Whether and how people reach care.
Everything below was reached through this subject, not through the words you typed. Every row states how it was reached.
Research library, full list
526 to 550 of 2,047Rates of depression and anxiety in urban and rural Canada.
Background: Studies of urban-rural differences in rates of non-psychotic psychiatric disorders have produced contradictory results, with some finding higher urban rates and others no difference.
Aims: This study aimed to compare geographic variability of rates of depression and three anxiety disorders in a large, random community sample of Canadian residents.
Method: Data from the 2002 Canadian Community Health Survey 1.2 were analyzed, using a four-category classification of urban-rurality.
Results: Significant bivariate urban-rural differences were found for age, marital status, country of birth, ethnicity, education, household income, income adequacy, employment, home ownership, physical activity, perceived stress, and physical health. In addition, participants in the urban core and urban fringe had a weaker sense of belonging to their community and reported lower social support. Ther…
matched on Mental Health Services (mesh)
Long-term outcomes among drug-dependent mothers treated in women-only versus mixed-gender programs.
This study examined the long-term outcomes of women who were pregnant or parenting at admission to women-only (WO; n = 500) versus mixed-gender (MG; a matched sample of 500) substance abuse treatment programs. Administrative records on arrests, incarcerations, mental health services utilization, and drug treatment participation were collected, covering 3 years preadmission and 8 years postadmission. Women treated in WO programs had lower levels of arrest, mental health services utilization rates, and drug treatment participation during the first year after drug treatment. No differences were found between the two groups in the long-term trajectories except that the WO program participants had lower incarceration rates during the third year after treatment. The study findings suggest a positive short-term impact of WO versus MG programs with regard to arrest and mental health services uti…
matched on Mental Health Services (mesh)
Self-stigma, empowerment and perceived discrimination among people with schizophrenia in 14 European countries: the GAMIAN-Europe study.
There is a growing interest in examining self-stigma as a barrier to recovery from schizophrenia. To date, no studies have examined mental health service user's experiences of self-stigma throughout Europe. This study describes the level of self-stigma, stigma resistance, empowerment and perceived discrimination reported by mental health service users with a diagnosis of schizophrenia or other psychotic disorder across 14 European countries. Data were collected from 1229 people using a postal survey from members of mental health non-governmental organisations. Almost half (41.7%) reported moderate or high levels of self-stigma, 49.2% moderate or high stigma resistance, 49.7% moderate or high empowerment and 69.4% moderate or high perceived discrimination. In a reduced multivariate model 42% of the variance in self-stigma scores was predicted by levels of empowerment, perceived discrimina…
matched on Mental Health Services (mesh)
Prevalence and treatment of mental disorders among US children in the 2001-2004 NHANES.
Objective: This article presents the 12-month prevalence estimates of specific mental disorders, their social and demographic correlates, and service use patterns in children and adolescents from the National Health and Nutrition Examination Survey, a nationally representative probability sample of noninstitutionalized US civilians.
Methods: The sample includes 3042 participants 8 to 15 years of age from cross-sectional surveys conducted from 2001 to 2004. Data on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for mental disorders were derived from administration of selected modules of the National Institute of Mental Health Diagnostic Interview Schedule for Children, version IV, a structured diagnostic interview administered by lay interviewers to assess psychiatric diagnoses of children and adolescents.
Results: Twelve-month prevalence rates of Diagnosti…
matched on Mental Health Services (mesh)
Scott J, Colom F, Popova E, Benabarre A, Cruz N, Valenti M, Goikolea JM, Sánchez-Moreno J, Asenjo MA, Vieta E (2009)cohort or longitudinalMEDLINE-indexed journal, not yet read by usThe Journal of clinical psychiatry53 citations Long-term mental health resource utilization and cost of care following group psychoeducation or unstructured group support for bipolar disorders: a cost-benefit analysis.
Objective: To explore the short- and long-term mental health resource utilization and cost of care in a sample of 120 individuals with bipolar disorders who participated in a randomized controlled efficacy trial of group psychoeducation versus unstructured group support.
Method: Prospective, independent monitoring of DSM-IV bipolar disorder type I or II patients aged 18 to 65 years was conducted during the intervention phase (6 months) and follow-up phase (5-year postintervention) of a randomized controlled trial reporting clinical outcomes and inpatient and outpatient mental health service utilization, with estimation of cost of treatment per patient. The study was conducted from October 1997 through October 2006.
Results: Compared with individuals with bipolar disorder receiving the control intervention, psychoeducated patients had twice as many planned outpatient appointments, but the…
matched on Mental Health Services (mesh)
Self-stigma, group identification, perceived legitimacy of discrimination and mental health service use.
Stigma may interfere with mental health service use. We measured self-stigma and stigma-related cognitions (group identification and perceived legitimacy of discrimination) at baseline in 85 people with schizophrenia, schizoaffective or affective disorders. After 6 months, 75 (88%) had reported use of mental health services. Controlling for baseline psychopathology, perceived stigma and diagnosis, low perceived legitimacy of discrimination predicted use of counselling/psychotherapy. Strong group identification was associated with participation in mutual-help groups. More self-stigma predicted psychiatric hospitalisation. Cognitive indicators of stigma resilience may predict out-patient service use, whereas self-stigma may increase the risk of psychiatric hospitalisation.
matched on Mental Health Services (mesh)
Postpartum mental illness: perspectives from an Arabian Gulf population.
There is growing awareness of the importance of mental health issues in the perinatal period in Western societies, but very little information is available from Muslim and Arab countries. Qualitative information gathered using focus group discussions of women of childbearing age is presented along with additional information obtained from key informant interviews with grandmothers, husbands, and health care professionals in the United Arab Emirates. The participants were women attending a public sector clinic in Al Ain, Abu Dhabi, and a private clinic in Dubai on a particular day. There were 19 women in the age range 17 to 46 years (M age = 29 yr.). The majority of the women who took part in the study did not recognize postnatal depression as a psychological issue but considered the problems a result of "evil eye" or "Jinn." The present findings suggest the need for initiating awareness …
matched on Mental Health Services (mesh)
The economic burden of personality disorders in mental health care.
Objective: Some evidence suggests that personality disorders are associated with a high economic burden due to, for example, a high demand on psychiatric, health, and social care services. However, state-of-the-art cost studies for the broad range of personality disorder diagnoses are lacking. The present study examines the direct medical costs, as well as the indirect costs, of patients seeking mental health treatment with DSM-IV personality disorders.
Method: The 1740 subjects included in this study were recruited from March 2003 to March 2006 from 6 different mental health care institutes in the Netherlands specializing in the psychotherapeutic treatment of personality disorders. The direct and indirect costs were assessed using the Trimbos and Institute for Medical Technology Assessment Questionnaire on Costs Associated with Psychiatric Illness. Personality disorders were diagnosed u…
matched on Mental Health Services (mesh)
Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons.
Objectives: Previous research has found that lesbian, gay, bisexual and transgender (LGBT) individuals are at risk for a variety of mental health disorders. We examined the extent to which a recent experience of a major discriminatory event may contribute to poor mental health among LGBT persons.
Methods: Data were derived from a cross-sectional strata-cluster survey of adults in Hennepin County, Minnesota, who identified as LGBT (n=472) or heterosexual (n=7,412).
Results: Compared to heterosexuals, LGBT individuals had poorer mental health (higher levels of psychological distress, greater likelihood of having a diagnosis of depression or anxiety, greater perceived mental health needs, and greater use of mental health services), more substance use (higher levels of binge drinking, greater likelihood of being a smoker and greater number of cigarettes smoked per day), and were more likely …
matched on Mental Health Services (mesh)
Pattern of psychiatry morbidity during Hajj period at Al-Noor Specialist Hospital.
Objective: To study the pattern and extent of psychiatric morbidity in the Hajj period (pilgrimage to Mecca by a Muslim).
Method: Study was conducted by psychiatry department and Health Research Centre, Al-Noor Specialist Hospital. We recorded demographic and clinical characteristics of all patients presenting during first two weeks of Zulhajjah, 1425H (11th to 24th of January 2005). Detailed clinical interviews were conducted by qualified psychiatrists and findings were recorded in semi-structured form. Diagnoses were made following the guidelines in clinical version of chapter V (Mental and Behavioral Disorders) of International Classification of Diseases (ICD-10). In difficult cases diagnosis was assigned by consensus between three psychiatrists.
Results: During study period 92 patients presented. Males were dominant (54%). Mean age was 43 +/- 17. Highest proportion (52%) belonged to …
matched on Mental Health Services (mesh)
The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication.
Context: Only limited information exists about the epidemiology of DSM-IV panic attacks (PAs) and panic disorder (PD).
Objective: To present nationally representative data about the epidemiology of PAs and PD with or without agoraphobia (AG) on the basis of the US National Comorbidity Survey Replication findings.
Design and setting: Nationally representative face-to-face household survey conducted using the fully structured World Health Organization Composite International Diagnostic Interview.
Participants: English-speaking respondents (N=9282) 18 years or older.
Main outcome measures: Respondents who met DSM-IV lifetime criteria for PAs and PD with and without AG.
Results: Lifetime prevalence estimates are 22.7% for isolated panic without AG (PA only), 0.8% for PA with AG without PD (PA-AG), 3.7% for PD without AG (PD only), and 1.1% for PD with AG (PD-AG). Persistence, lifetime number…
matched on Mental Health Services (mesh)
Psychiatric disorders and mental health service use in patients with advanced cancer: a report from the coping with cancer study.
Background: Psychological morbidity has been proposed as a source of distress in cancer patients. This study aimed to: 1) determine the prevalence of diagnosable psychiatric illnesses, and 2) describe the mental health services received and predictors of service utilization in patients with advanced cancer.
Methods: This was a cross-sectional, multi-institutional study of 251 eligible patients with advanced cancer. Eligibility included: distant metastases, primary therapy failure, nonpaid caregiver, age > or =20 years, stamina for the interview, English or Spanish-speaking, and adequate cognitive ability. Trained interviewers administered the Structured Clinical Interview for the Diagnostic Statistical Manual IV (DSM-IV) modules for Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder, Post-Traumatic Stress Disorder, and a detailed questionnaire regarding mental health…
matched on Mental Health Services (mesh)
Telepsychiatry program for rural victims of domestic violence.
Domestic violence is a significant public health problem and is correlated with serious mental and physical disorders. Victims' fear and isolation seriously limit access to psychiatric evaluation and treatment. Telemedicine provides a means to overcome these obstacles. This article describes a telemedicine program that provides psychiatric screening, evaluation, treatment, and referral for ongoing care to clients of a rural women's crisis center. Psychiatric evaluation and treatment were provided to a rural women's shelter program using telepsychiatry. The shelter program had difficulty accessing traditional mental health service. All new clients entering the program were screened for mental health problems. Those requiring further evaluation received a physical examination with medical history and initial psychological interview on site, followed by psychiatric evaluation by videoconfer…
matched on Mental Health Services (mesh)
Understanding pathways to breast cancer diagnosis among women in the Western Cape Province, South Africa: a qualitative study.
Objectives: The aim of this study was to explore and understand women's pathways to breast cancer diagnosis and factors influencing this journey.
Design and setting: Indepth interviews were conducted with clients at a tertiary level breast cancer clinic in Cape Town, South Africa. A thematic analysis was performed underpinned by the theoretical concepts of the Model of Pathways to Treatment framework.
Participants: 20 women were interviewed within 1 week of being diagnosed with breast cancer.
Results: The average time between discovery of bodily changes to breast cancer diagnosis was 8.5 months. Deficits in breast self-awareness and knowledge of breast cancer symptoms delayed women's interpretation of bodily changes as being abnormal. All women first noticed breast lumps; however, many did not perceive it as abnormal until additional symptoms were present. General good health, attributio…
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), help-seeking (text)
Seeking help for first-episode psychosis: a family narrative.
Aim: Delayed help-seeking can have serious consequences for young people with first-episode psychosis (FEP), in terms of treatment response and outcome. Young people's narratives about help-seeking are important to understand why delays occur; however, as the majority of help-seeking is initiated by family members, through a general practitioner (GP), family narratives are also of interest. The aim of this study was to explore help-seeking for FEP, including first contact with a GP.
Method: A semistructured interview was developed using a topic guide. Framework analysis was used to analyse data and a deductive qualitative method for applied research. The study was set in Birmingham, UK. Participants were interviewed separately by researchers. Joint coding and identification of 14 complete family dyads was then explored for emerging patterns within the family context.
Results: Family resp…
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), help-seeking (text)
Mental health problems of undocumented migrants (UMs) in The Netherlands: a qualitative exploration of help-seeking behaviour and experiences with primary care.
Objective: To explore health-seeking behaviour and experiences of undocumented migrants (UMs) in general practice in relation to mental health problems.
Design: Qualitative study using semistructured interviews and thematic analysis.
Participants: 15 UMs in The Netherlands, varying in age, gender, country of origin and education; inclusion until theoretical saturation was reached.
Setting: 4 cities in The Netherlands.
Results: UMs consider mental health problems to be directly related to their precarious living conditions. For support, they refer to friends and religion first, the general practitioner (GP) is their last resort. Barriers for seeking help include taboo on mental health problems, lack of knowledge of and trust in GPs competencies regarding mental health and general barriers in accessing healthcare as an UM (lack of knowledge of the right to access healthcare, fear of prosec…
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), help-seeking (text)
Professional help-seeking for gambling problems: awareness, barriers and motivators for treatment.
Despite the negative consequences associated with gambling, few problem gamblers seek professional help. This study aimed to examine awareness of professional sources of help and help-seeking behaviour amongst regular and problem gamblers. Australian gamblers (N = 730) were recruited from the general population, multicultural gambling venues, and gambling helplines and treatment services. Surveys measured awareness of professional help services, help-seeking behaviour and motivators and barriers to seeking help. Gamblers demonstrated low awareness of professional help services. Problem gamblers born in Australia or who were divorced were more likely to seek help. Problem gamblers who were reluctant to seek help due to a desire solve the problem on their own and feeling ashamed for themselves or their family pride were more likely to have overcome these barriers to seek help. However, sig…
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), help-seeking (text)
Access to treatment for substance-using women in the Republic of Georgia: socio-cultural and structural barriers.
Background: In the Republic of Georgia, women comprise under 2% of patients in substance use treatment and to date there has been no empirical research to investigate what factors may facilitate or hinder their help-seeking behaviour or access to treatment services.
Methods: This study included secondary analysis of in-depth interviews with 55 substance-using women and 34 providers of health-related services.
Results: The roles and norms of women in Georgian society were identified as major factors influencing their help-seeking behaviour. Factors that had a negative impact on use of drug treatment services included an absence of gender-specific services, judgmental attitudes of service providers, the cost of treatment and a punitive legal position in regard to substance use. Having a substance-using partner served as an additional factor inhibiting a woman's willingness to seek assistan…
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), help-seeking (text)
Postpartum depression and help-seeking behaviors in immigrant Hispanic women.
Objectives: To describe perceptions of immigrant Hispanic women experiencing symptoms of postpartum depression (PPD) and to identify barriers to seeking mental health services.
Design: Qualitative descriptive.
Setting: Community health clinic.
Participants: Twenty immigrant Hispanic women scoring positive for symptoms of PPD receiving health care at a community health clinic who declined mental health services participated in audiotaped interviews held in their homes.
Methods: Following Institutional Review Board approval and informed consent, interviews were conducted with study participants. Transcribed data were analyzed as appropriate for qualitative inquiry.
Results: Some of the women did not recognize and/or denied their symptoms attributing their sadness to financial concerns, family relationships, and/or work stressors. Study participants articulately described their symptoms and…
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), help-seeking (text)
Assessing barriers to care and readiness for cognitive behavioral therapy in early acute care PTSD interventions.
Cognitive Behavioral Therapy (CBT) interventions are efficacious in reducing posttraumatic stress disorder (PTSD) but are challenging to implement in acute care and other non-specialty mental health settings. This investigation identified barriers impacting CBT delivery through a content analysis of interventionist chart notes from an acute care PTSD prevention trial. Only 8.5% of all intervention patients were able to complete CBT. Lack of engagement, clinical and logistical barriers had the greatest impact on CBT entry. Treatment preferences and stigma only prevented entry when more primary barriers resolved. Patients with prior diagnosis of alcohol abuse or dependence were able to enter CBT after six months of sobriety. Based on the first trial, we developed a CBT readiness assessment tool. We implemented and evaluated the tool in a second early intervention trial. Lack of engagement …
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), barriers to care (text)
A qualitative study of perceived social barriers to care for eating disorders: perspectives from ethnically diverse health care consumers.
Objective: The study aim was to identify and describe health consumer perspectives on social barriers to care for eating disorders in an ethnically diverse sample.
Method: We conducted an exploratory secondary analysis of qualitative data comprising transcripts from semi-structured interviews with past and prospective consumers of eating disorder treatment (n = 32). Transcripts were inputted into NVivo 8 for coding, sorting, and quantifying thematic content of interest within strata defined by ethnic minority and non-minority participants. We then examined the influence of key social barriers-including stigma and social stereotypes-on perceived impact on care.
Results: The majority of respondents (78%) endorsed at least one social barrier to care for an eating or weight concern. Perceived stigma (or shame) and social stereotyping-identified both within social networks and among clinician…
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), barriers to care (text)
How people decide to seek health care: a qualitative study.
Background: There is considerable variation in service use, with overuse in conditions such as upper respiratory tract infections and high levels of unmet need in older patients with embarrassing conditions such as incontinence. The reasons for this situation are varied but to facilitate appropriate accessing of services the decision processes involved in help-seeking require greater understanding.
Objectives: This study aimed to describe the decision making process for help-seeking in middle and older aged people with urinary storage symptoms.
Methods: In-depth qualitative interviews were carried out with 33 men and women who had sought medical care for urinary symptoms. Respondents were recruited from an epidemiological study of the prevalence of urinary symptoms in community dwelling adults aged 40 years and over. Questions were directed at help-seeking for urinary symptoms as well as…
matched on Health Services Accessibility (mesh), Patient Acceptance of Health Care (mesh), help-seeking (text)
Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography.
Background: Evidence regarding the presence and persistence of ethnic inequalities in mental healthcare is well established. The reasons for these inequalities and lack of progress in diminishing them are less understood. This meta-ethnography aims to provide a new conceptual understanding of how ethnic inequalities are created and sustained; this is essential to develop effective interventions. Specifically, we sought to understand why people from ethnic minority groups are underrepresented in primary care mental health service provision and overrepresented in crisis pathways and detention.
Methods and findings: Following eMERGe guidelines for meta-ethnographies, we searched OpenGrey, Kings Fund, CINAHL, Medline, PsycINFO, and Social Care Online databases for qualitative articles published from database inception until October 2, 2022, using broad categories of search terms relating to …
matched on Mental Health Services (mesh), help-seeking (text)
Explaining adults' mental health help-seeking through the lens of the theory of planned behavior: a scoping review.
Background: Despite evidence-based efficacy, mental health services are underutilized due to low rates of help-seeking, leaving unmet mental health needs a global concern. The Theory of Planned Behavior (TPB) has been applied to understand the help-seeking process and in the development of behavior change interventions. The aim of this scoping review was to map the literature on the TPB as applied to mental health help-seeking in adults aged >18 years.
Methods: This scoping review was conducted based on the methodology presented by Arksey and O'Malley (2005). Six databases (CINAHL, PsycINFO, MEDLINE, ProQuest Health and Medicine, ProQuest Dissertations and Theses, Web of Science) and two grey literature sources (OpenGrey, Google Scholar) were systematically searched in February 2018 and updated in March 2020. Studies that explicitly discussed the TPB in the context of mental health help-…
matched on Mental Health Services (mesh), help-seeking (text)
Men's Depression and Suicide.
Purpose of review: To explore recent research evidence addressing men's depression and suicide. Included are discussions of recent literature investigating male depression symptoms, and men's depression and suicidality help-seeking and engagement with professional mental health care services.
Recent findings: Specific externalizing symptoms of substance misuse, risk-taking, and poor impulse control among men indicate the need for gender-sensitized depression screening and risk assessments. The reticence of some men for seeking professional health care has drawn public awareness raising and de-stigmatizing efforts, while clinical guidelines for working with boys and men have been offered to better serve men seeking help for depression and/or suicidality. There is a strengthening case for male depression comprising specific externalizing symptomology, and these findings, along with high ma…
matched on Mental Health Services (mesh), help-seeking (text)