scholarly journals Treatment gap and mental health service use among Syrian refugees in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D C Fuhr ◽  
C Ataturk ◽  
M McGrath ◽  
Z Ilkkursun ◽  
A Woodward ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Service Use ◽  
Mental Health Problems ◽  
Mental Health Service Use ◽  
Continuing Care ◽  
Syrian Refugees ◽  
Depression And Anxiety ◽  
Treatment Gap

Abstract Introduction Turkey hosts the highest number of Syrian refugees in Europe. Refugees are often vulnerable to situational forms of psychosocial distress as a consequence of exposure to war and violence which may result in more profound mental health problems if no treatment is sought. The aim of this study is to report evidence on mental health and psychosocial support (MHPSS) needs, access and barriers to MHPSS care among Syrians refugees living in Istanbul, Turkey. Methods A cross-sectional survey was conducted among Syrian refugees aged 18 years or over in Istanbul (Sultanbeyli) between February and May 2018. Data among 1’678 Syrian refugees were collected on mental health outcomes using the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) and the Hopkins Symptoms Checklist (HSCL-25) for depression and anxiety. We also collected data on health care utilization, barriers to seeking and continuing care as well as knowledge and attitudes towards mental health. Descriptive analyses were used. Results The prevalence of PTSD, depression and anxiety was 19.6%, 34.7% and 36.1% respectively. The treatment gap was 89% for PTSD, 90% for anxiety and 88% for depression. 249 respondents (15%) screened positive for either PTSD, depression or anxiety in our survey and self-reported emotional/behavioural problems since arriving in Sultanbeyli. Several structural and attitudinal barriers for not seeking care were reported. Conclusions To overcome the treatment gap, mental health care programmes need to be more responsive to the needs of Syrian refugees. Barriers to seeking and continuing care can be overcome by providing MHPSS services in the community which facilitate access to care. Community-based programmes of care should be supported by activities which increase awareness about mental health issues and tackle negative attitudes towards mental illness. Key messages This study provides the first nationally representative data on the mental health of Syrian refugees in Turkey, and shows that refugees have high mental health needs. Syrian refugees do not seek mental health care despite availability of mental health services in the community.

Pathways to Mental Health Services and Perceptions about the Effectiveness of Treatment

2018 ◽  
Vol 9 (3) ◽  
pp. 388-407 ◽  
Author(s):  
Sirry M. Alang ◽  
Donna D. McAlpine
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
Severity Of Illness ◽  
Mental Illnesses ◽  
Social Characteristics ◽  
Treatment Gap ◽  
Quality Outcomes ◽  
Effectiveness Of Care

The gap between need and effective treatment for mental health problems continues to be a challenge for researchers and policymakers. Much of the attention has been on differences in treatment rates, with insufficient attention to variation in pathways that people take into treatment. Individuals may choose to seek help but may also be substantially influenced by others or coerced into care. The chances of each type of pathway are influenced by social characteristics and may shape perceptions of effectiveness of care. This paper investigates variation in pathways into care and perceived effectiveness of care. We also examine whether choice or coercion into care are associated with whether individuals perceive care as effective and if severity of illness moderates this relationship. We use data from the 2010–2014 National Survey on Drug Use and Health (N = 10,020). Persons who independently sought mental health care were more likely to rate treatment as effective compared to persons ordered into care. Among people with severe mental illnesses, the probability of rating treatment as effective is lowest among those who were ordered into care. Entry into mental health care is not sufficient for closing the treatment gap if coerced care leads to poorer quality outcomes.

scholarly journals The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

2020 ◽  
Vol 17 (22) ◽  
pp. 8612
Author(s):  
Marta Estrela ◽  
Maria Teresa Herdeiro ◽  
Pedro Lopes Ferreira ◽  
Fátima Roque
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Older Patients ◽  
Common Mental Disorders ◽  
Health Policies ◽  
Depression And Anxiety ◽  
Treatment Gap ◽  
Mental Health Policies

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

scholarly journals Maternal Psychological Distress & Mental Health Service Use during the COVID-19 Pandemic

2020 ◽  
Author(s):  
Emily E Cameron ◽  
Kayla M. Joyce ◽  
Chantal P Delaquis ◽  
Kristin Reynolds ◽  
Jennifer Protudjer ◽  
...  
Keyword(s):  
Mental Health ◽  
Service Use ◽  
Mental Health Problems ◽  
Age Groups ◽  
Well Being ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Depression And Anxiety ◽  
Child Age

Background: Mental health problems are increasingly recognized as a significant and concerning secondary effect of the COVID-19 pandemic. Research on previous epidemics/pandemics suggest that families, particularly mothers, may be at increased risk, but this population has yet to be examined. The current study (1) described prevalence rates of maternal depressive and anxiety symptoms from an online convenience sample during the COVID-19 pandemic, (2) identified risk and protective factors for elevated symptoms, and (3) described current mental health service use and barriers. Methods: Participants (N = 641) were mothers of children age 0-8 years, including expectant mothers. Mothers completed an online survey assessing mental health, sociodemographic information, and COVID-19-related variables. Results: Clinically-relevant depression was indicated in 33.16%, 42.55%, and 43.37% of mothers of children age 0-18 months, 18 months to 4 years, and 5 to 8 years, respectively. Prevalence of anxiety was 36.27%, 32.62%, and 29.59% for mothers across age groups, respectively. Binary logistic regressions indicated significant associations between risk factors and depression/anxiety across child age groups. Limitations: Cross-sectional data was used to describe maternal mental health problems during COVID-19 limiting the ability to make inferences about the long-term impact of maternal depression and anxiety on family well-being. Conclusions: Maternal depression and anxiety appear to be elevated in the context of COVID-19 compared to previously reported population norms. Identified risk factors for depression and anxiety across different child age ranges can inform targeted early intervention strategies to prevent long-term impacts of the COVID-19 pandemic on family well-being and child development.

scholarly journals Mental Health Service Use and Perceived Unmet Needs for Mental Health Care in Asian Americans

2018 ◽  
Vol 55 (2) ◽  
pp. 241-248 ◽  
Author(s):  
Yuri Jang ◽  
Hyunwoo Yoon ◽  
Nan Sook Park ◽  
Min-Kyoung Rhee ◽  
David A. Chiriboga
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Care ◽  
Asian Americans ◽  
Service Use ◽  
Unmet Needs ◽  
Mental Health Service Use ◽  
Health Service Use

scholarly journals Factors Associated With Mental Health Service Use AmongBlack, Latinx, and Asian Older Adults in Community-Based Organizations

2021 ◽  
pp. 073346482110128
Author(s):  
Liao Zhang ◽  
Isabel O’Malley ◽  
Mario Cruz-Gonzalez ◽  
Mayra L. Sánchez González ◽  
Margarita Alegría
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Care ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Care ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Factors Associated

Objective: Older adults of color face systemic obstacles in seeking mental health care. Unaddressed late-life mental health issues can challenge independent living and increase disability and mortality risk. This study examined factors associated with mental health service use among community-dwelling older adults. Method: This cross-sectional analysis used data from the Positive Minds-Strong Bodies trial ( N= 1,013). Results: Higher anxiety, depressive, and posttraumatic stress disorder (PTSD) symptoms increased odds of service use (odds ratio [OR] = 1.05–2.11). Asian and Latinx, but not Black, older adults had lower odds of service use than Whites (OR = 0.15–0.35). Yet Asian and Latinx older adults with higher anxiety and depression symptoms and Asians with at least one PTSD symptom had higher odds of service use than Whites with the same symptomatology (OR = 1.16–2.88). Conclusion: White older adults might be more likely to seek mental health care at lower levels of need, while Asian and Latinx older adults might seek services when they perceive greater need.

scholarly journals Treatment gap and mental health service use among Syrian refugees in Sultanbeyli, Istanbul: a cross-sectional survey

2019 ◽  
Vol 29 ◽  
Author(s):  
D. C. Fuhr ◽  
C. Acarturk ◽  
M. McGrath ◽  
Z. Ilkkursun ◽  
E. Sondorp ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Health Needs ◽  
Syrian Refugees ◽  
Depression And Anxiety ◽  
Treatment Gap ◽  
Mental Health Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Negative Attitudes

Abstract Aims Syrian refugees may have increased mental health needs due to the frequent exposure to potentially traumatic events and violence experienced during the flight from their home country, breakdown of supportive social networks and daily life stressors related to refugee life. The aim of this study is to report evidence on mental health needs and access to mental health and psychosocial support (MHPSS) among Syrians refugees living in Sultanbeyli-Istanbul, Turkey. Methods A cross-sectional survey was conducted among Syrian refugees aged 18 years or over in Sultanbeyli between February and May 2018. We used random sampling to select respondents by using the registration system of the municipality. Data among 1678 Syrian refugees were collected on mental health outcomes using the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) and the Hopkins Symptoms Checklist (HSCL-25) for depression and anxiety. We also collected data on health care utilisation, barriers to seeking and continuing care as well as knowledge and attitudes towards mental health. Descriptive analyses were used. Results The estimated prevalence of symptoms of PTSD, depression and anxiety was 19.6, 34.7 and 36.1%, respectively. In total, 249 respondents (15%) screened positive for either PTSD, depression or anxiety in our survey and self-reported emotional/behavioural problems since arriving in Sultanbeyli. The treatment gap (the proportion of these 249 people who did not seek care) was 89% for PTSD, 90% for anxiety and 88% for depression. Several structural and attitudinal barriers for not seeking care were reported, including the cost of mental health care, the belief that time would improve symptoms, fear of being stigmatised and lack of knowledge on where and how to get help. Some negative attitudes towards people with mental health problems were reported by respondents. Conclusions Syrian refugees hardly access MHPSS services despite high mental health needs, and despite formally having access to the public mental health system in Turkey. To overcome the treatment gap, MHPSS programmes need to be implemented in the community and need to overcome the barriers to seeking care which were identified in this study. Mental health awareness raising activities should be provided in the community alongside the delivery of psychological interventions. This is to increase help-seeking and to tackle negative attitudes towards mental health and people with mental health problems.

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

2015 ◽  
Vol 9 (3) ◽  
pp. 275-282 ◽  
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)

Intensive Use of Mental Health Care

1996 ◽  
Vol 41 (2) ◽  
pp. 93-101 ◽  
Author(s):  
Cameron A Mustard ◽  
Shelley Derksen ◽  
Douglas Tataryn
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Psychotic Disorder ◽  
Service Use ◽  
Initial Period ◽  
Mental Health Service Use ◽  
Intensive Use

Objective: To describe the profile of the intensive use of mental health services over a 4-year period in a population of 1.1 million people. Methods: Data obtained from computerized hospital separation records and physician reimbursement claims were combined to form patient-based histories of mental health care utilization. Users of mental health services in a 24-month period were hierarchically classified as having a psychotic disorder (ICD-9-CM 295–299) or a nonpsychotic disorder (ICD-9-CM 300–301, 306–309, 311). Intensive use was defined as 12 or more contact months or a minimum of 2 episodes of therapy in the 24-month period. The cohort of intensive users were followed over the subsequent 24-month interval to describe the persistence of intensive use. Results: In the initial observation period, intensive users constituted 27.4% of individuals in treatment for psychotic disorder and 4.4% of persons in treatment for nonpsychotic disorder. These 2 groups, which represent 7.4% of all users of mental health care, were responsible for 53% of physician services, 72.7% of contacts with psychiatrists, and 64.4% of acute psychiatric bed days in the initial period. In the follow-up period, intensive use status was replicated by 44.6% of the cohort. Conclusions: The diagnostic and therapeutic characteristics of intensive users of mental health services are heterogeneous. There is substantial persistence of intensive mental health service use over time.

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