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Islam MI, Salam SS, Kabir E, Khanam R. Identifying Social Determinants and Measuring Socioeconomic Inequalities in the Use of Four Different Mental Health Services by Australian Adolescents Aged 13-17 Years: Results from a Nationwide Study. Healthcare (Basel) 2023; 11:2537. [PMID: 37761734 PMCID: PMC10531418 DOI: 10.3390/healthcare11182537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
AIM In this study, we aimed to identify the determinants of four different forms of mental health service usage (general health services, school counselling, telephone, and online services), and the number of mental health services accessed (single and multiple) by Australian adolescents aged 13-17 years. We also measured socioeconomic inequality in mental health services' usage following the concentration index approach within the same sample. SUBJECT AND METHODS The data came from the nationwide cross-sectional survey, Young Minds Matter (YMM): the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Random effect models were used to identify the factors associated with four different mental health services and the number of services accessed. Further, the Erreygers' corrected concentration indices for binary variables were used to quantify the socioeconomic inequality in each mental health service. The four services were the general health service (GP, specialist, psychiatrist, psychologist, hospital including emergency), school services, telephone counselling and online services. RESULTS Overall, 31.9% of the total analytical sample (n = 2268) aged 13-17 years old visited at least one service, with 21.9% accessing a single service and 10% accessing multiple services. The highest percentage of adolescents used online services (20.1%), followed by general mental health services (18.3%), while school services (2.4%) were the least used service. Age, gender, family type and family cohesion statistically significantly increased the use of general health and multiple mental health service usage (p < 0.05). Area of residence was also found to be a significant factor for online service use. The concentration indices (CIs) were -0.073 (p < 0.001) and -0.032 (p < 0.001) for health and telephone services, respectively, which implies pro-rich socio-economic inequality. CONCLUSION Adolescents from low-income families frequently used general mental health services and telephone services compared to those who belonged to high-income families. The study concluded that if we want to increase adolescents' usage of mental health services, we need to tailor our approaches to their socioeconomic backgrounds. In addition, from a policy standpoint, a multi-sectoral strategy is needed to address the factors related to mental health services to reduce inequity in service utilisation.
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Affiliation(s)
- Md Irteja Islam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
- Centre for Health Research and School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
- School of Mathematics, Physics and Computing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
| | | | - Enamul Kabir
- School of Mathematics, Physics and Computing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
| | - Rasheda Khanam
- Centre for Health Research and School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
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Vasiliadis HM, Léon C, du Roscoät E, Husky MM. Suicidal ideation and mental health care: Predisposing, enabling and need factors associated with general and specialist mental health service use in France. Int J Soc Psychiatry 2023; 69:1285-1292. [PMID: 36905113 DOI: 10.1177/00207640231159020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
BACKGROUND Population-based studies have shown that less than one in two individuals reporting suicidal ideation also report past-year mental health service use. Only a few studies have looked at different types of providers consulted. There is a need to better understand the factors associated with different provider combinations of mental health service use in representative samples of individuals with suicidal ideation. AIMS The aim of the current study is to assess, using Andersen's model of healthcare seeking behaviors, the predisposing, enabling and need factors associated with type of mental health service use in adults with past-year suicidal ideation. METHODS Data were drawn from the 2017 Health Barometer survey, a representative sample of the general population aged 18 to 75 years, among whom 1,128 respondents had reported suicidal ideation in the past year were analyzed. Past-year outpatient mental health service use (MHSU) was categorized into mutually exclusive groups as no use, general practitioner (GP) only; mental health professional (MHP) only; and both GP and MHP. Multinomial regression analyses were used to model mental health service use as a function of predisposing, enabling and need factors. RESULTS Overall, 44.3% reported past-year MHSU and this was higher in females than males (49.0% vs. 37.6%). Prevalence of GP only use in the overall sample was 8.7%, consulting with GP and MHP was 21.3%, consulting with MHP only was 14.3%. Higher education was associated with increased MHP use. Residing in a rural area was associated with increased GP only use. Presence of a suicide attempt within the year, a major depressive episode and role impairment were associated with consulting a GP and MHP, and MHP only, but not GP only. CONCLUSIONS When controlling for need and predisposing factors, socio-economic factors related to employment and income were associated with higher levels of consulting with mental health professionals.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, QC, Canada
- Centre de recherche Charles-Le Moyne, Campus de Longueuil Université de Sherbrooke, QC, Canada
| | | | - Enguerrand du Roscoät
- Santé publique France, Saint-Maurice, France
- Laboratoire Parisien de Psychologie Sociale (LAPPS), EA 4386, Université Paris Nanterre, France
| | - Mathilde M Husky
- Equipe ACTIVE, Bordeaux Population Health Research Center, INSERM U1219, Université de Bordeaux, France
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Vasiliadis HM, Léon C, du Roscoät E, Husky MM. Predisposing, enabling and need factors associated with past-year health service use for mental health reasons in adults with suicidal ideation in France. J Affect Disord 2022; 319:62-69. [PMID: 36126787 DOI: 10.1016/j.jad.2022.09.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to determine the prevalence of past-year health service use for mental health reasons in a French representative sample of adults overall and in those reporting suicidal ideation in the past year and assess the factors associated with health service use according Andersen's model of healthcare seeking behaviors. METHODS Data were drawn from the 2017 Health Barometer survey a large computer-assisted telephone survey on a representative sample of the general population aged 18-75 years living in France (n = 25,319). Logistic regression analyses were used to study past-year health service use for mental health reasons as a function of predisposing, enabling and need factors. Analyses were stratified according to suicidal ideation and sex. RESULTS Among individuals with suicidal ideation, 45.1 % of adults, 50.4 % of females and 37.6 % of males, reported past-year health service use for a mental health reason. Increased odds of health service use were observed regarding predisposing (female sex, younger age, higher education), enabling (income level), and need factors (prior suicide attempts, role impairment and major depression). Among males, the only significant factors included age 65-75 (aOR = 0.16, 95%CI = 0.03-0.84) and major depression (aOR = 2.79, 95%CI = 1.79-4.36). LIMITATIONS Self-reported service utilization. Cross-sectional survey. CONCLUSIONS In a country with a high level of medical coverage, further research is needed to identify sex-specific socio-demographic, economic and clinical differences in the use of different types of health services as well as perceived need for care, structural and attitudinal barriers to treatment.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Canada; Centre de recherche Charles-Le Moyne, Campus de Longueuil Université de Sherbrooke, Canada
| | | | - Enguerrand du Roscoät
- Santé publique France, Saint-Maurice, France; Laboratoire Parisien de Psychologie Sociale (LAPPS), EA 4386, Université Paris Nanterre, France
| | - Mathilde M Husky
- Laboratoire de psychologie EA4139, Université de Bordeaux, Bordeaux, France.
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Discovering Clusters of Support Utilization in the Canadian Community Health Survey–Mental Health. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00880-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Clarke C, Oh J, Khan H, LoParo D, Lamis DA. Referral patterns and demographic factors predict treatment dropout in suicidal youth. Suicide Life Threat Behav 2021; 51:616-623. [PMID: 33870542 DOI: 10.1111/sltb.12755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Due to increasing suicide rates, treatment engagement among suicidal youth is paramount. Identification of factors that predict treatment dropout could aid in bolstering treatment engagement. In this study, we examine whether demographic factors, specific treatment referrals, and interactions among referrals predict treatment dropout in youth deemed at risk for suicide. METHODS Youth (N = 3606) were screened for suicide using the Early Identification, Referral, and Follow-up (EIRF) system across three community behavioral health centers. If considered at-risk, all were provided mental health referrals and some were provided family support, crisis hotline, and/or school support referrals. Analyses were performed to analyze dropout patterns based on the binary logistic regression framework. RESULTS Being older (OR = 1.06, p < 0.001) and being male (OR = 1.28, p < 0.001) were related to greater odds of dropping out from referrals, while being referred to family support (OR = 0.13, p < 0.001), and being referred to a crisis hotline (OR = 0.58, p < 0.001) were associated with smaller odds of dropping out. Interactions were also analyzed. CONCLUSION Monitoring utilization and referral patterns is essential to appropriately meet the needs of youth at-risk for suicide. Specifically, referring youth for family support and to use a crisis hotline may be particularly helpful in retaining treatment engagement.
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Affiliation(s)
- Christina Clarke
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - JungSu Oh
- Department of Psychology, Eastern Illinois University, Charleston, IL, USA
| | - Humama Khan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Devon LoParo
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Xie X, Wang N, Chu J. Social experiences with mental health service use among US adolescents. J Ment Health 2021; 31:203-211. [PMID: 34008455 DOI: 10.1080/09638237.2021.1922652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Little is known about the associations of social experiences with mental health service use. AIM This study aimed to classify social experiences variables in the past year and examine the associations of selected variables in social experiences with mental health service use among US adolescents. METHODS A total of 13,038 adolescents (aged 12 to 17), of which 2208 received mental health services, were from the 2018 National Survey on Drug Use and Health. Multivariate logistic regression (MLR) analysis was conducted. RESULTS The overall prevalence of mental health service use was 16.1%. 44 variables on social experiences were grouped into 10 disjoint clusters and one variable from each cluster was selected for MLR analysis. Being female, African American, Hispanics, insured and having depression in the past year were associated with increased odds of mental health service use. Negative feelings about going to school, having a serious fight at school/work, active involvement in substance use help programs, knowledge of drug prevention, negative perceptions about the role of religious beliefs on life decisions were positively associated with mental health service use. CONCLUSION Mental health service use is associated with feelings about school and peers, perceptions about drug use, and involvement in activities.
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Affiliation(s)
- Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN, USA
| | - Nianyang Wang
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA
| | - Jun Chu
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA
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Islam MI, Khanam R, Kabir E. The use of mental health services by Australian adolescents with mental disorders and suicidality: Findings from a nationwide cross-sectional survey. PLoS One 2020; 15:e0231180. [PMID: 32275704 PMCID: PMC7147749 DOI: 10.1371/journal.pone.0231180] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/17/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Mental disorders and suicidality among adolescents have been identified as a major public health concern worldwide; however, they often do not get the necessary attention from parents, school and health professional, and therefore are left untreated. This study aimed to investigate the factors associated with the use of mental health services among Australian adolescents aged 13-17 with mental disorders and/or suicidality. METHODS Adolescents aged 13-17 (n = 2134) from Young Minds Matter (YMM): the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing were included in this study. The YMM is a cross-sectional nationwide survey, in which information was collected from both parents and adolescents (aged 13-17 years). Both bivariate and multivariate analyses were conducted to identify the factors that have an impact on the use of mental health services (outcome variable) in two subsamples: (1) adolescents with mental disorder and (2) adolescents with suicidality. RESULTS Overall, 740 (34.7%) and 168 (7.9%) adolescents reported a mental disorder and/or suicidality, respectively. The incidence of seeking any service was higher among adolescents with suicidality (approximately 50%) compared to those with a mental disorder (about 30%). Girls, older age-group (15-17), adolescents living with disadvantaged families (lower-income, less educated and unemployed parents), those who had multiple mental disorders and history of substance use were most likely to use mental health services regardless of mental disorder and suicidality. Health services and online services were the most popular type of mental health service among adolescents aged 13-17 across two subgroups, while, school and telephone services were less utilized. CONCLUSIONS Many adolescents with mental disorders and/or suicidality do not use mental health services. The findings indicate differences in factors associated with the use of mental health services among adolescents with mental disorder and suicidality. Further research is needed to address the specific barriers that limit the use of the services.
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Affiliation(s)
- Md. Irteja Islam
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Centre for Health, Informatics, and Economic Research and School of Commerce, University of Southern Queensland, Queensland, Australia
| | - Rasheda Khanam
- Centre for Health, Informatics, and Economic Research and School of Commerce, University of Southern Queensland, Queensland, Australia
| | - Enamul Kabir
- Centre for Health, Informatics, and Economic Research and School of Commerce, University of Southern Queensland, Queensland, Australia
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Nam B, Wilcox HC, Hilimire M, DeVylder JE. Perceived need for care and mental health service utilization among college students with suicidal ideation. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:713-719. [PMID: 29384469 DOI: 10.1080/07448481.2018.1434779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 12/09/2017] [Accepted: 01/28/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study aimed to identify correlates of service utilization and perceived need for care among college students with suicidal ideation. PARTICIPANTS Respondents were recruited from introductory psychology courses at an undergraduate college during the Fall 2014 semester. METHODS Independent correlates of (1) mental health service utilization, (2) self-perceived need, and (3) other-perceived need for mental health services among college students (N = 190) with suicidal ideation were identified. RESULTS Service utilization was associated with need for care as perceived by others. Perceived need for care by others was associated with suicidal ideation intensity and suicide attempt history. Perceived need by the respondents themselves was correlated with depression severity, sex, and race but was not independently associated with actual service utilization. CONCLUSIONS Perceived need by others was the sole significant correlate of service utilization, suggesting it is an important target for public health interventions aimed at facilitating pathways into mental health treatment.
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Affiliation(s)
- Boyoung Nam
- a School of Social Work, University of Maryland , Baltimore , Maryland , USA
| | - Holly C Wilcox
- b Department of Mental Health , Johns Hopkins Schools of Medicine and Bloomberg School of Public Health, Johns Hopkins University , Baltimore , Maryland , USA
| | - Matthew Hilimire
- c Department of Psychology , The College of William & Mary , Williamsburg , Virginia , USA
| | - Jordan E DeVylder
- a School of Social Work, University of Maryland , Baltimore , Maryland , USA
- d Graduate School of Social Service , Fordham University , New York , New York , USA
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Brownlie EB, Chaim G, Heffernan O, Herzog T, Henderson J. Youth Services System Review: Moving From Knowledge Gathering to Implementation Through Collaboration, Youth Engagement, and Exploring Local Community Needs. ACTA ACUST UNITED AC 2017. [DOI: 10.7870/cjcmh-2017-018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article describes a two-phase, multi-sectoral project aimed at enhancing youth services addressing substance use in Ontario. In the information gathering phase, a youth-focused website and survey, focus groups, and interviews were used to elicit perspectives from multiple stakeholders. In the implementation phase, capacity-building and consultations on transition-aged youth needs were conducted to inform youth transition-readiness checklists. We discuss the importance of engaging youth as collaborators as well as respondents and the processes used to tailor findings to local contexts for implementation.
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Affiliation(s)
- E. B. Brownlie
- Centre for Addiction and Mental Health and University of Toronto
| | - Gloria Chaim
- Centre for Addiction and Mental Health and University of Toronto
| | | | | | - Joanna Henderson
- Centre for Addiction and Mental Health and University of Toronto
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Summerhurst C, Wammes M, Wrath A, Osuch E. Youth Perspectives on the Mental Health Treatment Process: What Helps, What Hinders? Community Ment Health J 2017; 53:72-78. [PMID: 27146307 DOI: 10.1007/s10597-016-0014-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
Abstract
In this study we explored adolescent perceptions of what was most helpful and most challenging about mental health treatment for mood and/or anxiety disorders. Youth seeking treatment at the First Episode Mood and Anxiety Program were recruited to participate in a follow-up survey about their experiences of mental health care services. Responses to two open-ended questions were analyzed for emerging themes and differences between age groups and gender. Males were more likely to report therapy as being helpful than females, 16-18 year olds were more likely to report medication as a challenge to treatment and 19-26 year olds were more likely to report accessing services as a challenge to treatment. Understanding what helps and what hinders treatment-seeking youth can guide both clinical treatment and service delivery models for this population.
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Affiliation(s)
| | - Michael Wammes
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, 860 Richmond St., London, ON, N6A 3H8, Canada
| | - Andrew Wrath
- Lawson Health Research Institute, London, ON, Canada
| | - Elizabeth Osuch
- Lawson Health Research Institute, London, ON, Canada. .,Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, 860 Richmond St., London, ON, N6A 3H8, Canada. .,London Health Sciences Centre, London, ON, Canada.
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Arcaro J, Summerhurst C, Vingilis E, Wammes M, Osuch E. Presenting concerns of emerging adults seeking treatment at an early intervention outpatient mood and anxiety program. PSYCHOL HEALTH MED 2016; 22:978-986. [PMID: 27781492 DOI: 10.1080/13548506.2016.1248449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examined presenting concerns and characteristics of emerging adults (EAs) seeking treatment at an early intervention program for mood and anxiety disorders to better understand presenting concerns when treatment is needed. During an intake assessment conducted by a social worker or clinical psychologist, participants (N = 548; 62% female, 38% male) reported their top three current life concerns, which were analyzed qualitatively using thematic analysis. Participants completed a battery of questionnaires assessing demographic information, symptomatology, and daily functioning. Females presented with significantly higher levels of anxiety, and both females and younger individuals (age 16-18) presented with significantly higher levels of depression compared to males and older individuals (age 19-26), respectively. The two most commonly reported presenting concerns were problems in interpersonal relationships and academics, and females were more likely to report academic concerns than males. The majority of participants reported seeking help for a wide range of problems commonly faced by EAs (83.7%), and participants rarely expressed concerns about particular symptoms of mood and/or anxiety disorders (16.3%). EAs and those supporting EAs may benefit from learning when psychosocial concerns are indicative of mental health challenges warranting professional attention.
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Affiliation(s)
- Justin Arcaro
- a Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, and London Health Sciences Centre , London , Canada
| | - Carolyn Summerhurst
- a Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, and London Health Sciences Centre , London , Canada
| | - Evelyn Vingilis
- b Department of Family Medicine, Schulich School of Medicine and Dentistry, The Western Centre for Public Health and Family Medicine, University of Western Ontario , London , Canada
| | - Michael Wammes
- a Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, and London Health Sciences Centre , London , Canada
| | - Elizabeth Osuch
- a Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, and London Health Sciences Centre , London , Canada
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LeCloux M, Maramaldi P, Thomas K, Wharff E. Health Care Resources and Mental Health Service Use Among Suicidal Adolescents. J Behav Health Serv Res 2016; 44:195-212. [PMID: 27146895 DOI: 10.1007/s11414-016-9509-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Developing policies and interventions that increase rates of mental health service use for suicidal adolescents is crucial for suicide prevention. Data from a sample of suicidal youth (n = 1356) from the National Longitudinal Study of Adolescent Health (Add Health) were analyzed to examine whether type of insurance, receipt of routine medical care, and access to school-based mental health treatment predicted mental health service use cross-sectionally and longitudinally. Rates of mental health service use were low in cross-sectional analyses at all three waves (∼11%-30%), despite the fact that respondents were at high risk for suicide attempts and depression. With demographic factors and symptom severity controlled, only receipt of a routine physical predicted an increased likelihood of mental health service use at wave I and in longitudinal analyses. Implications discussed include the utility of universal suicide screenings and integrated behavioral health care as potential intervention strategies for this population.
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Affiliation(s)
- Mary LeCloux
- School of Social Work, West Virginia University, Morgantown, WV, USA.
| | - Peter Maramaldi
- School of Social Work, Simmons College, Boston, MA, USA.,Harvard School of Dental Medicine, Harvard University, Boston, MA, USA.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kristie Thomas
- School of Social Work, Simmons College, Boston, MA, USA.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Elizabeth Wharff
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Han KM, Won E, Paik JW, Lee MS, Lee HW, Ham BJ. Mental health service use in adults with suicidal ideation within a nationally representative sample of the Korean population. J Affect Disord 2016; 193:339-47. [PMID: 26796234 DOI: 10.1016/j.jad.2016.01.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/30/2015] [Accepted: 01/08/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Use of mental health services (MHS) by people with suicidal ideation is critical in prevention of suicide, and identification of the factors that influence MHS use may assist in providing efficient interventions and treatments for suicidal individuals. Thus, we investigated the association between socioeconomic factors and use of MHS in people with suicidal ideation. METHOD We analyzed the data of the Fifth Korea National Health and Nutrition Examination Survey 2010-2012, a nationally representative cross-sectional study of the Korean population. Among the 24,173 people from the national health survey, we investigated the socioeconomic, clinical, and health-related characteristics of 2616 participants aged 19 years and older with suicidal ideation within the previous year. RESULTS In the logistic regression analyses, after adjusting for potentially confounding factors, the odds ratio (OR) for nonuse of MHS was significant in the subjects aged 65 years or older (OR=4.90), aged 50-64 years (OR=2.11), with 10-12 years of education (OR=1.87), widowed (OR=2.75), with economic activity (OR=1.60), with an employment status of paid employee (OR=1.97), without depressive mood (OR=2.73), having not attempted suicide (OR=4.04), and with no reported problems in their usual activities (OR=2.17). LIMITATIONS We did not use standardized assessment tools to evaluate suicidal ideation and depressive mood. CONCLUSIONS We observed a significant influence of several socioeconomic factors, depressive mood, and suicide attempts on the MHS use of adults with suicidal ideation, based on a nationally representative sample of the Korean population.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eunsoo Won
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jong-Woo Paik
- Department of Neuropsychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Min-Soo Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hae-Woo Lee
- Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea.
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea; Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea.
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14
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Khan A, Hamdan AR, Ahmad R, Mustaffa MS, Mahalle S. Problem-Solving Coping and Social Support as Mediators of Academic Stress and Suicidal Ideation Among Malaysian and Indian Adolescents. Community Ment Health J 2016; 52:245-50. [PMID: 26499062 DOI: 10.1007/s10597-015-9937-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 09/02/2015] [Indexed: 10/22/2022]
Abstract
This study examined whether productive coping styles and social support were significant mediators of the relationship between academic stress and suicidal ideation. The survey was performed on a sample of 300 Malaysian and 300 Indian college students. The participants completed psychological assessments of productive coping styles, social support, academic stress, and suicidal ideation. Significant cultural and demographic differences emerged. Indian students reported higher suicidal ideation and academic stress than did Malaysian students, and Malaysian students received more social support and had better problem-solving coping styles than did Indian students. Overall, students who were male, non-religious, and from low-income families reported more academic stress and more suicidal ideation. Productive coping styles and overall social support strongly affected the relationship between academic stress and suicidal ideation among both countries' participants.
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Hom MA, Stanley IH, Joiner TE. Evaluating factors and interventions that influence help-seeking and mental health service utilization among suicidal individuals: A review of the literature. Clin Psychol Rev 2015; 40:28-39. [DOI: 10.1016/j.cpr.2015.05.006] [Citation(s) in RCA: 213] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 05/17/2015] [Accepted: 05/20/2015] [Indexed: 01/17/2023]
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Meyer IH, Teylan M, Schwartz S. The role of help-seeking in preventing suicide attempts among lesbians, gay men, and bisexuals. Suicide Life Threat Behav 2015; 45:25-36. [PMID: 24825437 PMCID: PMC4871112 DOI: 10.1111/sltb.12104] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/12/2014] [Indexed: 11/26/2022]
Abstract
One possible approach to prevention of suicide attempts is to encourage help-seeking among individuals at risk. We assessed whether different forms of treatment were associated with lower odds of a suicide attempt in a diverse group of 388 lesbian, gay, and bisexual (LGB) adults aged 18-59, sampled from New York City venues. Of individuals who attempted suicide, 23% sought mental health or medical treatment and 14% sought religious or spiritual treatment prior to the suicide attempt. Black and Latino LGBs were underrepresented in mental health or medical treatment and Black LGBs were overrepresented in religious or spiritual treatment. Seeking mental health or medical treatment was not associated with lower odds of a suicide attempt; seeking religious or spiritual treatment was associated with higher odds of a suicide attempt. We discuss these results and posit hypotheses for further research of this understudied topic.
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Affiliation(s)
- Ilan H Meyer
- The Williams Institute, School of Law, UCLA, Los Angeles, CA, USA
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Islam F, Khanlou N, Tamim H. South Asian populations in Canada: migration and mental health. BMC Psychiatry 2014; 14:154. [PMID: 24884792 PMCID: PMC4052282 DOI: 10.1186/1471-244x-14-154] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 05/14/2014] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND South Asian populations are the largest visible minority group in Canada; however, there is very little information on the mental health of these populations. The objective of this study was to determine the prevalence rates and characteristics of mental health outcomes for South Asian first-generation immigrant and second-generation Canadian-born populations. METHODS The Canadian Community Health Survey (CCHS) 2011 was used to calculate the estimated prevalence rates of the following mental health outcomes: mood disorders, anxiety disorders, fair-poor self-perceived mental health status, and extremely stressful life stress. The characteristics associated with these four mental health outcomes were determined through multivariate logistic regression analysis of merged CCHS 2007-2011 data. RESULTS South Asian Canadian-born (3.5%, 95% CI 3.4-3.6%) and South Asian immigrant populations (3.5%, 95% CI 3.5-3.5%) did not vary significantly in estimated prevalence rates of mood disorders. However, South Asian immigrants experienced higher estimated prevalence rates of diagnosed anxiety disorders (3.4%, 95% CI 3.4-3.5 vs. 1.1%, 95% CI 1.1-1.1%) and self-reported extremely stressful life stress (2.6%, 95% CI 2.6-2.7% vs. 2.4%, 95% CI 2.3-2.4%) compared to their Canadian-born counterparts. Lastly, South Asian Canadian-born populations had a higher estimated prevalence rate of poor-fair self-perceived mental health status (4.4%, 95% CI 4.3-4.5%) compared to their immigrant counterparts (3.4%, 95% CI 3.3-3.4%). Different profiles of mental health determinants emerged for South Asian Canadian-born and immigrant populations. Female gender, having no children under the age of 12 in the household, food insecurity, poor-fair self-rated health status, being a current smoker, immigrating to Canada before adulthood, and taking the CCHS survey in either English or French was associated with greater risk of negative mental health outcomes for South Asian immigrant populations, while not being currently employed, having a regular medical doctor, and inactive physical activity level were associated with greater risk for South Asian Canadian-born populations. CONCLUSIONS Mental health outreach programs need to be cognizant of the differences in prevalence rates and characteristics of mental health outcomes for South Asian immigrant and Canadian-born populations to better tailor mental health services to be responsive to the unique mental health needs of South Asian populations in Canada.
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Affiliation(s)
- Farah Islam
- School of Kinesiology and Health Science, York University, 357 Bethune College mailroom, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Nazilla Khanlou
- School of Nursing, York University, Toronto, ON M3J 1P3, Canada
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, 357 Bethune College mailroom, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
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Gagné S, Vasiliadis HM, Préville M. Gender differences in general and specialty outpatient mental health service use for depression. BMC Psychiatry 2014; 14:135. [PMID: 24884891 PMCID: PMC4028012 DOI: 10.1186/1471-244x-14-135] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/02/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND This study ascertained gender-specific determinants of outpatient mental health (MH) service use for depression to highlight any gender disparities in barriers to care and explain how depressed men and women in need of care might differ in their help-seeking behaviour. METHODS Data used in this study came from the Canadian Community Health Survey on Mental Health and Well Being, cycle 1.2 (CCHS 1.2) conducted by Statistics Canada in 2002 (N = 36,984). The sample was limited to respondents filling criteria for a probable major depression in the 12 months prior to the interview (n = 1743). Gender-specific multivariate logistic regression analyses were carried out. RESULTS The results showed that 54.3% of respondents meeting criteria for major depression had consulted for mental health reasons in the year prior to interview. When looking at type of outpatient mental health service use, males were more likely to consult a general practitioner and a mental health specialist in the past year as opposed to females. However, females were more likely to consult a general practitioner only as opposed to no service use than males. Gender specific differences in determinants associated with outpatient service use included for males, lower adjusted household income, and for females, a younger age, the presence of social support, self-reported availability barriers, the presence of self-reported suicidal thoughts or attempt and a poorer self- perceived mental health. CONCLUSIONS Continued efforts to promote access to mental health care are needed for men and women affected by depression, and this, to target specific vulnerable populations and increase utilization rates.
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Affiliation(s)
- Sarah Gagné
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbooke, Canada.
| | - Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbooke, Canada,Charles Lemoyne Research Centre, 150, place Charles-LeMoyne, Bureau 200, Longueuil, (Québec) J4K 0A8, Canada
| | - Michel Préville
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbooke, Canada,Charles Lemoyne Research Centre, 150, place Charles-LeMoyne, Bureau 200, Longueuil, (Québec) J4K 0A8, Canada
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Breland DJ, McCarty CA, Zhou C, McCauley E, Rockhill C, Katon W, Richardson LP. Determinants of mental health service use among depressed adolescents. Gen Hosp Psychiatry 2014; 36:296-301. [PMID: 24417955 PMCID: PMC4517666 DOI: 10.1016/j.genhosppsych.2013.12.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 11/29/2013] [Accepted: 12/03/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Evaluate determinants of mental health service use among depressed adolescents. METHOD We assessed mental health services use over the 12 months following screening among 113 adolescents (34 males, 79 females) from an integrated healthcare system who screened positive for depression (Patient Health Questionnaire-9 score ≥11). Youth characteristics (demographics, depression severity, and co-morbidity) and parent characteristics (parent history of depression, parent-report of youth externalizing and internalizing problems) were compared among youth who had received mental health services and those who had not. Multivariate regression was used to evaluate the strongest factors associated with mental health service use. RESULTS Overall, 52% of adolescents who screened positive for depression received mental health service in the year following screening. Higher parent-reported youth internalizing problems (OR 5.37, CI 1.77-16.35), parental history of depression/anxiety (OR 4.12, CI 1.36-12.48) were significant factors associated with mental health service use. Suicidality and functional impairment were not associated with increased mental health services use. CONCLUSION Parental factors including recognition of the adolescent's internalizing symptoms and parental experience with depression/anxiety are strongly associated with mental health service use for depressed adolescents. This highlights the importance of educating parents about depression and developing systems to actively screen and engage youth in treatment for depression.
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Affiliation(s)
- David J. Breland
- Department of Pediatrics, University of Washington School of Medicine,Seattle Children’s Hospital
| | - Carolyn A. McCarty
- Department of Pediatrics, University of Washington School of Medicine,Seattle Children’s Hospital
| | - Chuan Zhou
- Department of Pediatrics, University of Washington School of Medicine,Seattle Children’s Hospital
| | - Elizabeth McCauley
- Seattle Children’s Hospital,Psychiatry and Behavioral Medicine, University of Washington School of Medicine
| | - Carol Rockhill
- Seattle Children’s Hospital,Psychiatry and Behavioral Medicine, University of Washington School of Medicine
| | - Wayne Katon
- Department of Psychiatry & Behavioral Sciences; UW School of Medicine
| | - Laura P. Richardson
- Department of Pediatrics, University of Washington School of Medicine,Seattle Children’s Hospital
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Chartrand H, Robinson J, Bolton JM. A longitudinal population-based study exploring treatment utilization and suicidal ideation and behavior in major depressive disorder. J Affect Disord 2012; 141:237-45. [PMID: 22703701 DOI: 10.1016/j.jad.2012.03.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 03/12/2012] [Accepted: 03/19/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND This study aimed to longitudinally examine the relationship between treatment utilization and suicidal behavior among people with major depressive disorder in a nationally representative sample. METHODS Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (Wave 1: N=43,093; Wave 2: N=34,653). Suicidal and non-suicidal individuals at Wave 1 were compared based on subsequent treatment utilization. Suicidal behavior at Wave 2 was compared between people with major depressive disorder who had sought treatment at Wave 1 versus those that had not. RESULTS Individuals with past year major depressive disorder at Wave 1 who attempted suicide were more likely to be hospitalized at follow up compared to non-suicidal people with major depressive disorder [adjusted odds ratio (AOR)=4.46; 95% confidence interval [95% CI]: 2.54-7.85]; however, they were not more likely to seek other forms of treatment. Among those with past year major depressive disorder who sought treatment at baseline, visiting an emergency room (AOR=3.08; 95% CI: 1.61-5.89) and being hospitalized (AOR=2.41; 95% CI: 1.13-5.14), was associated with an increased likelihood of attempting suicide within 3 years even after adjusting for mental disorder comorbidity, depression severity, and previous suicidal behavior. LIMITATIONS Unable to draw conclusions about completed suicide or adequacy of treatment. CONCLUSIONS Suicidal behavior does not lead individuals with major depressive disorder to seek treatment with professionals or use antidepressant medications; instead, they are more likely to use emergency services. These findings suggest that treatment efforts for people with major depressive disorder who are suicidal need improvement.
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Affiliation(s)
- Hayley Chartrand
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
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Husky MM, Olfson M, He JP, Nock MK, Swanson SA, Merikangas KR. Twelve-month suicidal symptoms and use of services among adolescents: results from the National Comorbidity Survey. Psychiatr Serv 2012; 63:989-96. [PMID: 22910768 PMCID: PMC5100004 DOI: 10.1176/appi.ps.201200058] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study assessed the prevalence of suicidal ideation, suicide plans, and suicide attempts as well as patterns of mental health service use among adolescents. METHODS Data came from the National Comorbidity Survey–Adolescent Supplement, a nationally representative sample of 10,123 adolescents aged 13 to 18 years who participated in computer-assisted, face-to-face interviews between February 2001 and January 2004. Prevalences of suicidal thoughts and behaviors in the past year were determined. Past-year use of any mental health treatment and receipt of four or more visits from one provider among youths with suicidal ideation, plans, or attempts were also assessed. Associations were evaluated by using logistic regression. RESULTS During the course of 12 months, 3.6% of adolescents reported suicidal ideation without a plan or attempt, .6% reported a suicide plan without an attempt, and 1.9% made a suicide attempt. Overall, two-thirds of adolescents with suicidal ideation (67.3%) and half of those with a plan (54.4%) or attempt (56.9%) did not have any contact with a mental health specialist in the past year. Different predictors of use of care were identified for each group. CONCLUSIONS Adolescent suicidality often is untreated in the United States. Increased outreach efforts to improve treatment access for youths with suicidal ideation and attempts are needed.
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Affiliation(s)
- Mathilde M Husky
- Department of Psychology, Aquitaine Institute for Cognitive and Integrative Neuroscience, University of Bordeaux, Place de la Victoire, Bordeaux, France.
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Mental health screening of African American adolescents and facilitated access to care. Community Ment Health J 2012; 48:71-8. [PMID: 21559920 DOI: 10.1007/s10597-011-9413-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 04/25/2011] [Indexed: 10/18/2022]
Abstract
This study retrospectively reviews de-identified records from school-based mental health screening in a predominantly African American community. We compare participation rates, screening results, referrals to services and access to care of white and African American adolescents. Among those offered screening, 20.1% of white students (n = 297), and 28.8% of African American students (n = 499) were screened (χ(2) = 32.47, df = 1, P < .001). African American students (45.1%) were significantly more likely than white students (33.0%), (AOR = 1.59; P = .003) to be identified as being at risk. In both racial groups, most youth accessed the school-based services (89.02%, 95% CI 82.25-95.79) and community services (86.57%, 95% CI 78.41-94.73) to which they were referred. The groups did not differ in the odds of accessing community-based services (AOR = .58; P = .49). African American students were, however, more likely than white students to access school-based services (AOR = 10.08; P = .022). The findings support the effectiveness of screening in school settings in predominantly African American communities.
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Husky MM, Sheridan M, McGuire L, Olfson M. Mental health screening and follow-up care in public high schools. J Am Acad Child Adolesc Psychiatry 2011; 50:881-91. [PMID: 21871370 DOI: 10.1016/j.jaac.2011.05.013] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 05/25/2011] [Accepted: 05/26/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Despite increased interest in screening adolescents for mental health problems and suicide risk, little is known regarding the extent to which youth are identified and connected with appropriate services. METHOD Between 2005 and 2009, a total of 4,509 ninth-grade students were offered screening. We reviewed the records of the 2,488 students who were screened. Students identified as being at risk were provided with a referral. Data were collected on screening results, mental health referrals, and completion of recommended treatment over approximately 90 days. RESULTS Among students screened, 19.6% were identified as being at risk, 73.6% of whom were not currently receiving any treatment. Students referred for school services tended to be less severely ill than those referred for community services, with lower rates of suicidal ideation, prior suicide attempts, and self-injury. Among at-risk students not currently in treatment, 76.3% of students referred received at least one mental health visit during the follow-up period. Overall, 74.0% of students were referred to school and 57.3% to community services. A great majority of school referrals (80.2%) successfully accessed services, although a smaller proportion of community services referrals successfully accessed treatment (41.9%). CONCLUSIONS Systematic voluntary school-based mental health screening and referral offers a feasible means of identifying and connecting high-risk adolescents to school- and community-based mental health services, although linkages to community-based services may require considerable coordination.
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Affiliation(s)
- Mathilde M Husky
- New York State Psychiatric Institute, Columbia University, New York, NY 10019, USA.
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