forms of these disorders and more than half of those with moderate or mild disorders do not seek or receive treatment from health services . Previous studies [Leaf et al, 1988;Bassett et al, 1998;Lefebvre et al, 1998;Ten Have et al, 2002] have suggested that severity of the psychiatric symptoms, psychiatric comorbidity, available resources, and different health behavior patterns influence seeking treatment. Also, different sociodemographic factors may have an influence on help-seeking [Olfson and Klerman, 1992;Crow et al, 1994;Lin and Parikh, 1999].…”

Infertility: Testing a helpseeking model

“…This literature suggests that co-morbidity, general use of healthcare, salience of symptoms, deviance of symptoms, and interference with daily life predict helpseeking for conditions as diverse as psychological problems (Lefebvre, Lesage, Cyr, Toupin, & Fournier, 1998), pre-menstrual syndrome (Robinson & Swindle, 2000), urinary incontinence (Hannestad, Rortveit, & Hunskaar, 2002), and brain tumors (Salander, Bergenheim, Hamberg, & Henrikkson, 1999). Finally, as theory suggests, social network support (Carpentier & White, 2002) and especially spousal support (Salander et al, 1999) are related to helpseeking.…”